Tyler ER Doctor says healthcare system is being overwhelmed and needs the state's help

Dr. Brad Robertson, a board-certified emergency room physician, works for Tyler Complete Care in Tyler and said his facility is having an extremely hard time getting patients transferred into a hospital. He hopes legislators address funding or COVID-19 relief to help frontline workers to bring in extra staff. 

As Texas faces yet another surge in COVID-19, a local Emergency Room doctor is asking for the state’s financial help to address the dangerous staffing shortage, affecting Texas hospital capacity.

Dr. Brad Robertson, a board-certified emergency room physician, said the healthcare system is being overwhelmed and frontline workers need help.

Robertson works for Tyler Complete Care in Tyler and said his facility is having an extremely hard time getting patients transferred into a hospital.

The facility prides itself on providing faster and quality of care, while also being a resource to hopefully help offload volumes hospitals are seeing during the crisis situation. Unfortunately within the past weeks, Robertson said there has been an unexpected turning point.

As a result, healthcare workers at Tyler Complete Care are being forced to hold patients for days before they can be sent to hospitals to get the proper medical attention they need that the emergency room doesn’t offer, for example a surgery for appendicitis.

“At our facility, the wait times we’ve seen are pretty consistently under 20 or 30 minutes, occasionally at full capacity, it can be up to an hour, but it’s rarely over that,” said Robertson about wait times prior to COVID-19 spikes.

“When we’ve seen a patient that’s admitted, it’s hard to put an exact number or average, but we’ve had patients that have stayed over 24 hours waiting on a hospital bed, and I know there’s admitted patients at the hospital that can spend longer than that, in technically, an emergency room bed, that’s admitted into the hospital,” he said.

With stories like this happening statewide, Robertson said legislators should advocate for funding and resources for frontline workers as they’re experiencing staffing shortages at such an unexpected time.

“I’m not a legislator or a hospital administrator, and these guys, they’re a lot of smart people working on this problem that might have specific answers, but in general, any funding, any relief we can give to the frontline workers, whether that’s bringing in extra staff, nurses, etc, to take care of this load of patients during this pandemic, I think, should be in high priority,” said Robertson.

“Most things start with funding, and if they can get funding for that, I’m sure they can find very good use for it,” he said.

The staffing shortage is affecting hospital capacity across the state, putting anyone with an emergency at risk.

The Southeast Trauma Regional Advisory Council are the administrative bodies responsible for trauma system oversight within the bounds of a given Trauma Service Area in Texas. Each of the 22 RACs is tasked with developing, implementing, and monitoring a regional emergency medical service trauma system plan. Generally, RAC stakeholders are healthcare entities and other concerned citizens with an interest in improving and organizing trauma care. The council reported Thursday that nearly 590 patients had orders waiting for a general bed opening and another 70 patients waiting for ICU bed opening. 

Healthcare leaders like Dr. Robertson see this shortage as a critical priority that needs immediate attention from lawmakers.

Robertson said that with the unexpected, recent COVID-19 spike in cases, the general volumes of patients per day have greatly escalated.

“All of that trickles down into longer wait times, facilities are busier, getting to see the doctors, it’s a little busier, it kind of affects everything,” he said.

For example if someone suffers a stroke and needs emergency care, Robertson said there have been times hospitals are turning ambulances away because they’re overwhelmed. He said that when hospitals work together, patients could end up going to a different hospital they initially thought they were going to.

“And that hospital is going to be busy and probably close to overwhelmed as well. They’re seeing patients in the hallways of the emergency room, in the waiting room, just doing the best they can with the situation at hand,” Robertson said.

The number of patient volumes are overwhelming the system, along with how sick each patient is, is also elevated as well.

“Not only is there a large volume of patients, a high percentage of those are very ill and need to be hospitalized, and that combination alone, just kind of overwhelms your physical space and your staffing with nurses, and primarily, it’s driven by covid right now,” Robertson said.

As far as what the community can do to help frontline workers who may be experiencing overwhelming times, Robertson said get vaccinated.

“The overwhelming majority of hospitalized patients with COVID are unvaccinated, so if we can get the vaccination rate up, we would lower the hospitalization rate and that would free up resources that’s stopping the care of other medical needs besides COVID,” Robertson said.

White House Data Director Dr. Cyrus Shahpar said Friday half of the U.S. population is fully vaccinated against COVID-19.

As of Thursday in Smith County, 46.19% of people 12 and older have received at least one dose of the COVID-19 vaccine, while 39.79% of people 12 and older have been fully vaccinated, according to the Texas Department of State Health Services.

DSHS data states 78.35% of people aged 65 and older have been vaccinated with at least one dose, while 71.77% of that population have been fully vaccinated.

Robertson said most people seeking medical attention at the freestanding emergency room are seeing a combination of people having COVID-19 symptoms, along with normal emergency room patients who need to be hospitalized with medical or surgical problems.

“We’re just kind of pushing our system closer to the edge,” he said.

“It’s certainly stressful on all levels,” Robertson said.

“It’s our passion and our job to take care of patients, so in the throes of battle, it’s not an overwhelming feeling, you’re just trying to do the best for the patient and work with our colleagues at the hospital who have been amazing and helping in every way they can. I just recognize the stress levels that it puts on every staff member, whether you’re the front desk receptionist or the neurosurgeon, at all levels, it’s stressful not to be able to handle and take care of patients in the best way that we’ve been trained and know how to,” he said.

Robertson said he encourages people with emergencies to seek emergency care and not to stay home.

“If you have an emergency, you do need to be seen and you will get seen and get taken care of. We don’t want to see people staying home with problems for fear of COVID or long waits, that end up becoming a bigger problem by not seeking care,” Robertson said.

“It’s going to get better, both legislatively and medically, and hopefully the vaccination rates will pick up and help, but we will get through this with everybody working as hard as they are now, we will definitely get through this.”

As of Friday, a spokesperson for UT Health said hospitalizations are increasing. The hospital is seeing 143 COVID-19 patients hospitalized across the division, of all ages and that patients are trending younger, the vast majority being unvaccinated.

"Hospitals across Texas, and in much of the country, are continuing to see sharp increases in COVID-19 and non-COVID patients, which is putting extreme pressure on all providers," a spokesperson from UT Health said.

"Additionally, a national shortage of nurses has resulted in fewer staffed beds across the country and has therefore made it more difficult to place patients in higher tertiary level care facilities."

"It is important to note that the overwhelming majority of COVID-19 hospitalized patients are unvaccinated. We urge everyone who is eligible to get vaccinated. To make an vaccine appointment call 903-877-5152," read the statement. 

Christus Trinity Mother Frances does not share data on hospitalized patients receiving care. 

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