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'No place anyone wants to be'

Cranston field hospital, unused to date, prepares to accept patients

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With hospitals close to reaching their capacity to treat COVID-19 patients, the news media was given a tour on Friday of the Cranston field hospital, a place where the people who built it never want it to open.

Accommodations are sparse. Arranged in pods, beds stretch in stiff lines. Beside each bed, a table lamp sits on top of a two drawer, table-high steel cabinet. It’s the only place for personal belongings, and patients are allowed as little as possible – no extra changes of clothes.

Books are advised to be burned after the stay. Privacy is a draw curtain. There is no bedside button to hail a nurse. There’s no television, no bedside telephone. There is an outlet at each bed so that patients can charge their personal and electronic devices.

Depending on the pod, the restrooms, which were taped off Friday, can be hundreds of feet away. Lacking toilets or sinks, the shower room visited offered only three fiberglass enclosures.

Patients are referred to by the letter and number above their bed.

Each pod is named after a Rhode Island beach, perhaps in a way to bring a small sliver of familiarity to an otherwise disorientating place. Everything is beige and white, and it’s easy to get lost down the maze of long corridors. The only bright colors come from the garish yellow gurneys, mounted on the end of each row.

At one end of the building is a room – now empty – where patients will be wheeled in their beds should their condition deteriorate and they need to be placed on a ventilator. On the other end of the building is the discharge lounge, and the luxury is only in name. Once their stay is over, if at all, patients will be released by descending a long concrete ramp, which was once a loading zone, and right into family members’ waiting cars. 

If patient deaths reach a significant number, a morgue will be added to the building.

Patient requests to be transferred to another hospital won’t be entertained. Visits are not allowed.

The hospital, built in the former Citizens Bank building on Sockanosset Cross Road next to the Cranston Public Library, has 335 beds divided into 19 pods. Should it become fully operational, it would be staffed by a number of personnel, but the exact figure remains unknown. The numbers of staff are dependent on how many patients are occupying beds. There will be one physician for every 50 patients, and one nurse for every 25. In a conventional hospital, the ratio is usually one physician for 25 patients, and one nurse for six or seven patients.

The field hospital is currently being used by staff for safety, clinical and operational drills, according to Shannon Sullivan, president and chief operating officer at Women & Infants Hospital.

Sullivan led the team that converted the bank offices into the field hospital in less than three weeks in late March at a cost of $8 million. According to Brett Smiley, director of the state’s Department of Administration, the hospital costs $3 million per month to maintain at a status where it is ready to accept patients. If it fills with patients, operating costs will rise to $15 million per month.

Regardless of the hard work and preparations, the level of treatment just won’t be the same as it would be at a regular hospital, where staff have access to more equipment. Dr. Laura Forman, chief of emergency medicine at Kent Hospital, added: “It’s going to be difficult for patients. This is not going to be the setting people are used to.”

When touring the facility, Forman pointed out that each bed has access to oxygen, because they anticipate “that most patients who are here will need some oxygen therapy.”

In a dark comparison, Forman spoke about her time working in refugee camps, which she considers “last resorts.” She emphasized that the Cranston field hospital was not unlike those she had worked in around the world.

“I’ve dealt with crisis level care in a number of medical situations. And it’s not something I ever, ever want to do here. But I’m afraid that’s where we’re headed … [The field hospital] is no place anyone ever wants to be,” she said. “It does not have an optimal level of care, and you’re forced to make a lot of very difficult medical decisions because the resources just aren’t there.”

The Cranston hospital is considered a “warm zone,” according to Smiley – “It is ready to go the minute the need arises.” But despite that status, Care New England is still finalizing the staffing plan.

“We’re still working on building that up,” Sullivan said, mentioning that while there have been many willing volunteers, they are still looking for hospital pharmacists, physicians, nurses, medical assistants, runners and CNAs. If the hospital had to open tomorrow, it would be understaffed.

Forman wearily spoke about the toll health care workers are currently taking. “We’re all taxed beyond belief. Staff have to be quarantined. Staff are caring for family members at home. Staff are having to take care of kids at home who are also in quarantine. The staff is exhausted. We spent eight months taking care of people with COVID. And it's really hard to maintain resilience.”

COVID-19 hospitalizations are continuing on an upward trend. As of Nov. 17, 265 Rhode Islanders were hospitalized due to the coronavirus. There were 247 new hospitalizations last week.

For now, the field hospital will remain eerily empty, anticipating patients at any moment. Hopefully, that day won’t come.

“We have worked incredibly hard on this,” Forman said. “We're very proud of the team that put this together and all the work that's been done, but we hope that we never need to use it. And we don't have to use this, this could all be avoided, if people would just be safe.”

hospital, COVID

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