With BBRMC regularly on diversion, Fort Stockton hospital no longer admitting obstetrics patients from tri-county, complicating access to care

With BBRMC regularly on diversion, Fort Stockton hospital no longer admitting obstetrics patients from tri-county, complicating access to care

Illustration by Crowcrumbs

Far West Texas –– In early July, the labor and delivery ward at the Big Bend Regional Medical Center began intermittently shutting down for days on end due to a nursing shortage, and over the past two months, six obstetrics patients were directed to other facilities, mainly Pecos County Memorial Hospital in Fort Stockton. However, PCMH in Fort Stockton will now no longer accept obstetrics patients outside of Pecos County, as the hospital is facing a surge in COVID hospitalizations as the delta variant of the virus has swept all throughout the state. 

Over the weekend, PCMH reported that they have 20 patients (16 with COVID), leaving only five beds available at the hospital. Betsy Briscoe, the CEO of PCMH said, “This second wave of COVID has hit harder and faster in the area than the first. Many hospitals are on diversion, including the larger hospitals where we send our patients for higher levels of care. As such, we are forced to provide that care in our own facilities.” 

Malynda Richardson, the EMS director for Presidio, said her crew has had to transport two obstetrics patients to Fort Stockton, a two-and-half hour drive, since BBRMC began shutting down, also known as being “on diversion,” two months ago. 

Richardson received word last Thursday that PCMH would no longer be accepting her obstetrics transports, and she has since been scrambling to figure out where to take them. “So if we get an OB [obstetrics patient], I don’t know who would take them right now. Odessa-Midland? We are going to be out of service for 12 hours,” Richardson told The Big Bend Sentinel last week. 

There’s also the issue of whether the hospitals in Odessa-Midland would be able to take these obstetrics patients from the tri-county area. Midland Memorial Hospital did not respond to questions by print time, however, it has been seeing a huge surge in hospitalizations and attendant staffing shortages, as Marfa Public Radio previously reported.

Richardson also considered taking her obstetrics transports to Culberson Hospital in Van Horn, about 130 miles away from Presidio. However –– according to Chief Nursing Officer Yolanda Jurado –– Culberson Hospital doesn’t have a labor and delivery unit. “We don’t do labor and delivery here. If a patient comes here to the ER they get transferred to El Paso,” Jurado said. 

Ruth Hucke, the spokesperson for BBRMC, said, “Currently, Del Sol Medical Center and Las Palmas Medical Center [in El Paso] are accepting transfer patients in need of labor and delivery care. When our hospital is on diversion for elective obstetrics patients, we communicate in advance with nearby emergency transport services and acute care providers to make certain there is a continuity of care.” And while BBRMC lets area EMS services know the labor and delivery unit is on diversion, the hospital does not alert the public, and nowhere on its website can a potential patient find such information. 

On Monday, Richardson said that as it stands now, if she gets an obstetrics call while BBRMC is closed, her first plan is to call First Flight, an air ambulance company, to fly the patient to whichever hospital will admit them. “If First Flight is not able to do that, we would go ahead and take them to Big Bend Regional [Medical Center] and en route we would advise the ER and they would arrange a flight for the patient,” Richardson said. 

To make matters worse, Presidio only has one working ambulance at the moment. The town’s newest ambulance, which has well over 100,000 miles on it, has been having issues with its engine and is currently getting repaired. “We had troubles with it several years ago, but it’s now at the point where it’s got to go in for service. I mean, it’s got to,” Richardson said. “According to the Fort Stockton dealer, it could be as much as two months to get the ambulance available.”

As The Big Bend Sentinel previously reported, BBRMC began reducing its labor and delivery room hours as there is a shortage of nurses trained to deliver babies at the hospital. Hucke previously told The Big Bend Sentinel, “I can confirm that we, like other healthcare providers across the country, are facing challenges filling much-needed nursing positions.” Hucke added that the staffing issues at the hospital began escalating at the beginning of July.

“Until we have additional labor and delivery providers, we may be forced to utilize diversion status. Again, out of an abundance of caution and in a commitment to patient safety, we cannot provide care without the proper level of staffing,” Hucke said. 

BBRMC says it is actively addressing this nursing shortage and that it will soon have more nurses staffed in the labor and delivery wing. “We expect to have additional staff starting in September. We are hopeful that with these additional nurses, we can limit the number of days on diversion. We also have one permanent OB/GYN registered nurse starting soon,” Hucke said. “To return to 24/7, 365, we need an additional seven to eight more employees.”