Rhode Island’s largest hospital system has suspended all “non-essential” surgical procedures to free up inpatient beds and staff as COVID-19 cases spike. 

Lifespan last week temporarily suspended outpatient and same-day surgeries – which can include operations for cancer, heart disease and other serious conditions – at Rhode Island Hospital. The Miriam and Newport hospitals suspended most non-essential surgical procedures effective Monday.

The move comes as the state’s hospitals face a mounting staffing crisis. Health reporter Lynn Arditi spoke with Dr. Jeremiah (“Jay”) Schuur, Lifespan’s chief of emergency medicine, about the situation on Tuesday. 

Lynn Arditi: Dr. Jay Schuur, we've been hearing about the staffing crisis and the hospitals and Rhode Island. Tell us what the staffing situation is like right now at Lifespan hospitals, specifically, Rhode Island Hospital, the Miriam and Hasbro Children's Hospital.

Dr. Schuur: The staffing is very challenging. We've had staffing challenges for the last several months. And this recent spread of COVID has exacerbated that, because the people who are working are getting COVID and calling out sick. So we are not offering as many elective or ambulatory surgeries so that we can preserve space for the patients who come into the emergency department and need to be admitted.

Lynn Arditi: Dr. Schuur, as you know, Rhode Island recently adopted the CDC’s guidance to allow COVID-positive health care workers to continue to work if hospitals are at crisis level of staffing. Do you anticipate allowing some COVID positive staff to work at any of the Lifespan hospitals and what do you think about that possibility?

Dr. Schuur: So I want to be clear, at this point Lifespan is not doing that at any of our hospitals. I think it all depends on what happens in the next couple of weeks. We will do everything we can to avoid doing that. The question would be, if we get to a point where, you know, so many staff get COVID that we can't provide critical services. That's not a decision that I would make. It's a decision that would be made at a system level, but we're not at that level right now.

Lynn Arditi: Of all the things that you can think of that the state could do to help relieve the strain on hospitals, what would be number one and number two priority for you?

Dr. Schuur: I think there are three things that would be most helpful. The first would be centralizing the distribution of ambulances. Almost all of the hospitals in the state this morning were at maximum capacity in their hospital and their emergency department. And so the historical system of just taking patients to the closest hospital, or even letting one hospital call off on diversion, doesn't work at this level of crowding. Other states such as Maryland have put together systems where ambulances call in, they explain what a patient has, and a central command center figures out which reasonably close hospital has the best capacity to care for that patient. That's something that the state could set up and it would help preserve capacity across the system. Second, I think there are some restrictions that the state could probably make temporary changes on around licensure issues for particular clinical staff, such that the staff that are actually in the hospitals could practice at the top of their skills where right now they may not be allowed to by license. So for example, LPNs, or paramedics who may work in a hospital may have clinical skills to do certain things that they're not allowed to do. And then third, anything that could bring additional staff into the hospital would be helpful. I know hospitals are doing everything they can to hire staff. But whether it's the National Guard or FEMA, you know, for this short period of time, while we're dealing with Omicron, it would be helpful.

Lynn Arditi: What are you anticipating for the next week or two or three here as we head into January?

Dr. Schuur: Things could get worse. And so my message to the public is, I think we all need to take a step back and for a couple of weeks, do everything we can to try to slow the spread. And that means getting vaccinated or boosted, if you're not yet. It means wearing a mask when you're in a closed space with people. And it means trying to avoid large spaces where people would be without masks.

Lynn Arditi: Does that include avoiding going to restaurants for example?

Dr. Schuur:  I'm not ready to make a blanket ban. I think it really depends on the situation. We do know that this spreads in areas where people are closely together with masks off. Personally, as a healthcare worker who doesn't want to have to call out and call one of my colleagues in, I'm personally avoiding eating in restaurants, but I have a different obligation than some other people do.

In a Twitter posting on Tuesday, Governor Dan McKee said that his team is working with hospital leaders to assist with staffing issues, including requested help from the Federal Emergency Management Agency (FEMA) and mobilizing the Rhode Island National Guard. McKee Tweeted that he had toured Rhode Island Hospital’s emergency department, met with frontline workers and he and his team is “finalizing operational plans for @RINationalGuard to provide support to hospitals…”

Correction: an earlier version of this story incorrectly reported the date of Rhode Island Hospital's suspension of non-essential surgical procedures.

Health reporter Lynn Arditi can be reached at larditi@thepublicsradio.org. Follow her on Twitter @LynnArditi