Hospital CEO in Florida says staffers are overworked, angry and quitting: ‘Our breaking point’


TAMPA, Fla. (WFLA) — A county commission meeting in Florida on Friday turned into a plea to take the COVID-19 pandemic more seriously as cases increase in the state, overwhelming and infecting hospital staff and emergency rooms.

Mickey Smith, the CEO of Oak Hill Hospital in Brooksville addressed the Hernando County commission and answered questions about how the hospital is faring during the latest COVID surge.

“We have 133 COVID-positive patients out of our 309 total patients in the hospital,” Smith said. “We’ve now had to dedicate five nursing units to COVID. We are very close to our ICU being filled with COVID patients.”

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Smith told the county commissioners that 25 patients in the ICU have COVID-19, and 17 are on ventilators, ranging in ages from 25-75.

Of the patients on ventilators, 14 are under the age of 65. Only one had been vaccinated against COVID-19.

“I will tell you that I don’t care what variant it is. There’s only one protocol for treatment. If you have COVID, we have that one protocol, we don’t care about the variant, we don’t test for it,” Smith said.

“I can tell you, I don’t care whether you’ve been vaccinated or not, because dead is dead.”

Smith referenced the recent COVID death of a 29-year-old EMT in Citrus County. He died at Oak Hill, leaving his 5-year-old child behind.

“This is killing people and it’s totally unnecessary,” Smith said. “We were at the breaking point Wednesday night. I had 108 patients in my 29-bed ER.”

Even patients who are testing positive for COVID-19 are being sent home because they don’t meet the criteria for admission, and that’s “even if” a bed was available for them. The bigger issue for the hospital, Smith said, is the effect of the pandemic on staff.

“Beds are not a problem for us, it’s the staff,” Smith said. “My staff are worn out.”

At Oak Hill, 62 people are out of work after contracting COVID-19, though none are hospitalized.

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Smith said he doesn’t have the staff to care for the “really sick” patients that have been admitted.

“It’s totally unnecessary. If people would get the vaccine, if people would wear masks, and wash their hands,” Smith said. “I’m pleased to report the last 36 hours, we’ve stabilized. It’s still really really bad, but compared to Wednesday we’re not pulling our hair out and having our nurses work double their number of patient assignments. But it’s a very serious situation. Interestingly enough, this particular surge, we were the tip of the sword.”

Smith said that compared to last year, the area south of Tampa peaked first. He believes they’ll peak first this time, instead. Fifteen of the hospital staff out with COVID-19 were vaccinated, Smith told the commissioners. He says not only is the virus rapidly progressing, but the vaccines are less effective against them.

He wants more people to get the vaccine, saying that the faster spread could be “totally avoided” if enough people had already been vaccinated. Smith also warned about asymptomatic spreaders, who don’t know they’re COVID-positive, feel fine, but can still spread the virus and its variants.

Addressing questions of ICU availability and shortages, Smith said it’s a combination of factors, including staff infections, higher numbers of patients, and some healthcare workers leaving the profession “angry.”

In a national trend, ICU and inpatient bed availability at hospitals is changing, according to data from the U.S. Department of Health and Human Services.

The data shows where higher percentages of ICU and inpatient beds are in use. In Florida, 85.56% of inpatient beds are occupied and 10.43% are being used by COVID-19-positive patients. In ICUs, 77.12% of Florida’s beds are occupied, and 23.44% are from COVID-19 patients.

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“Our breaking point in beds and staff, at ICU, again I’ve got people out with COVID, people who have left the profession,” Smith said. “They’re angry, they’re angry, they’re taking care of them, they’re being professional, but they’re angry that people have put us into that particular situation.”

While emergency rooms and COVID units are overflowing, Smith said the patients cannot be transferred to other locations, even when the need is there.

“Beds are not my issue, it’s the staff,” Smith said. “Virtually all of the hospitals in Florida are closed to transfer right now.”

Smith said they’ve had to grant emergency privileges for critical care physicians to get additional staff in to treat COVID patients. They’ve also petitioned the Accreditation Council for Graduate Medical Education, the organization that accredits residency programs, and stopped training residents, instead of using them for patient care.

“Unfortunately if you show up with a brain bleed, at my place, we’ll make you as comfortable as possible,” Smith’s voice cut out at those words. Smith praised the effects of monoclonal antibody treatments, such as Regeneron and remdesivir, but noted that some patients and families were upset when loved ones infected with COVID did not qualify for the treatment to be administered.

The criteria for use of treatments like remdesivir are set by the U.S. Centers for Disease Control, Smith said.

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