We may be days away from finding ourselves between a rock and a hard place. We need nurses. And not just here. It’s a nationwide problem.

Al Tomkins of the Poynter Institute for Media Studies has been tracking print coverage of COVID. According to his blog on Monday, the American Health Care Association and the National Center for Assisted Living say:

— Nearly every nursing home (99%) and assisted living community (96%) in the U.S. is facing a staffing shortage.

— Nearly every nursing home and assisted living community is asking staff to work overtime or extra shifts. 58% of nursing homes are limiting new admissions due to staffing shortages.

— And 45% of nursing homes say vaccine requirements make recruiting difficult.

Add to the mix that several states set Monday as the deadline for which health care workers face termination if they don’t have at least one COVID-19 shot.

According to Tomkins, as of Friday, about 81% of the health care workers met the vaccine deadline, but thousands of workers are on the edge of losing their jobs.

That pressure has many health care workers throwing up their hands.

Tomkins notes that the The Philadelphia Inquirer has a compelling essay from two veteran nurses who say in decades on the job, they have never seen turnover like they see now.

One of the nurses, Peg Lawson, writes, “I see someone quit every day.”

On Sept. 23, Maureen May, wrote for The Inquirer, “Nurses quite literally have their fingers on the pulse of patient care — and we’re sounding the alarm: There are not nearly enough of us at the bedside. What this means in ERs and on hospital floors in our area, throughout the state and even across the nation, is that nurses, already physically and emotionally drained from a year and a half on the front lines of a pandemic, are being asked to care for more patients than is safe for either the patient or the nurse. … When this happens — when nurses are routinely required to care for more patients than is safe — it’s called chronic nurse short-staffing, and care suffers. Nurses suffer, too.”

Two weeks ago, VTDigger and the Valley News reported that Dartmouth-Hitchcock Medical Center in Lebanon, New Hampshire, the largest hospital in our region, was seeking to fill about 730 positions in Lebanon alone, according to its website. According to the report, “Smaller hospitals around the Upper Valley also are seeking dozens of workers. The shortage is especially acute in nursing but also is apparent in sectors such as food and janitorial services, and in various technology positions.”

Meanwhile, the Associated Press on Monday reported that hospitals and nursing homes around the U.S. are bracing for worsening staff shortages as state deadlines arrive for health care workers to get vaccinated against COVID-19.

With ultimatums taking effect this week in states like New York, California, Rhode Island and Connecticut, the fear is that some employees will quit or let themselves be fired or suspended rather than get the vaccine, the AP wrote.

“How this is going to play out, we don’t know. We are concerned about how it will exacerbate an already quite serious staffing problem,” said California Hospital Association spokesperson Jan Emerson-Shea, adding that the organization “absolutely” supports the state’s vaccination requirement.

New York health care employees had until the end of the day Monday to get at least one dose, but some hospitals had already begun suspending or otherwise taking action against holdouts.

According to the AP, some New York hospitals prepared contingency plans that included cutting back on noncritical services and limiting nursing home admissions. The governor also drew up plans to summon help from National Guard members with medical training, retirees 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 often must submit to regular COVID-19 testing.

States that have set such requirements tend to have high vaccination rates already. The highest rates are concentrated in the Northeast, the lowest ones in the South and Midwest.

The Biden administration is requiring the roughly 17 million workers at health facilities that receive federal Medicare or Medicaid to be fully vaccinated under a rule still being developed.

That has worried some hospital officials, particularly in rural communities where vaccination rates tend to be lower. That is little consolation when the shortage is a real thing right now.

If health care professionals say “no,” the bigger question becomes: What does this part of the pandemic look like with a severe shortage of hospital workers?

We may be about to find out.

(1) comment

John K.

The question in that final paragraph is a penetrating one. What is the greater risk? Unvaccinated staff (who are most likely healthy) caring for patients (who are likely already vaccinated), or insufficient staff to cover all the occupied beds?

The solution is simple: Drop the mandates. It is not the responsibility of the unvaccinated to protect the vaccinated. That’s the vaccine’s job. That may sound harsh, but we either trust the vaccine to work or we don't.

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