Listen: Bryan Health's chief medical officer says Nebraska hospitals still seeing high number of patients

Sept. 6, 2022, noon ·

A respiratory therapist in a blue gown stands beside the bed of a patient in a hospital room with other medical equipment nearby.
A respiratory therapist cares for a patient inside the sixth floor COVID-19 unit at Bryan East Campus in Lincoln. (Photo courtesy of Bryan Health)

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There are less COVID-19 patients in Nebraska hospitals, but staffing remains a challenge. Nebraska Public Media's Jackie Ourada spoke to Bryan Health's chief medical officer, Dr. John Trapp, about lingering issues hurting one of the state's biggest medical providers.

Dr. John Trapp: The hospital has been busy. From a patient perspective, we've had a full house. We continue to have patients at times boarding and our emergency room. At times, we've had patients awaiting transfer to Bryan. As far as COVID patients, we've had in the range of 20 to 25 patients. We've not seen high utilization of our critical care services with COVID patients. So whereas, in the past, particularly with the Delta variant, [we had] high utilization of critical care services — many patients in the ICU, many patients with respiratory failure. Now, we're seeing much lower numbers. So for us, COVID has become kind of running water, if you will. And we're not seeing COVID have as tremendous of an impact on our hospitalized patients.

Jackie Ourada: How would you say your nurses and doctors are doing? I'm surprised to hear you're still seeing higher number of patients, even though they aren't all COVID patients. How is morale going while still dealing with what sounds like still a lot of stress.

Trapp: Where the stress lies is in that staffing — continuing to have high volumes of the hospital. [We] continue to say, 'How do we how do we manage these patients in the emergency department?' We continue to use triage beds in hallways, which is challenging as we continue to see record numbers of patients utilize the emergency room. Those patients that require admission, then need to wait in the emergency room until a bed becomes available. So those have been our primary challenges with regard to that. There continues to be a sense of fatigue — that there's been no break. It's not like we've all the sudden said, 'Ah, we're done with the pandemic, everybody go take a couple of weeks vacation.' That's not happened. The pandemic has transitioned to more normal care. That's been great. People love seeing the normal types of patients that we see in the hospital, [but] the workload remains high.

Dr. John Trapp
Bryan Health Chief Medical Officer Dr. John Trapp. (Photo courtesy of Bryan Health)

Ourada: I want to go back and touch more on the emergency department numbers. Can you speak to why you're still seeing such a high number of patients?

Trapp: Well, that's a great question to ask. We're seeing all kinds of different levels of illness that come to the emergency department. I don't know that I can give you a specific answer on why we're seeing more utilization of the emergency department and more people looking to access health care. [More people seeking health care] has been a part of it. We've exceeded volumes that we had last year by about 15%. This is probably delayed health care they didn't get during the pandemic. It may have to do with Medicaid expansion. More people have access to health care. It may be due to more people working from home who are now able to access health care when they need it and not take time off from work. Or some of the government programs that assist people with the health care costs.

Number of emergency department patients per year at Bryan Medical Center's two locations: Bryan East Campus and Bryan West Campus.

  • 2019 - 78,941 patients
  • 2020 - 69,033 patients
  • 2021 - 81,021 patients

Note: Bryan Health believes 2020 count is lower because of lockdowns and restrictions.

Ourada: What can we do to help? I mean, state senators are starting to look at legislation for the session that begins in January. Do you think there's anything legislatively we can do to provide more relief or even relaxing restrictions that could hinder staffing? What can we do for you?

Trapp: Anything that can be done to promote careers in healthcare. I think there's value in that. Right now, I don't think limitations are in licensing or what legislatively we can control. Dollars always help. But I don't know that the legislature is going to transfer more dollars to hospitals. Right now, hospitals are having a challenging time with regard to revenue. You would think that with high volumes, we would be doing better. But with some of the challenges of longer length of stay for a variety of illnesses, hospitals across the country aren't doing nearly as well as people might think.

Ourada: Maybe we don't even need to tie it to the legislature possibly Speaking more broadly. Are there ways to provide more help?

Trapp: Yeah, one thing that I've identified that really is a value is that we've seen more people from government legislation coming into the hospital to learn what we do. I think the more they learn how we function and how we operate, that's given enlightenment to how they can help us and actually, they may be able identify and legislative opportunities and how they can help us. I think that's provided probably the most support. They may actually see opportunities as they go about their daily work — how they can help health care, whether we deliver health care to our public, providing hospital support to provide that health care, and providing our workers opportunities to engage in the healthcare career.

Editor's note: This conversation has been edited for clarity and length.