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An ICU Nurse's View Of Crisis Standards Of Care In Idaho

St. Luke's Meridian Medical Center
Gustavo Sagrero
Boise State Public Radio
St. Luke's Meridian Medical Center

Editor's Note: A few weeks ago, Ashley Brown, a nurse at St. Luke's, recorded her thoughts for Boise State Public Radio after some hospital shifts. Now, we're checking in with her again after crisis standards of care was declared statewide.

We highly recommend listening to the audio version of this story. Press the play button above to listen.

Last Thursday, Ashley Brown reported for work at the St. Luke's Meridian ICU where she works as a nurse.

The hospital had just opened up a new floor with overflow beds. ICU-level care was happening outside of the ICU. And some adults were in the pediatric unit.

That same morning the Idaho Department of Health and Welfare announced it was expanding crisis standards of care statewide.

"I'm exhausted. I feel scared. I feel sad."

St. Luke’s, the largest health system in the state, requested the state activate those guidelines. They mean hospitals can ration health care if necessary to save as many lives as possible.

“I have gotten to the point where I’m beyond tears. I’m just angry," Brown said last Thursday.

A couple days later, she recorded a few more minutes on being a nurse at a hospital right now. In St. Luke's intensive care units, 98% of patients are unvaccinated.

It was about a 15-hour day for me. It was really hard on the floor today. We're completely full of COVID patients and I would say the majority of them are probably dying. It's becoming evident that we are at a point where we don't have enough ICU beds anymore. We're arguing over which patient should come to the ICU next. The moment a bed is free because someone has passed away, we're getting them down to the morgue and turning over the room and getting up a new patient just to re-intubate them.

They're talking about starting to have us take three ICU patients. Normally we would take one really severely ill person, or maybe two. And even last night, there were two nurses that had to take three ICU patients.

The two [patients] that I had today, one of them made some progress this morning and this afternoon, I turned him. His oxygen levels went down and he was fighting against the breathing machine, and I couldn't get him back to where he was before I turned him. It just speaks to how fragile these people are because you just turn them on their side, and that's enough to cause them major problems with their respiratory status. So we went back a few steps and we had to re-paralyze him to get him to breathe easier with the vent. It was devastating. His significant other was at the bedside and she stepped out for like 30 minutes, and that's all it took for something major to change. He's young and he has a daughter.

I think a lot of us are scared. Because when you put this amount of critically ill patients that can just go down just because you turned them, you get nervous about if you could make a mistake. And how safe is it to have all of these really critically ill people paired up with one nurse? I'm exhausted. I feel scared. I feel sad. Because I can't — I can't fix what's happening.

If you or someone you know is struggling with mental health, there is help. Call 208-398-4357 to talk with a trained professional at the Idaho Suicide Prevention Hotline. You don't have to be suicidal to call.

I cover environmental issues, outdoor recreation and local news for Boise State Public Radio. Beyond reporting, I contribute to the station’s digital strategy efforts and enjoy thinking about how our work can best reach and serve our audience. The best part of my job is that I get to learn something new almost every day.

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