Why Health-Care Workers Are Quitting in Droves

The moment that broke Cassie Alexander came nine months into the pandemic. As an intensive-care-unit nurse of 14 years, Alexander had seen plenty of “Hellraiser stuff,” she told me. But when COVID-19 hit her Bay Area hospital, she witnessed “death on a scale I had never seen before.”

Last December, at the height of the winter surge, she cared for a patient who had caught the coronavirus after being pressured into a Thanksgiving dinner. Their lungs were so ruined that only a hand-pumped ventilation bag could supply enough oxygen. Alexander squeezed the bag every two seconds for 40 minutes straight to give the family time to say goodbye. Her hands cramped and blistered as the family screamed and prayed. When one of them said that a miracle might happen, Alexander found herself thinking, I am the miracle. I’m the only person keeping your loved one alive. (Cassie Alexander is a pseudonym that she has used when writing a book about these experiences. I agreed to use that pseudonym here.)

The senselessness of the death, and her guilt over her own resentment, messed her up. Weeks later, when the same family called to ask if the staff had really done everything they could, “it was like being punched in the gut,” she told me. She had given everything—to that patient, and to the stream of others who had died in the same room. She felt like a stranger to herself, a commodity to her hospital, and an outsider to her own relatives, who downplayed the pandemic despite everything she told them. In April, she texted her friends: “Nothing like feeling strongly suicidal at a job where you’re supposed to be keeping people alive.” Shortly after, she was diagnosed with post-traumatic stress disorder, and she left her job.

Since COVID-19 first pummeled the U.S., Americans have been told to flatten the curve lest hospitals be overwhelmed. But hospitals have been overwhelmed. The nation has avoided the most apocalyptic scenarios, such as ventilators running out by the thousands, but it’s still sleepwalked into repeated surges that have overrun the capacity of many hospitals, killed more than 762,000 people, and traumatized countless health-care workers. “It’s like it takes a piece of you every time you walk in,” says Ashley Harlow, a Virginia-based nurse practitioner who left her ICU after watching her grandmother Nellie die there in December. She and others have gotten through the surges on adrenaline and camaraderie, only to realize, once the ICUs are empty, that so too are they.

Some health-care workers have lost their jobs during the pandemic, while others have been forced to leave because they’ve contracted long COVID and can no longer work. But many choose to leave, including “people whom I thought would nurse patients until the day they died,” Amanda Bettencourt, the president-elect of the American Association of Critical-Care Nurses, told me. The U.S. Bureau of Labor Statistics estimates that the health-care sector has lost nearly half a million workers since February

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Professional medical ethicists argue for obligatory vaccination for well being treatment workers

The authorized foundation for necessitating vaccination is not considered controversial.

“Specified existing facts about COVID-19 vaccines and recent EEOC/CDC guidelines, the dilemma faced by healthcare corporations … is not so much no matter whether vaccination can be mandated lawfully, somewhat no matter if it is ethically justifiable to do so,” wrote a coalition of medical doctor-authors in a Culture of Essential Medication weblog post previous summertime.

For a staff of healthcare ethicists composing in the newest issue of the journal Mayo Clinic Proceedings, the responsibility of health treatment personnel to get vaccinated is an effortless call as nicely.

“You don’t want to expose clients … who are by definition vulnerable especially if they are in the ICU, to the threat of having COVID,” states Robert S. Olick, Affiliate Professor Emeritus, the Center for Bioethics and Humanities SUNY Upstate Medical University.

As co-writer of “Moral Difficulties in Mandating COVID-19 Vaccination for Health Treatment Personnel,” Olick says the foundation for demanding vaccination will come down to better superior.

“There’s very clear evidence supporting the plan that vaccination is significant and will work to shield the wellness treatment institution, the group and surrounding community in opposition to infection with a really contagious and potentially lifetime-threatening virus and disease. So the rationale of shielding the better excellent for the higher amount outweighs respect for specific choice to say no, I you should not want to be vaccinated.”

Olick suggests a common counter-argument that the vaccinated will need not worry about the unvaccinated is weakened by the reality of breakthrough infections and large percentages of immunocompromised patients not completely shielded by vaccination.

He saves a sharp critique for those who would depict the refusal to acquire a vaccine as an expression of specific alternative.

“While I would strongly assist the ideal of everybody to make their own health care conclusions,” he claims, “freedom to pick out and to opt for not be vaccinated ends when hazard of hurt to other folks begins. In other text, you can make that decision, but there are opportunity penalties for refusing vaccination.”

Of those people who deal with getting fired, he suggests this:

“I would characterize that form of circumstance as unfortunate but not unfair.”

“What from time to time is lacking is the concept that while you may well have a appropriate to say no to vaccination, you do not have a suitable to put other individuals in harm’s way.”

ICU beds at capacity

Ethcists say the refusal by health care workers to get vaccinated creates an undue burden on those who must work overrun, understaffed hospitals and ICU's, a phenomenon now affecting over one half of the state. (Graphic: Minnesota Department of Health)

Ethcists say the refusal by well being treatment employees to get vaccinated creates an undue load on people who have to do the job overrun, understaffed hospitals and ICU’s, a phenomenon now influencing around just one half of the point out. (Graphic: Minnesota Division of Health)

Statewide, 55 of 91 staffed ICUs are efficiently maxed out In Minnesota, with less than 5% of beds accessible. As for non-urgent beds, 65 of 130 of all non-ICU beds are at capacity as very well.

