Patients’ refusal of treatment creates new challenge for hospitals

Wichita hospitals starting to see hospitalizations leveling off but challenges still remain.
Published: Sep. 29, 2021 at 7:47 AM CDT
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WICHITA, Kan. (KWCH) - COVID-19 isn’t the only battle healthcare workers are facing. Some patients and their families are refusing standard treatments – and leaving against medical advice. That’s what a Wichita doctor said is becoming more common at local hospitals, creating a new challenge during an already taxing time.

The Sedgwick County dashboard shows COVID-19 hospitalizations and ICU admissions seeing small decreases over the last two weeks. But local doctors say it’s more of a leveling off or plateau than an improvement on recent trends.

Dr. Sam Antonios, chief medical officer for Ascension Via Christi, said Wednesday, “We’re hopeful and optimistic that maybe it’s starting to stabilize. This morning we had close to 90 patients in the hospital. That’s still a lot of patients who are unfortunately suffering from COVID-19.”

He added, “We’ve been trying to make sure that we’re able to create capacity to take care of the patients. Most of the patients are still in the contagious phase of their disease.”

In an opinion piece Wednesday, Dr. Antonios urged vaccinations as the safest and most effect way to provide protection against COVID-19.

Doctors watching for stabilizing hospitalizations

Wesley ICU Medical Director Chloe Steinshouer, M.D. said, “It’s hard to say that the situation is improving when you’re in it all day, every day.”

Dr. Chloe Steinshouer, the ICU medical director at Wesley, said they’ve been seeing a shifting demographic of the patients they’re treating for COVID-19, including a recent increase in unvaccinated pregnant women. This makes vaccinations for those women even more important.

“Pregnant women who are critically ill and requiring ventilator support or are losing their pregnancy or are having to deliver early,” Dr. Steinshouer said. “We know that women who are fully vaccinated are more likely to deliver safely, less likely to have a spontaneous abortion or a miscarriage.”

Dr. Steinshouer said Wesley is seeing more COVID-19 patients leaving the hospital against medical advice only to return sicker. Many of them refuse standard treatments. She said more than 90 percent of Covid patients are unvaccinated.

“People are refusing things as simple as inhaled steroids or Pepcid for stomach acid, or blood thinners,” Dr. Steinshouer said. “People are refusing ventilation, which we accept.”

She also described situations where “We have families who feel that we are, who are attacking and threatening to medical staff and tell us that we’re trying to kill people or that we’re lying and it’s not really COVID. That’s really hard, we just want to help these people, and unfortunately, some of them leave against medical advice, and they end up coming back and they are more ill than they were before. We also have families that are trying to bring in unproven medications or demanding things that have no data behind them. Nebulized Hydrogen Peroxide is the newest one. That’s actually pretty hazardous to the airway. Obviously, non-human Ivermectin and Ivermectin at unknown doses is problematic for us. We see lots of things right now that are sort of difficult to navigate when we’re trying our best to take care of a large number of really sick patients.”

Dr. Steinshouer said data they have tracked at the hospital. Only 8 percent of their patients have been vaccinated. Those who are vaccinated are 25 percent less likely to die in their hospital and 54 percent less likely to need a ventilator.

Even though flu cases have yet to show up, that is also a concern for healthcare workers.

Dr. Steinshouer said with masking requirements at schools is a positive sign, serving as a deterrent for COVID-19 and respiratory viruses like influenza and RSV.

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