North Bay hospitals gear up for a possible wave of coronavirus infections

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E ven though the number of hospitalizations from the new coronavirus has started to stabilize in the North Bay area, hospitals are in “surge preparation” mode in the face of an unpredictable global pandemic.

The prep work involves ensuring enough beds, equipment, ventilators, adequate personal protective equipment, and even information technology infrastructure for additional sites within a hospital that can be converted to an intensive care unit.

Hospitals in the North Bay area are also among those fortifying their teams by cross-training nurses who normally work in units outside of critical care, teaching them to become proficient in supporting ICU nurses on the front lines treating patients with COVID-19.

Eager to help

So far, 71 nurses employed at Sutter Santa Rosa Regional Hospital have been cross-trained to work in a critical care environment, according to hospital spokeswoman Ashley Boarman. Of the 71 registered nurses, 47 are now trained to work on the medical-surgical floors; 14 for the emergency department, and 10 for the ICU.

One of those nurses is Pamela Reed, director of nursing/clinical director at Sutter Health’s Santa Rosa Surgery and Endoscopy Center, located directly across the street from the hospital.

“I became interested in wanting to help as I started hearing about COVID,” said Reed, who, before moving into a hospital leadership role, worked in clinical care for many years, including 10 years as a critical care nurse. “I have a daughter who lives in Brooklyn, and I was hearing about the surge that was happening there and the shortage of nursing staff. I was really motivated to help in more of a direct way.”

Reed traveled to Sutter Health’s Sacramento headquarters to attend a 3-day program at Sutter Health University, the educational component of the health care system for clinical staff.

Reed said the course was valuable, not only to refresh her critical-care nursing expertise, but also because a large part of the education was tailored specifically to patients who require respiratory support, including the need for possible intubation and ventilator management.

“Many of these patients have cardiovascular or multisystem organ failure as their disease progresses and they’re critically ill with COVID,” Reed said, “so (the education also) focused on those treatment protocols that you would need to support a COVID patient.”

Reed also noted the importance of the cross-training in another scenario.

“In outpatient surgery, we do elective cases on healthy patients, so in a surge pandemic, our center would be repurposed as an extension of the hospital, and we would need to learn new skills to be able to care for patients that were hospitalized,” she said. “(Sutter) realizes that they have this tremendous resource in their staff in that most of us have done hospital work previous to our (current) career, but we may just need a refresher course.”

Ready to jump in

As an operating room nurse at Sutter Santa Rosa Regional Hospital, Joey Benton takes care of patients for a short period of time, getting them safely through surgery. Now she is trained to assist ICU nurses who need to stay with COVID-19 patients in isolation.

There are a number of ways Benton could help, such as retrieving pain medication for an ICU nurse to give to a COVID-19 patient in isolation, or caring for the nurse’s other patients who aren’t as acutely ill.

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Track cases in the North Bay, across California, the United States and around the world here.

Benton didn’t cross-train at Sutter Health University. Rather, she took online courses through Sutter and trained one-on-one with nurses she may be supporting.

“It was a very comfortable learning experience because of the staff and by training on the (medical-surgical) floors well in advance of any emergency panic situation,” Benton said. “If something does happen down the road, we’re going to be prepared because we have the time and opportunity to learn and be the best support staff possible.”

Guiding the team

From a hospital leadership standpoint, CEO Dan Peterson stressed the importance of ensuring the entire Sutter Santa Rosa Regional Hospital staff are prepared for a surge of COVID-19 patients.

“Our nonpatient care staff have received a lot of basic training around how to keep themselves safe and how to perform their work safely within the hospital,” Peterson said. “From our housekeeping staff to our dietary aides to our imaging technologists, they’ve all received a lot of training.”

In addition, the hospital’s ICU nurses received intensive training on how to care for COVID-19 patients and knowing the appropriate PPE, he said, noting that as guidance from the Centers for Disease Control and Prevention and other agencies have changed, “it’s been a constant process of reeducating the staff on what these new protocols are.”

Peterson declined to say how many COVID-19 patients have been, or currently are, admitted to Sutter Santa Rosa Regional Hospital. However, according to a March 20 report from the Press Democrat, the hospital confirmed that a Sonoma County resident died that day after contracting the novel coronavirus.

Peterson remains focused on long-term preparation to battle the highly contagious virus that researchers say could be prevalent for two years. Another component of that preparation involves PPE requirements for all staff.

“It is a very rigorous process and really does take a lot of work and a lot of attention to make sure we’re doing everything right,” he said.

Ready to go again

As executive director of nursing at MarinHealth Medical Center in San Rafael, Andrew Apolinarski oversees a staff of 750 people, primarily nurses, but also certified nursing assistants, respiratory therapists, and equipment and patient care technicians.

The hospital’s clinicians have already treated four COVID-19 patients, and had about 17 “people under investigation”— those who have met the criteria for possibly having the novel coronavirus.

“We cross-trained several (post-anesthesia care unit) R.N.s, as they had a similar skill set and required limited training, (so) this allowed us to have staff ready to take ICU patients in a minimal amount of time,” Apolinarski said. They also supplemented with traveling nurses who were prepared to take ICU patients.

As of May 6, there has been a total of 247 COVID-19 cases in Marin County. Of that number, 196 people recovered; 46 people were hospitalized; and 14 people died, according to Marin County’s Health and Human Services Department. The county also reported that 6,128 people have been tested for the novel coronavirus.

The hospital continues to monitor the spread and will train more health care workers if needed, Apolinarski said.

Robust training also has taken place in preparing staff how to care for COVID-19 patients.

“(Our) infection prevention team has trained multiple hospital personnel and physicians on proper PPE use, trained on proper swabbing techniques, specimen handling (and more),” Apolinarski said. “We fit-tested numerous staff for N-95 (masks), and made several other preparations to adjust processes and clinical practice, such as intubation protocol, to accept (the COVID-19) patient population.”

No fear

Amanda Harms, a postpartum nurse at Kaiser Permanente Medical Center in Santa Rosa, has volunteered to care for patients in her unit who are awaiting test results after showing symptoms for the novel coronavirus. In her everyday role, she is responsible for caring for women right after giving birth, as well as their babies to make sure they’re thriving.

“We serve a very specific patient population, so we didn’t know what to expect (with the novel coronavirus),” she said.

After the postpartum unit had its first patient that needed to be ruled out, Harms wasn’t scared of the situation. She also had a coworker who was a new mom, and another who was pregnant, so she wanted to keep them at a distance.

“I felt like if we have (COVID-19) patients, it would be best if the minimal amount of people were exposed,” Harms said.

So far, the patients that have required testing came back negative. A patient who tests positive would be transferred out of the postpartum unit. But that doesn’t change the fact that Harms could potentially be exposed to COVID-19.

“For whatever reason, it’s not something that has struck great fear in me,” she said. “Being a nurse, we’re aware of what best precautions are, and we are able to protect ourselves by using those best practices.”

Staff Writer Cheryl Sarfaty covers tourism, hospitality, health care and education. Reach her at or 707-521-4259.

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