COVID-19 Surge

Vaccine vex: Mandates could hamper staffing shortages at Phoenix hospitals

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Phoenix hospitals are being hammered by a third surge of COVID-19 as they continue to work amid severe staffing shortages. But medical professionals and experts worry those long-running shortages may only be further hampered by hospitals’ vaccine mandates, which require employees to get vaccinated against the virus as a condition of employment.

Several Valley health care systems have issued the mandate, including Banner Health, Valleywise Health and the Mayo Clinic. National data shows that 97% of recent hospitalizations and 99% of deaths are among the unvaccinated.

Banner Health, Arizona’s largest health care system, became the first provider in the state to mandate the vaccine for its employees. Banner staffers were told they must receive one of the three approved COVID-19 vaccines — Pfizer, Moderna or Johnson & Johnson — by Nov. 1 or find a new place to work. The FDA gave Pfizer its full approval on Monday.

Dr. Marjorie Bessel, Banner’s chief clinical officer, addressed the vaccine mandate and the organization’s staffing issues at a news conference last Wednesday.

“As I’ve shared previously, it is our intent to have all of our team members continue along with us,” she said. “And we will be working with all of those if they have a medical or religious exemption to help them through that process. Our intent is to keep all of our team members with us.”

Bessel admitted staffing continues to be a concern for Banner leadership, which has prompted Banner to implement creative solutions. Because of its rising patient volume, corporate employees with clinical credentials are now able to sign up for shifts in the hospitals, including at patients’ bedsides.

“Staffing will remain one of our greatest challenges during the pandemic,” said Bessel. “We continue our efforts to fill core positions as well as bring in travel nurses and respiratory therapists to provide support this fall and winter.”

Staffing, particularly among physicians and skilled nurses, was a sore spot in Arizona long before the pandemic hit the state.

According to NurseJournal, Arizona in 2018 had 75,600 registered nurses for its population of 7.2 million people. That’s just 10.39 nurses for every 1,000 people. Similarly, the Life Science division of global research firm IHS Markit predicts the United States will need an astounding 121,900 primary care and specialty doctors by 2032.

Dr. Michael White, chief medical officer with Valleywise Health, said during a Wednesday news conference the health system currently has more than 400 open positions, approximately 160 of which are nursing positions.

As a result, Valleywise is relying on traveling nurses and other temporary team members to help fill the gap.

But with COVID hospitalizations once again on the rise, resources are dwindling.

“We want to be able to meet those needs of patients, as they’re coming into the organizations in a timely fashion,” said Dr. White. “As you increase the number of COVID-positive patients, it decreases those available resources.”

Valleywise has not yet been forced to divert patients to any other local hospitals, but it is something officials are prepared to do if necessary, he continued.

As the pandemic worsens, vaccinations are on the rise, too. Just more than 1,000 of Valleywise’s over 4,000 employees still needed to get vaccinated against COVID-19 as of last week, said White. Like Banner, Valleywise is making exceptions for employees who can’t get vaccinated for medical or religious reasons.

“We have seen an increase in those folks that had not previously been vaccinated at work within our organization now seek out and get that vaccine to be prepared for our deadline of being fully vaccinated within the organization by Nov. 1,” he announced.

While Valleywise is making strides thanks to its mandate, Holly Ward, a spokesperson for the Arizona Hospital and Health Care Association, said it’s too soon to tell what the mandates will mean for staffing in the long run as due dates are still a ways away. But Ward said her organization’s main concern was staffing, as nearby states are pulling from the same roster of resources as Arizona.

“If staff is not able to get vaccinated or not willing to get vaccinated, that is going to put a tremendous strain on staffing levels,” she said. “That’s really our primary concern, because we’re trying to look for staffing solutions, but as you can imagine as other states experience the same thing, that pool of traveling nurses for example, is very small to start with and then if they choose to go to other states, that’s what we’re concerned about.” Ward said the association supports vaccine mandates, as the vaccines have been proven safe and effective, but time will tell what they do to an already struggling system.

“We are hearing from our rural hospitals that are experiencing a significant surge in hospitalizations, not just with COVID patients but also other emergency care, that it is a challenge to make sure that we’re mindful of our staff that is tired,” she said. “They have been the frontline of the response continually where some of us have been able to kind of take a break. They’ve been continually working and caring for anyone that comes through their door.”

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