A14 The BulleTin • Tuesday, June 29, 2021 High court won’t revive school’s transgender bathroom ban BY DENISE LAVOIE AND MARK SHERMAN Associated Press The U.S. Supreme Court on Monday rejected a Virginia school board’s appeal to re- instate its transgender bath- room ban, handing a victory to transgender rights groups and a former high school student who fought in court for six years to overturn the ban. After learning that the high court refused to hear the board’s appeal, Gavin Grimm, now 22, said that his long battle is over. “We won,” he tweeted. “Honored to have been part of this victory,” he added. Grimm was a 15-year-old student at Gloucester High School when he was banned from using the boys bath- room. The Gloucester County School Board’s policy required Grimm to use restrooms that corresponded with his biolog- ical sex — female — or private bathrooms. Grimm filed a fed- eral lawsuit that wound its way through the courts for six years. Grimm said that being forced to use the nurse’s room, a private bathroom and the girl’s restroom was humiliating and severely interfered with his education. He said he is heart- ened by his victory in court because “a win in Virginia is a win everywhere.” Nurses Continued from A1 “I’ve been here eight years, and I’ve never seen this many acutely ill patients coming through the door,” said Dr. Mary Tanski, interim chair of the OHSU Emergency Depart- ment. “When we see sicker patients, that’s a stress. Nurses were already tired. They’ve been at the front lines for a year. It’s to the point that we have seen some of our nursing colleagues leave the profes- sion.” Traffic jam When COVID-19 arrived in Oregon, many hospitals expe- rienced an immediate drop in business. In the first months of the pandemic, OHSU’s emer- gency department saw patient volume fall by half. Some hospitals figured they could afford to cut staff, save some money and lessen the financial pounding they were taking as a result of the pan- demic. But ER traffic is hard to pre- dict. By law, they don’t have the luxury of turning people away. Sure enough, ER demand surged this spring to a level that caught everyone by sur- prise. After studiously avoiding hospitals and doctors’ offices for a year due to COVID-19, many of the patients are too sick to be treated and released. That has led to another prob- lem: Some hospitals don’t have enough staffed beds elsewhere in the hospital to house the in- flux. That leads to “boarding,” the practice of holding patients in the ER, until a hospital bed or some other destination can be found. The practice is contro- versial because it keeps patients in limbo and because it blocks the normal flow of sick patients into the hospital. Behavioral health patients are particularly prone to boarding because of the chronic shortage of beds dedicated to their needs. The backlog of boarded pa- tients means more delays for new ER patients, who can wait hours to see a nurse. Under- standably angry patients and their families at times lash out at hospital staff. Karlee Hoffart is a four-year veteran of the ER at Kaiser Per- manente Sunnyside Medical Center in Clackamas. “I love the emergency department,” she said. “I’m a bit of an adren- aline junkie. I like being a val- ued member of a small team.” But things have changed in recent months. “We cannot move our pa- tients,” she said. “There are days when I start a shift, half of our beds are taken up by folks needing a hospital bed. Some- times, they can wait 24 hours.” In the interim, it is Hoffart and her colleagues who must treat them. “We are no longer just ER Wyden Continued from A1 “I believe what we will hear about is making sure there are personnel available in the West to fight multiple fires at the same time. This is a departure from the past. Usually we have one big fire and other western states would chip in to help the state that was hit the hard- est. Now, we are talking about something that is unprece- dented: Big fires simultane- ously throughout the West.” Wyden led the committee for about one year, from 2013 to 2014, when he took over the tax-writing Finance Commit- tee, which he now leads again after Democrats became the Senate’s majority party with Vice President Kamala Har- ris the tie-breaker in a 50-50 chamber. Allen J. Schaben/Los Angeles Times, file Nurse Stephanie Scott keeps an eye on patients in the emergency department at St. Joseph’s Hospital in Orange, California, in 2018. nurses,” she said. “We are men- tal health counselors; we are hospital nurses; we are being asked to do it all, with no extra help.” Nowhere to divert The problem is more than just a shortage of skilled work- ers and staffed hospital beds. Emergency responders are delivering patient loads that are too much for hospital emer- gency rooms to handle. The surge of calls began several months ago and only worsened in the last two months. Emergency calls always spike in the summer as more people are on the roads. In Multnomah County, the num- ber would typically increase to about 300 a day. This month, the county is running on aver- age 390 a day. When Portland-area hospi- tal ERs are jammed, they go on “divert” status, meaning am- bulances that would normally go there are diverted to an- other hospital. It’s never been unusual for one or two met- ro-area hospitals to get over- whelmed on a busy night. But in recent months it’s become almost a daily occur- rence for every hospital in the area to go on divert. OHSU, for example, spent about 150 hours per month in divert status in April and May 2020. A year later, Tanski con- firmed, OHSU’s emergency de- partment was full and off-lim- its between 450 and 500 hours per month. OHSU is one of the region’s key trauma hospitals that takes the most serious cases. “When we’re on divert