Nursing shortage forces BBRMC to reduce labor and delivery wing hours of operation

The Big Bend Regional Medical Center in Alpine. Photo by Stephen Paulsen.

ALPINE –– There is a shortage of nurses trained to deliver babies at the Big Bend Regional Medical Center, reducing the hours the labor and delivery wing has been open to the public. In the past three weeks, the labor and delivery room –– or L&D, for short –– has twice been on “diversion,” meaning that L&D is closed with staff directing, or diverting, obstetrics patients to other facilities. The first time was on Tuesday, July 6, and it lasted until Friday, July 9. The second time was on Thursday, July 15, when L&D shut its doors to patients until the following Monday.

“This issue is evaluated daily and with the collaboration of our L&D providers, we schedule these diversions for our patients’ safety, which includes having sufficient staff to care for our patients,” said Ruth Hucke, a spokesperson for the hospital.

“I can confirm that we, like other healthcare providers across the country, are facing challenges filling much-needed nursing positions,” Hucke said, adding that the staffing issues at the hospital began escalating this month.

Presidio EMS Director Malynda Richardson, who was one of the first to sound the alarm on this issue, received word on July 8 that the L&D room was having to go on diversion. She had just arrived at the hospital on an ambulance run when an emergency room nurse tipped her off that L&D was closed for the day.

Richardson said that ambulances –– in the event that L&D is closed –– are being directed to transport obstetrics patients to other facilities, like Pecos County Memorial Hospital in Fort Stockton, unless the delivery is imminent. Hucke said, “We try to adhere to the patient’s choice along with their provider’s advice when transportation is necessary for these OB patients.”

“If delivery is imminent then we would take the patient to the emergency room, and the baby would be delivered in the emergency room,” Richardson said. And if there’s a walk-in, staff will evaluate the patient to determine whether or not to send them to another hospital.

Richardson, when interviewed last Thursday, said that the Presidio EMS has not received an obstetrics patient while L&D was not in operation. That said, Presidio paramedics do go out on obstetrics calls on a regular basis. “A month rarely goes by that we don’t have an OB call,” Richardson said.

BBRMC says it is actively addressing this nursing shortage. “We are working through many initiatives to bring high-quality OB staff to our facility,” Hucke said.

When asked if there were any planned diversions in the coming weeks, Hucke said that the hospital evaluates the situation on a daily basis. “When diversion is necessary, we communicate with all our area’s emergency transport services and other providers as well,” she said.

Of course, when one link in the Far West Texas healthcare chain breaks, all other resources are further strained. If the Presidio EMS ambulances are forced to make the two-and-half hour trip to Fort Stockton on a more regular basis, they will quickly rack up even more miles than they already do en route to Alpine. As The Presidio International previously reported, both of the Presidio ambulances have logged well over 100,000 miles, with the older vehicle practically on its last leg.

Despite that, a recent study from a healthcare consulting firm –– at the Big Bend Regional Hospital District’s behest –– concluded that it’s not fiscally viable to operate a hospital in Presidio County. As Richardson put it, “Rural healthcare is endangered.”

And to add insult to injury, a faculty-led report out of Sul Ross State University recommended closing the nursing program if it is unable to fiscally sustain itself via grants and enrollment within one year of being a fully-licensed program. But as The Big Bend Sentinel reported this week, President Pete Gallego appears to have rejected many of the committee’s recommendations, leaving some hope for the university’s nursing program.