'We can't keep people here': Rural hospitals struggle with limited access to ventilators

"We don't have ICU level care": Doctors in rural Nebraska say they don't have the infrastructure to treat critically in patients. Sometimes, they have to provide oxygen manually.


In small-town Nebraska, there's a crisis of care.

"We don't have ICU level care," said Dr. Katie Thelen, a physician in Holdrege — population about 5,500. "You end up sitting in a rural ER much much longer than you would have otherwise if there wasn't a pandemic."

She says her hospital is an anomaly: it has a handful of ventilators, but not enough specialized staff to operate them.

"The amount of time and energy it requires of our staff to have a ventilated patient is huge because we only have maybe a few doctors that are comfortable managing that, so that's one person around the clock getting all the phone calls for a ventilator patient," Thelen said.

Thelen added she has even gotten "surprising" patient transfer requests from other rural hospitals, hoping to use her hospital’s equipment.

"If it's gonna be anything long term, if it's gonna be more than a few people, they really need to be at a facility with a higher level of care and specialty care," Thelen said.

At Jefferson Community Health and Life in Fairbury, Nebraska, there are no in-house ventilators. They have just added their first portable ventilator to use in ambulances, during transfers.

"We can't keep people here that are ventilated," said Dr. Rebecca Stroklund. She said that's typical for a small critical access hospital. Patient stays are only supposed to last an average of three days, but now some visits are being extended.

"If there's no bed at a bigger hospital where people can get the help and speciality care they need, we just have to wait until one opens up," Strukland said.

So what do they do when a patient requires oxygen while waiting?

"You just bag by hand," Strukland explained, saying that method is inconsistent and can risk barotrauma on the lungs. A ventilator is preferable.

Thelen says patients with non-COVID-19 needs are suffering.

"What gets scary for us is that patient that's acutely sick with something else and because of COVID there is not a bed for them," said Thelen. She said she recently called eight hospitals in order to get a patient transferred.

Both doctors say the sickest COVID-19 patients they are treating are unvaccinated.