At 1,159 individuals hospitalized with COVID-19 in the condition,

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Winston Medical Center CEO fears even more healthcare workers could quit over Medicare & Medicaid vaccine rule

LOUISVILLE, Miss. (WCBI) – November 1st was the deadline for staff at Baptist Memorial Healthcare and University of Mississippi Medical Center in Jackson to get the COVID-19 vaccine.

However, smaller hospitals like Winston Medical Center are still bracing for a decision by the Centers for Medicare & Medicaid Services.

“I do anticipate we will have some people that will leave if this comes down,” says Winston Medical CEO Paul Black. “We’ll just have to adjust to it when it happens.”

That is the reality facing Winston Medical and those like it as they await the expected CMS ruling requiring their employees to get their COVID shots.

“To say the least, I’m a little bit concerned,” Black says. “We haven’t had 100 percent participation with the vaccine here by our employees or associates. Last I checked, it’s somewhere around the 55 percent range.”

In early September, CMS expanded their vaccination requirement for all healthcare facilities receiving their funding. To do that, they are changing their Conditions of Participation.

“We’re going to have to comply and we won’t have a choice,” Black says. “There’s not a healthcare facility or operation that I can think of that can operate without the Medicare & Medicaid funding.”

The rule requiring vaccination for workers at Medicare & Medicaid facilities has passed a White House review and takes effect as soon as it is published in the Federal Register.

“When the ruling first came out that was only related to long-term care facilities, there was concern there for us too,” Black says. “Because we have a long-term care facility that we (worried) would have a whole (lot) of people just leave and go work somewhere else in healthcare.”

Now he fears the same thing will happen on an even larger scale.

“The concern is that there are going to be some portions of the healthcare market will just say, ‘To heck with it, I’m getting out of health care, I’ll go work somewhere else,’” Black says.

The CEO expects it to be the latest blow to an already dwindling workforce.

“We’re hoping that as the virus wanes throughout the country, that a lot of these healthcare workers that have gotten a contract and gone somewhere else will come back to the state and things will kind of level out,” he says. “But, we may be in a position where it may never come back to normal.”

After CMS proposes a rule change, there is a 45 to 60-day period to gather feedback before the rule is finalized.

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Maine Court Upholds Vaccine Mandate for Healthcare Workers

A unanimous panel of the U.S. Court of Appeals for the First Circuit recently affirmed the Maine District Court’s denial of a motion for a preliminary injunction challenging Maine’s COVID-19 vaccination mandate for health care workers.[1] The plaintiffs, a group of unvaccinated health care workers, raised constitutional and statutory challenges to the mandate in their requests for a temporary restraining order and preliminary injunction. In its decision, the First Circuit emphasized the validity of Maine’s purpose in issuing the mandate and emphasized a state statute that sets this matter apart from similar challenges throughout the country.

In May 2019, the Maine legislature enacted a statute that disallowed religious or philosophical exemptions from all vaccine mandates.[2] The law took effect in early 2020 after nearly three-quarters of voters rejected a referendum opposing the law.

In managing the COVID-19 pandemic, Maine faces two issues that factor seriously into its risk profile: the largest population of elderly citizens by the percentage of any state in the country and a limited health care workforce. Public health authorities in Maine, therefore, sought to reach a vaccination rate of 90% to stop community spread and protect its most vulnerable residents. Despite several efforts to encourage and incentivize vaccination, the state was unable to reach its 90% goal. As the Delta variant emerged, the state deemed the number of outbreaks occurring in health care facilities unacceptable. On August 12, 2021, the state issued a vaccine mandate for all workers in licensed health care facilities. The mandate, which included only a medical exemption, did not include a religious exemption for on-site employees per the above-mentioned 2019 statute.

With the enforcement of the mandate set to begin on October 29, 2021, plaintiffs sought relief by way of a temporary restraining order and preliminary injunction, both of which the District Court denied. On appeal, the First Circuit affirmed the lower court and rejected the appellants’ constitutional challenges. Under the First Amendment Free Exercise clause, the court subjected the mandate to rational basis review after determining that it was facially neutral and generally applicable. The mandate’s medical exemption furthers Maine’s interest in protecting the health of its most vulnerable residents, the court determined, whereas a religious exemption would defeat that purpose. In declining to apply strict scrutiny, the court wrote, “Few interests are more compelling than protecting public health against a deadly virus.”

The court put litigants in other states on notice by distinguishing why the Maine plaintiffs’ challenge failed whereas challenges elsewhere succeeded. In New York, for example, a group of similarly aligned plaintiffs succeeded in challenging a comparable vaccine mandate for health care workers.[3] There, the district court granted a preliminary injunction on the grounds that New York eliminated its religious exemption after promulgating the mandate.

While the broader implications of the First Circuit’s decision remain unknown, employers in the health care sector should track their state’s public health authorities closely as new mandates roll out across the country. As the Delta

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