By Heather Hollingsworth and Tammy Weber
Hospitals and nursing homes around the US are forced to meet staff shortages as the state’s deadline approaches for health care workers to get vaccinated against COVID-19.
With ultimatums going into effect this week in states like New York, California, Rhode Island and Connecticut, fears are that some workers will quit or find themselves fired or suspended instead of getting the vaccine.
“How this is going to play out, we don’t know. We are concerned about how this will exacerbate an already quite serious staffing problem,” said Jan Emerson-Shea, a spokesman for the California Hospital Association, adding that the organization “Absolutely” supports the state’s vaccination requirement.
New York health care workers had until the end of the day to take at least one dose on Monday, but some hospitals had already begun suspending or otherwise taking action against holdouts.
Erie County Medical Center Corp in Buffalo said that along with 20% of its nursing home staff, about 5% of its hospital staff have been placed on unpaid leave for not being vaccinated. And Northwell Health, the state’s largest health care provider, said it had begun removing unvaccinated workers from its system, though it said its workforce is nearly 100% vaccinated.
“For those who haven’t made this decision yet, please do the right thing,” said New York Gov.
Some New York hospitals devised contingency plans that included cutting non-critical services and limiting admissions to nursing homes. The governor also devised a plan to seek help from members of the National Guard with medical training, retired or vaccinated workers from outside the state.
About a dozen states have vaccination mandates covering health care workers in hospitals, long-term care facilities, or both. Some allow exemptions on medical or religious grounds, but those employees will often have to submit to regular COVID-19 testing.
States that have set such requirements already have high vaccination rates. The highest rates are concentrated in the Northeast, with the lowest in the South and Midwest.
The Biden administration would also require the nearly 17 million workers at health facilities that receive federal Medicare or Medicaid to be fully vaccinated under a rule still being developed.
This has worried some hospital officials, especially in rural communities where vaccination rates are low.
“We are seeing a need to reallocate staff, in some cases only to maintain essential services, and there are going to be some delays,” said Troy Bruntz, president and CEO of Community Hospital in McCook, Nebraska. .
He said 25 of the hospital’s 330 staff said they would definitely resign if they needed to be vaccinated. Of the nearly 100 unvaccinated workers, the remainder – a group that includes nurses as well as cleaning and maintenance workers – have decided not to.
He also worries that hiring new staff will be difficult when the hospital is already small.
“It doesn’t make us feel very confident that this is going to be nothing less than a nightmare for American health care,” he said.
Many hospitals and nursing homes are already facing staff shortages as many nurses and others have left jobs as a result of pandemic-related burnout or traveled from state to state for lucrative jobs.
White House Press Secretary Jen Psaki noted that hospitals in Houston and Maine recently lost relatively small numbers of staff after requiring vaccinations.
“We are seeing in many places that it is working, it is effective. It is creating more certainty and security in their workforce,” Saki said.
In California, where health care workers have until Thursday to fully vaccinate, some hospitals are anticipating firing, suspensions or other positions of people, Emerson-Xi said. She said many traveling nurses have declined assignment in California because of the state’s vaccine requirement.
But with the statewide mandate, health workers will not be able to leave their jobs and go to other hospitals, said Dr. Jeff Smith, chief operating officer and executive vice president of hospital operations at Cedars-Sinai Medical Center in Los Angeles. .
He expects about 97 percent of Cedars-Sinai’s roughly 17,000 employees affected by the vaccine mandate will adhere to the deadline. Another 1 percent have applied for a medical or religious exemption. Those who don’t comply by Friday will be suspended for a week, and fired on October 8 if they don’t comply or if the circumstances are mitigating, he said.
The hospital was able to hire over 100 nurses last month and uses some travel nurses.
“We’re in a good place, but don’t want to downplay the challenges other hospitals are facing,” Smith said.
In Rhode Island, where the vaccine mandate takes effect Friday, the state said hospitals could allow unvaccinated workers to work 30 days before the deadline, where firing them would compromise patient safety. The mandate is being challenged in court because it does not allow religious exemptions.
In the states which do not have the mandate, some hospitals are imposing their own.
Ginger Robertson, a registered nurse working in a mental health clinic at a hospital in Bismarck, North Dakota, has requested a religious exemption from her hospital’s vaccination requirement. She said that if she could not find it, she would look for another job.
“To be honest, I love my job. I’m doing it well. I enjoy my patients. I enjoy being where I am,” she said. “So it’s a really tough place , have to choose between two things I don’t want to do. I don’t want to quit, and I don’t want to get vaccinated. “
She said other nurses are also considering calling it an “outrageous” mandate.
“We feel hopeless, as if we are not intelligent enough to make these choices for ourselves,” Robertson said.
A North Carolina-based hospital system announced Monday that more than 175 of its more than 35,000 employees have been fired for failing to comply with its COVID-19 vaccination requirement.
Last week, Novant Health announced that 375 workers had been suspended and given five days to comply. Spokesperson Megan Rivers said about 200 of them did so – including those who submitted approved exemptions – before the Friday deadline.
Massachusetts’ mandate, issued by Republican Gov. Charlie Baker, applies only to rest homes, assisted living facilities, hospice programs, and home care programs. It allows medical and religious exemptions but does not require routine testing. Deadline is 31 October.
In Connecticut, a vaccine mandate for employees of government hospitals went into effect Monday. This does not apply to privately run hospitals, some of which are imposing their own requirements. Medical and religious exemptions are possible, but anyone who fails to be vaccinated will be barred from the workplace.
As of Wednesday, about 84% of the more than 450,000 hospital workers in New York had been fully vaccinated, according to state figures. Nursing home data as of Sunday showed that about 89 per cent of nursing home workers have been fully vaccinated.
New York City’s hospital system reported a 95% vaccination rate for nurses and a higher rate for doctors.
In Missouri, which became a serious COVID-19 hot spot over the summer, the Mersey hospital system is requiring vaccination among staff at hundreds of its medical centers and clinics in Missouri and neighboring states as of Thursday.
Mercy spokeswoman Bethany Pope said anyone who did not comply by that time would be placed on an unpaid 30-day suspension.
Weber reported from Fenton, Michigan and Hollingsworth from Mission, Kansas. Philip Marcelo and Mark Pratt in Boston; Michael Melia in Hartford, Connecticut; Michael Hill in Albany, New York; Skip Foreman in Charlotte, North Carolina; and Zeke Miller in Washington contributed to this story.
This story was first published on September 27, 2021. It was updated on September 30, 2021, to correct the title of Dr. Jeff Smith to Chief Operating Officer instead of CEO.