Greater Portland area hospitals have switched to crisis care standards due to staffing shortages and an increase in patients who are severely ill.

Hospitals like Providence, Legacy Emanuel, Kaiser Permanente, and Oregon Health & Science University frequently provide vital and specialized treatment to a large portion of the state.

The adult and pediatric critical care unit care in the metropolitan area is now being provided in accordance with crisis standards for the first time since the start of the COVID-19 pandemic.

Crisis care guidelines also permit hospitals to prioritize patients, essentially concentrating on treating those with the best chance of short-term survival, when the resources actually aren’t available to treat everyone. By expanding beds and reducing the nurse-to-patient ratio, the four health systems claim they are not yet at the stage of triaging patients. Dr. Melinda Muller, interim senior vice president and chief medical officer at Legacy Health, stated that “if we fill all those beds and the demand goes up, we’ll definitely get there.”

According to Muller, intensive care unit nurses are given two patients to care for instead of the typical one patient at a time. The nurse-to-patient ratio in other departments may range from 4 to 1 to 5.

According to Muller, hospitals are ceasing to execute the majority of non-urgent surgeries that call for inpatient hospitalization, however they will still perform as many outpatient procedures as they can. Hospital administrators in Oregon claim that this is the largest capacity issue they have ever experienced, worse than it was during the pandemic when there were more COVID-19 hospitalizations.

According to Muller, patients with time-sensitive medical situations, such as strokes requiring neurosurgery, could be compelled to wait an excessive amount of time before receiving ICU-level care.

Muller claimed that recently, the Portland area’s intensive care units have been having trouble accepting transfer patients from hospitals in other regions of the state, who depend on them to handle the most complicated casesThe nationwide crisis has been building for months, partly due to a shortage of clinical staff, particularly nurses. Many have reduced their hours or switched from the most demanding bedside roles. And a shortage of long-term care beds for people with chronic illnesses or psychiatric conditions has left many patients stuck in hospital much longer than necessary.

At the same time, Oregon is facing its first full winter respiratory virus season since the statewide indoor masking guideline was discontinued. A rapid rise in adult respiratory virus cases – mainly influenza but also COVID and RSV – is making the situation worse.