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Using the bathroom in bags. Tiring shifts. Sponge baths: Inside a taxing week at Austin hospitals

Ryan Autullo Tony Plohetski
Austin American-Statesman

As Austin residents held tight to winter blankets early Wednesday at the height of the city's weather meltdown, registered nurse Amy White gripped the steering wheel of her Toyota RAV4 and headed to work.

White typically makes her pre-dawn drive in 10 minutes. But dressed in navy scrubs, two jackets and snow boots, she moved carefully over ice patches on Interstate 35 and finally reached St. David's South Austin Medical Center in 35 minutes.

She didn't go home for three days.

During those 72 hours, White bunked in tight quarters with other nurses, bathed with sponges after the hospital lost water service on her first day and relied upon food from restaurant deliveries donated to hospital workers. 

"I was determined to get there,” said White, a supervisor in the neonatal intensive care unit. "Every person in the hospital needs a nurse, and every nurse needs a co-worker. I wanted to be part of the team."

Russell Brown walks away in the snow after being discharged from St. David’s South Austin Medical Center on Thursday. Brown, who is homeless, spent two nights in the hospital with pain from chronic neurological damage.

White's story from Texas' unprecedented power and water crisis mirrored the experiences of other Austin health care workers — a group trained to handle chaotic situations, but who never anticipated that a massive winter storm would threaten to topple facilities that often separate life and death.

In interviews with physicians and their staff and patients, the American-Statesman learned of employees sleeping on floors between 12-hour shifts, defecating into biohazard bags because toilets wouldn't flush, catching rides to and from hospitals with co-workers who had four-wheel-drive vehicles and in a few instances, walking in frigid temperatures for an hour to work.

Employees also took to social media and other venues to sound a community alarm that became increasingly loud by midweek but lessened as the situation appeared to stabilize into the weekend.

Their firsthand accounts filled in the gaps as Austin hospital networks often provided vague statements and offered few specifics about the conditions inside their facilities. 

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A patient is readied to be taken from St. David's South Austin Medical Center on Wednesday after that hospital suffered water and heating problems.

“I’ve been an emergency medicine doctor for 15 years (if you count my residency) and I’ve never seen a city medical system in such strain as we are in Austin right now,” Dr. Sarah Martinez, the emergency department medical director at Ascension Seton Northwest, wrote in a public Facebook post Thursday.

The issues went far beyond inconveniences, but, based on interviews, the situation did not become as dire as some patients, health care workers and administrators feared as they saw space for patients nearing capacity and access to food and water growing scarce. Some health operators say the episode underscored the need for proper planning and the ability to quickly adapt when those plans fall apart.

The crisis was especially acute at St. David's South on Ben White Boulevard when heat plummeted and water service collapsed Wednesday, prompting a quick decision to move patients to the hospital's north location and to a surgery center in that area.

The issues confronting Austin’s hospitals came at a time when hospitals and staff were already exhausted from nearly a year of the COVID-19 pandemic.

“Our staff is tired, but they are nonetheless enthusiastic, committed,” St. David’s HealthCare CEO David Huffstutler told the Statesman. “This is their life’s work. They do it not for the money. They really want to serve people, and we really see that demonstrated in times of crisis.”

Ambulances line up Wednesday outside of St. David's South Austin Medical Center in preparation to carry patients to other facilities after water pressure and heat plummeted at the hospital.

An offer of dry cereal 

The mayhem reflected what was happening elsewhere in Texas, where more than 4 million homes lost power because the state's electric grid did not generate enough energy to keep up with a demand spike that operators say was greater than they had anticipated.

About 220,000 Austin Energy customers lost power, a number that now stands at about 6,000. The total number of residents without water service is unknown, but Austin Water on Friday estimated that it was in the "tens of thousands." A boil water notice was issued citywide on Wednesday evening and remained in effect Saturday.

As crews hustled to restore those basic services, physicians responded to health crises. Patients arrived at hospitals with injuries from slips on the ice and from vehicle collisions when drivers lost control on frozen roads.

Patients were treated for frostbite and hypothermia. Others were treated for carbon monoxide exposure after making the mistake of firing up gas-powered devices in their homes for warmth. A handful of them were pregnant mothers who reported to St. David's North Austin Medical Center.

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Over a seven-day period ending at noon Friday, the Austin Fire Department responded to 12,408 calls for service — an average of 1,772 calls per day. On a typical day, Austin firefighters might respond to about 500 calls for service.

Stewart White was among those injured. On Tuesday night, he stepped onto his porch, slipped and hit his head and broke two ribs.

An ambulance took him to Ascension Seton Medical Center, where he said staff were only able to offer dry cereal over a 12-hour period.

“The whole system was so strained,” he said. “I do think they rose to the occasion. It was a general supply issue that was affecting the whole community.”

Martinez, the emergency department director, said in her Facebook post that “all of our (emergency departments) and hospitals are overwhelmed.” She said doctors were treating people who had run out of oxygen in their homes and who were unable to receive dialysis because clinics are closed. 

“If you have a true emergency, come see us, we will help you the best that we can,” she wrote. “Otherwise, I beg you all to be careful and stay home if you can.”

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In a post 12 hours later Thursday, she wrote that the community had delivered 2,000 1-liter bottles of water “when we desperately needed it.”

In a statement, Ascension Seton said that "while extreme weather conditions have caused intermittent water issues at several Ascension Seton sites of care, facility teams are working quickly to resolve the issues."

Baylor Scott & White closed an emergency medical center in Cedar Park because of a water leak and engaged backup power sources at several facilities, the hospital system said Thursday.

At St. David's North, Chief Medical Officer Ryan Charbeneau drove nurses to and from the hospital who couldn’t safely make it on their own.

An emergency medical worker with Austin-Travis County EMS works at St. David’s South Austin Medical Center on Thursday.

One pregnant woman who was about to give birth picked up her doctor on the way to the hospital, according to Dr. Catherine Browne.

Browne said three doctors or nurses became patients themselves when they slipped and fell on ice while heading into the facility.

Browne, an obstetrician who worked a 48-hour shift, said pregnant patients were in a hospital wing with temperatures in the 50s. Space heaters were brought in for comfort, raising the temperature about 10 degrees.

For rest, nurses crammed into a single patient room until it was their time to work again.

"If you have no staff, you can't keep your emergency room," Browne said. "If you can't get new staff there, you have to find a way to keep the staff that's iced-in functional and working."

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Water from Phoenix 

Huffstutler said that as forecasters predicted the mammoth winter storm, St. David’s operators polished plans the company maintains, and, on Feb. 12, they began keeping 200 staff members at facilities.

Staffers checked to ensure that warehouses were fully stocked with medical supplies, and maintenance crews stood by to power up generators in case of a power loss, he said.

During the week, hospitals kept power, but water quickly became an issue.

Huffstutler said that the system has tanker trucks on standby for water, but that “the challenge we had this time was that our tanker trucks were also freezing. Mechanical parts were freezing and the water was freezing.”

System officials found tanker trucks — 1,000 miles away in Phoenix — and had them brought to Austin.

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EMTs with Austin-Travis County EMS work at St. David’s South Austin Medical Center on Thursday.

Employees, including medical personnel, who were kept at the hospital and those who were able to report to work ended up helping with food preparation, handing out food trays and even washing dishes. 

“Our employees have been incredible,” Huffstutler said. “They have been resilient.”

White. the nurse from St. David’s South, agreed. 

As the snow continued to thaw Friday evening and White prepared to finally go home, she focused on a positive.

“I feel like our hospital team is stronger than ever,” she said. “It has been tough, but we have all made it."

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