Matthew Shahan

West River Health Care Services’ chief executive officer Matthew

Shahan.

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A local health care CEO had a chance to explain the COVID-19 impact on southwestern North Dakota to the rest of the nation Wednesday (Nov. 18).

West River Health Care Services’ chief executive officer, Matthew Shahan, was interviewed for about five minutes on a national morning television show on how the pandemic surge in North Dakota and South Dakota on providing health care in the rural area around Hettinger and other small communities the company serves.

Shahan was appearing in the final half hour of the threehour Morning Joe program on MSNBC and was introduced by one of the hosts after going through a series of headlines for stories on states and cities adding new restrictions to curb the spread of the virus.

Right after displaying the recent NPR headline and story about COVID-19 surges in rural communities overwhelming some local hospitals, host Mika Brzezinski asked Shahan about how his hospital in Hettinger was handling the surge. “Our hospital is much like the rest of rural hospitals in this country. We have what we would normally be dealing with during these times, then you add on top of it the Coronavirus pandemic and what it is creating is an unsustainable model for rural health care.

“From a staffing standpoint, we only have so many people we can draw in and those people are tired. Many times, they work other jobs. They have farms and ranches at home that they have to take care of.

“Quite honestly, they are burned out already,” he explained. “The concerning thing for us is we don’t have a large labor pool. Where we are sitting at, we have what we have. There the best group of doctors, nurses, lab, radiology and housekeeping we could find, but there is only so many of them – and that is my number one concern right now,” he said.

When asked about supplies and space, Shahan said he thought the state of North Dakota had done well.

“I think our state did a great job leading up into this pandemic and they have done a good job of delivering those supplies during this time. So, we are doing pretty well on supplies.

“Space is certainly an issue. We only have so many rooms that are negative pressure where we can handle these types of patients. If we take them outside of that controlled space, then we put the rest of our staff at risk,” he explained.

“We deliver babies here and so we really have to be protective of where we keep these patients. We don’t have a large building. We don’t have separate floors that we can house these patients. “We really have to be restrictive and careful. Unfortunately, that means it limits the number of Coronavirus patients we can care for,” he said.

Another of the hosts referred to the fact that the state had the world’s highest COVID mortality rate (18.2 deaths per one million people) when he asked Shahan what is needed in the state and whom do they need it from. Shahan pointed out that rural hospitals and health care providers have succeeded in taking care of each other in the past. “When a farmer goes down, the neighboring farms step up and help them get their crops out of the group.

“What we need right now is just common sense. We need folks to just wash their hands. We need them to socially distance. We need them to wear a mask when and wear possible,” he said.

“I know it is not comfortable. I don’t like wearing one all the time.

“But, how can I look my staff in the eyes if I am not willing to do such a simple thing to protect them and to protect their patients. Quite honestly, daily and weekly they are caring for their neighbors – people who they have grown up with their entire lives who are in our COVID unit on their deathbed.

“I don’t think I would be a very good leader if I did that,” he said.

Shahan also was asked about Gov. Doug Burgum’s recent decision to allow COVID-positive health care workers to be able to care for patients with the virus. “As an organization and in the healthcare world, we certainly appreciate that measure being taken, but this organization has chosen not to utilize those staff. If they are COVID positive, we want them home and getting better. This is a long-term disease.

This is something that is going to be around for a while. “We cannot risk having them come into the unit, whether they have it or not,” Shahan said. “We want them to stay away from the building so that we can really limit those touch points where they could pass that on to another coworker.”

He said that while he appreciated the move by the governor, his facility has not been forced into that option. “I hope that that is our absolute last measure because I don’t want to have to make that decision.”

Another host, Mike Barnicle, asked about the impact of distance that the Hettinger facility has during the pandemic. Shahan answered by explaining the West River Health Care system serves about 15,000 square miles. “We have one hospital and six clinics. Our nearest tertiary facilities are over two hours away.

“We have a really proud community that when they are sick they usually have to be really sick to come to the hospital,” he explained.

It is also a matter of education, he added. “When you have shortness of breath, we want you to come in. We have a long-standing great relationship with the counties that we serve in North Dakota and South Dakota. I think that is the biggest thing. We have to have that trust and we hope that by now we have built that up with them. “We are going to evaluate them. We are going to figure out the best place for them to seek care.

“Maybe, that is at home with some simple measures we can provide to them. But, when it comes time to have them admitted into the hospital, we hope we have a bed – and if we don’t we have partners in the state we can call on. At times lately, even they haven’t had beds and when the people that we rely on and the hospitals they rely on don’t have beds that really become a concern.

“Those aren’t all COVID patients in those beds. People still have strokes. They still have heart attacks. They still have all the other issues going on right now,” Shahan said.

“It is really education and collaboration between hospitals.

I have been really proud of my colleagues in the state and the work we have done in the last few months to really try to build up this network.

“It is clearly an unsustainable model that right now is growing above what we can handle,” he said.

West River Health Care Services serves the communities of Hettinger, Bowman, Lemmon, Mott, and New England with clinics and also has long term care facilities in Dickinson. The Bowman facility was closed after a windstorm tore a section of the roof off and is still undergoing repairs.

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