Immunization mandate may have little impact on health care staffing levels

The United States Supreme Court is weighing challenges to a Biden administration vaccination mandate that requires eligible employees at Medicare or Medicaid-funded facilities to be vaccinated or receive an exemption.

The law goes into effect Jan. 27 in 25 states, including Michigan – the other 25 states have challenged the law in court. It will be spread over several months.

Sheria Robinson-Lane, Assistant Professor in the School of Nursing at the University of Michigan, is an expert in palliative and long-term care and nursing administration. His research focuses on the care and support of older people with cognitive or functional impairments, and the ways in which older people cope with changes in health, particularly how adaptive coping strategies affect health outcomes. . She discusses what these mandates might mean for health care staffing levels.

Some fear that immunization mandates may exacerbate already critical employee shortages in nursing homes and long-term care facilities. Is this a valid fear?

Vaccination mandates have been in place in hospitals and nursing homes for some time now with exemptions available. I don’t think a major change in personnel is inevitable.

The staffing of health care organizations that provide direct care is currently a nightmare. In an already stressed area that was experiencing shortages before the pandemic, there was a small exodus at the start of the pandemic. Over the past two years, staffing issues have continued to arise, primarily due to the management of infections among staff and also individuals leaving for perhaps better opportunities. Interestingly, some licensed practical nurses have left healthcare facilities to join staffing agencies where they have the opportunity, in some cases, to earn much more money.

For those who have been infected with COVID-19, some staff have been unable to return due to COVID-related death or disability (long COVID). Currently here in Michigan we have four military medical teams that have been deployed to assist at various hospitals across the state. So worrying about any change in staff, including those that might be precipitated by a vaccination mandate, is valid.

How might vaccine mandates impact hospitals?

They approached vaccinations a little differently. Vaccine was required there, exemptions were also available there but perhaps not as readily available, and any unvaccinated staff were put on leave. So I think the majority of the staffing effects with respect to hospitals have probably happened already.

Additionally, nursing home and hospital staff found that widespread immunization mandates limited the employment options available. One of the persistent arguments for vaccination has been increased immunity and limited community spread of COVID. Omicron seems to change that narrative a bit.

What does this mean for healthcare facilities that do not accept Medicare and Medicaid dollars?

The vast majority of healthcare organizations accept Medicaid and Medicare dollars, but until now, organizations that do not accept CMS funds still follow the same COVID-related protocols.

Looks like you are saying worker shortages were problematic long before COVID. Is there a solution ?

I’m not sure if there is a great solution at this point. The virus will continue to mutate and with Omicron’s incredible rate of transmission, it is likely that it has already done so. Both the vaccinated and the unvaccinated get sick and potentially expose the patients they care for. Weekly testing for unvaccinated staff is expensive and unsustainable in the long run, but due to the sadly high level of groundbreaking infections, most organizations, at least in long-term care, have reverted to weekly testing for everything. the staff. In the current situation, I don’t know if the vaccines are going to make a big difference.

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