NEWS
November 16, 2022

St. Michael Medical Center Activates Mass Casualty Protocol, Due To Overwhelmed ER

St. Michael Medical Center Activates Mass Casualty Protocol, Due To Overwhelmed ER

This article was updated on 11/16/22 at 5:30 pm to include additional information provided by St. Michael Medical Center regarding the accreditation status and collaborative emergency response.

11/15/22

St. Michael Medical Center in Silverdale, Washington has made national headlines again. At 6 pm last Friday, the ER was overwhelmed with patients while simultaneously, several of the county's fire agencies were receiving a high number of emergency calls. 

With a full ER and an ambulance bay full, as well as several others en route with severe traumas, Kitsap County's fire chiefs activated procedures based on those for mass casualty incidents. 

>>Listen on the Ask Nurse Alice podcast, "ER Nurse Who Called 911" - Kelsay Irby Tells Story Of What Really Happened That Night at St. Michael Medical Center

Mass casualty procedures are more commonly seen in times of war or after natural disasters. However, due to the ongoing nursing shortage, it is feasible that other hospitals in the future may need to implement such protocols. Furthermore, during the height of the COVID-19 pandemic, mass casualty protocols were often implemented in areas hit the hardest. 

The mass casualty designation allowed each medic to treat multiple patients, which would not have been allowed under normal circumstances, Gillard said.

"It's been our experience that even when the St. Michael ED is busy, the most critically-ill or injured patients are getting the care they need quickly. Still, we want to do what we can to make sure that all our emergency medical patients — critical or not — can get the treatment they're seeking in a timely manner and our units can get back to their districts, ready to respond to the next emergency," Jim Gillard, president of Kitsap County Fire Chiefs Association and chief of Poulsbo Fire Department, said in a statement.

Hospital president Chad Melton said,  "I am proud of the St. Michael Medical Center staff who went above and beyond to manage a multiple-trauma patient event over the weekend. We are grateful to our partnership with EMS which allows us to handle multiple emergencies immediately, without compromising care for other patients."

Kelsay Irby, the ER nurse that called 911 several weeks ago, said the situation on Friday was a perfect storm. The ER was short-staffed the night before, so there was already a backup of patients on Friday morning and they were never able to catch up. Irby reported the ambulance phone rang for over 35 minutes straight. "I've seen some busy days, but that really was incredibly busy," she said, "Sometimes it just happens like that. You could be the most well-staffed hospital in the world with no problems and sometimes you have things happen like that."

Irby added, "It could get ugly, and it wouldn't really change the outcome, but it would change the atmosphere and patients pick up on that. I can't speak enough to their patience and professionalism and understanding of the situation. They're fantastic. I cannot say that enough."

This is the third time in recent months that St. Michael Medical Center has been under scrutiny. In October, the charge nurse, Kelsay Irby, called dispatchers at Kitsap 911 through an official backline.

“The charged nurse from inside the emergency room called 911,” said Central Kitsap Fire and Rescue Chief Jay Christian. “The charging nurse said twice, 'we’re drowning,' conveying that they only had five nurses on duty and 45 patients in their waiting room, and she was asking for help from local firefighters to come work inside of the ER to help relieve some of that pressure.” 

A previous version of this article stated information regarding St. Michael's accreditation status. However, a representative of St. Michael Medical Center provided the following statement clarifying the timeline and providing updates on the hospital's accreditation status,

 "The Joint Commission visited St. Michael Medical Center in September to conduct its regular triennial survey which evaluates compliance with over 250 accreditation standards including patient rights and education, infection control, medication management, and more. The Joint Commission’s preliminary findings were focused on a very specific patient population and set of clinical conditions – not the emergency department as a whole. While there were no findings of adverse harm to any patients, St. Michael Medical immediately developed and implemented an action plan to address any potential concerns, which was accepted by The Joint Commission. Following the action plan, the hospital was cleared through an initial on-site survey and we are in the process of receiving final clearance for full accreditation," a representative of St. Michael Medical Center told Nurse.org

"While there were no findings of adverse harm to any patients, we immediately developed and implemented an action plan to address any potential concerns, which was accepted by The Joint Commission," Melton said. "Following the action plan, St. Michael Medical Center was cleared through an initial on-site survey and we are in the process of receiving final clearance for full accreditation.”

Press Release

St. Michael Medical Center provided the following press release with more comprehensive info on the significant influx of trauma, critically ill, and other emergency patients which led to a collaborative emergency response between EMS and St. Michael.