it presents a challenge,” Tanski said. “It just leads to this spiral effect.” That is a sea change for lo- cal county officials who run a sort of air-traffic control sys- tem coordinating ambulances with hospitals. In May of last year, all local hospitals went on total divert status maybe once or twice, said Shane Ryan, Wyden continues to sit on the Energy and Natural Re- sources Committee as the No. 2 Democrat behind Chairman Joe Manchin of West Virginia. Senate rules allow one com- mittee chairmanship per mem- ber. Budget details are decided by the Appropriations Com- mittee; Oregon Sen. Jeff Merk- ley leads the subcommittee that oversees the Forest Ser- vice. Wyden spoke on a weekend when temperatures exceeded 100 in virtually all of Oregon, and drought affects most of the state. Wyden and Merkley toured Oregon twice in the aftermath of the 2020 Labor Day wild- fires, which affected all four metropolitan areas on the westside — Portland, Salem, Eugene and Medford — with a spokesman for Metro West Ambulance, which serves Washington County. This May, all hospitals were diverted 54% of the time. Ambulances have made some unusual trips in re- sponse. Tualatin Valley Fire & Rescue had to transport a pa- tient to a hospital in Corvallis after Portland-area hospitals turned them away, said Cas- sandra Ulven, spokeswoman for the department. The deluge of shootings and other street violence has con- tributed to the surge. “Our trauma volume is huge,” said Jon Jui, medical di- rector of Multnomah County Emergency Medical Services. “We’ve never seen people get- ting shot at this rate, often at random. I’ve been doing EMS for over three decades, and I’ve never seen problems this sustained, this prolonged. We have a very significant strain on our emergency system.” Slow to staff up Kaiser and Providence nurses argue the solution to the problem is simple: Hospitals need to hire more staff, and they need to retain the talent they have. Hospital officials said they are trying to do exactly that. “No one would dispute that this is a challenging time across the state, region and country when it comes to care- giver staffing, going on divert and wait times in emergency departments,” Providence spokesman Gary Walker said. “Providence is actively man- aging the needs, including spending hundreds of hours in recruiting additional care- givers. We are excited to have a group of 54 new nurses joining us for ED residency in a couple of weeks.” Legacy Health Systems said it has hired more than 250 nurses in 2021 and will soon accept 50 additional nurses into its residency program. Providence, Kaiser and Leg- wildfire smoke or worse. (The Almeda Fire swept through communities south of Medford and destroyed an estimated 2,500 homes, the largest con- centrated loss statewide.) Wildfires also burned on the central coast, Central Oregon and near Roseburg and Grants Pass. Wyden says he expects one element of the response plan to be cooperation among the agencies responsible for fight- ing forest fires. “Local, state and federal firefighters are go- ing to be tightly coordinated in order to deal with this grave threat,” he said. In Oregon, that responsibil- ity is divided among fire pro- tection districts, Oregon De- partment of Forestry — which also contracts to protect West- ern Oregon forests overseen by the Bureau of Land Manage- acy all declined to provide any information about nurse attri- tion or turnover. Kaiser said it is hiring so- called traveling nurses from employment agencies to fill the gaps in its own payroll, and it’s offering sign-on bonuses for registered nurses who will work nights in the ER. “The nursing shortage af- fecting the whole nation is im- pacting the Northwest region as well,” said Kaiser spokes- woman Debbie Karman. “We’re actively working to re- cruit and hire nursing staff.” Hoffart, the Kaiser nurse, suggested Kaiser should con- centrate on retaining its trained veterans. Attrition is enor- mous. “She and her colleagues estimate that half or more of the nurses who worked in the Kaiser Sunnyside ER last year have left the department.”. Hoffart is a steward for the nurse’s union, the Oregon Fed- eration of Nurses and Health Professionals, which started negotiating a new contract early this month. Staffing is a central issue. Kim Stewart, another ER nurse at Kaiser Sunnyside, said there’s no bigger priority. “Kaiser has a great patient care model,” Stewart said. “But without the people there to do it right, it doesn’t work. I don’t even want more money or more benefits. I just want staff.” Lail, the Providence Port- land nurse who recently went on leave, echoes those senti- ments. He is a steward in his union, the Oregon Nurses As- sociation, which recently filed a grievance with Providence over staffing issues that was signed by 75% of its nursing staff. Lail doesn’t know what his future has in store. “I don’t want to quit, I don’t want to leave. But it’s getting really hard,” he said. “The money is really not that important to me. I just want the support and the right co-workers to do my job.” ment — and the Forest Service for national forests. Wyden said Congress should increase the amount of money available for the Forest Service to reduce haz- ardous-fuel buildups in na- tional forests. Oregon itself has about 2 million acres eligi- ble for treatment. Wyden said Forest Service chief Chris- tiansen estimates it will take $20 billion to eliminate the backlog. Wyden also is promoting the creation of a 21st cen- tury equivalent of the Civilian Conservation Corps, the New Deal-era agency that put pri- marily young and unmarried men to work in the nation’s forests between 1933 and 1942. Silver Falls State Park, east of Salem, is one of the CCC’s leg- acies in Oregon. e pwong@pamplinmedia.com