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Health care employee vaccine mandate pushes the state's staff shortage to the worst-case scenario

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Last week, the U.S. Supreme Court allowed the federal health care worker coronavirus vaccine mandate to go through. A lower court had put the mandate on pause in late November. Now any employee, volunteer, or contractor working at health care facilities receiving Medicaid or Medicare funding have to be fully vaccinated or provide an exemption by Feb. 28.

Leading Age and Wyoming Hospital Association President Eric Boley told Wyoming Public Radio's Kamila Kudelska they expect to see staff shortages in hospitals and nursing homes border to border in the state.

Eric Boley: I mean, potentially, and it's all a worst-case scenario. The guidance just came out. And we've got until mid-February to get the first shot and then March to get the second shot. But potentially worst-case scenario, as we have nursing homes that don't have enough staff, [we] might have to start finding places to discharge residents.

We could have hospitals that continue to struggle. I mean, we already have enough beds in the state, I think, to handle surges. But we don't have enough staff to staff those beds. And so as the numbers continue to climb, and I see that I think we're up to 90 [hospitalizations], as of yesterday, which is an increase of 30, over almost just last week, there's obviously the concern that we're gonna have Omicron and have all these surges.

And then we're gonna have shortages and not enough beds. And the problem is, it's regional. So our normal transfer patterns, whether we get help from Colorado, or we get help from Montana, or Utah, they're going to be facing the same issues in those states. And I'm afraid we're going to be back to where we were, maybe not worse, potentially when we were just a couple months ago.

Kamila Kudelska: Is there any solution? Is there any way of trying to get nurses or health care workers to stay? Anything that maybe the Wyoming Hospital Association is talking about trying to do or hospitals themselves or nursing homes?

EB: Well, we've worked closely with the governor's office over the last several months, and we've been able to push out additional funding to help retain staff, with bonuses and other things. And hopefully, that might help. Ultimately, though, this comes down to personal choice of health care workers. And, the association, I think the hospitals and nursing homes, all feel that the vaccine is really a strong solution to this problem, and will help get us through this. I don't think it's the be-all and end-all. But we're still hoping people will do the right things.

And I guess the one thing is, is that these workers, if they decide that vaccines is not the way they're going to go, it's not like they can go somewhere else and get a job. Because the entire country is under the same rules, but trying to get in traveling staff, we've been trying to do that. And it's very, very difficult, because they're in short supply, also, and we're competing with all the other states. And so our hope is that we won't see a huge migration of workers leaving the industry. But the fears are, and we've heard that there will be several, if not many, that will choose, to leave health care, as opposed to getting vaccinated.

KK: And then, you mentioned that hospitals, especially with surges that seem to be coming up, how long do you think, is it even possible for them to sustain their impact of care while having such a staff shortage?

EB: It's pretty heartbreaking, I think of the sacrifices that they've all made and how hard they've all worked. And we're already at a point where they're extremely burned out, they've been working seven days on and putting in extra hours because we're already short-staffed. And so this just exacerbates that problem. And then, you talk about the impact, but we're already feeling the impact there. Surgeries and other things are being canceled right now because the staff is needed to treat the COVID patients that are being seen in our facilities. And so other people's health care, those that don't have COVID, but need health care has already been impacted because of this.

And, I just see that continuing to get worse if we start seeing the additional shortages of staff. We're going to have to decide where we can most successfully use those staff members. And so folks that normally are in surgery are now being used on the acute care floor to treat COVID patients and so surgeries are going away. And so it's a domino effect on health care as a whole and I can see that getting worse before it gets better.

KK: And then when you mentioned the nursing facilities that some of them might have to just transfer the patients. Where would the patients go? Where would the residents go?

EB: That's the tough part because to transfer, to discharge a patient from a nursing home, you got to have another safe place for them to go in. Nursing homes already have pretty high levels of occupancy. And so realistically where are they going to go? The problem is more than likely, and unfortunately, it's the wrong place.

But there's a chance they may have to go to hospitals, which again exacerbates the situation we're already in. But if they can't be discharged and sent to another nursing facility because that nursing facility, either doesn't have the ability to have a bed or there aren't any, then we got to find other places and hospitals end up being kind of that safe safety net.

KK: Would hospitals even be able to handle that?

EB: Well, hospitals are pretty resilient. They find ways to do it. But no, I mean, it's gonna make it really, it'll make it really difficult. I mean, you've identified what problems potentially exist here, depending on what we see as far as the workforce. And we're already struggling with it. And so these are big concerns before the mandate, and I think they've only become more acute. Now that the mandates have been upheld.

KK: Long-term health care has always been a sore point for Wyoming. It's been hard. And so this is kind of just increasing that, it seems like.

EB: I mean, we've got fantastic nursing homes in our state, but we also have an aging population and so as we look to the future, nursing homes are going to become even more important in every one of our communities.

But as far as staffing is concerned, and having enough staff we've been struggling for years to find enough help. And then you throw in the mix with what we're dealing with now. And we're already seen where the directors of nursing are working instead of doing their administrative duties and the nursing home administrators that have nursing homes that have nursing licenses or working 10-hour shifts right alongside all hands on deck right now. And that's only sustainable for a short period of time.

There's so many other things that have to be done and then people can't continue to work the hours they're working right now. It's just not sustainable.

Kamila has worked for public radio stations in California, New York, France and Poland. Originally from New York City, she loves exploring new places. Kamila received her master in journalism from Columbia University. In her spare time, she enjoys exploring the surrounding areas with her two pups and husband.
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