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HCW staffing crisis


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5 hours ago, TechWife said:

Exactly! In some areas of the country, like mine, the staffing shortage, especially RN’s has been in full swing for years now. The people who didn’t see this coming didn’t WANT to see it coming. If you want qualified health care workers, then education opportunities must be there for them, period. At our community college, entry into the AS/RN program has been competitive for a long time. Think about that - a competitive community college program.  I’m not entirely sure, but I imagine the words competitive and community college aren’t often used together. Public funding is important to public health, full stop. 

Exactly. I tell this to everyone I know: It was more difficult for me to get into nursing school than it was for me to get into Stanford Law School (if you go based on # of applicants vs # accepted, it is worse than any medical school in the nation). I was rejected by Western Governors twice before I was admitted and my TEAS score was well over the 99% -- I scored 94.6 https://www.ppcc.edu/application/files/4215/6678/1303/ATI_ADN_Scores_as_of_late_Jan_2019.pdf.

I was basically told by the San Diego State admissions rep not to even bother applying because I didn't have a 4.0 in my science pre-reqs. He said that the average admitted student had a 4.0 in science and a 3.92 overall. I graduated magna cum laude/Phi Beta Kappa from a top 10 liberal arts college, am a SLS grad, had a three page resume of international experience at top law, consulting, and finance firms, volunteer healthcare experience in the ED and ICU of a magnet hospital and women's/community health experience at Planned Parenthood, and other volunteer/pro bono legal work for a disability rights organization representing the homeless and setting up domestic violence/crisis houses for women in Moscow, several competitive scholarships (e.g., the Rotary, which sent me to Moscow State University to study constitutional legal development after the fall of the Soviet Union), military service, plus stellar letters of recommendation, including one from a nurse practitioner I took a masters level nursing course with prior to even going to nursing school (I took advanced pathophysiology and advanced pharmacology -- both NP level courses before I went to nursing school), None of that was enough to get me into nursing school right away at WGU or SDSU.

I was admitted to one local community college, but couldn't make the schedule work with homeschooling. Two other local community colleges went by a "points" system and I wouldn't have scored enough points to have been competitive there. For two other community colleges near me, it would have been about 50-50 if I would have been competitive with their points system, so I didn't bother applying.

Now that I have my BSN, in my area, I am competing with close to 1000 applicants for every position because there are so few new grad residencies available to train new nurses at our hospitals.  

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4 hours ago, Frances said:

Of course the vaccine is not 100% (who claimed it was?), but it definitely reduces the likelihood of getting covid and therefore the likelihood of spreading it. Healthcare workers already could refuse the flu vaccine in my state for medical or religious reasons, so that is nothing new. And the other groups do not have other required vaccines, so no other effects for them either.

Have your vaccinated coworkers spread it to others who are now hospitalized or dead?

Yes, there have always been exemptions for the flu etc. My point is that those that previously took those vaccines are now exempt from all vaccines. So not only do we now have HCW that are not taking the covid vaccine they are also exempt from vaccines they would have continued to get prior to the mandates. I don't believe most of these HCF will fire their staff over this. They know they can't afford to so the threats were empty to begin with. There were better ways of encouraging HCW to be vaccinated. How about offering incentives (money, time off, etc..) rather than mandates and threats. HCW have had their fill of emails from administrators over the last 18 months of the latest crap like, no taking time off for the next X amount but, "thanks for all you do" over the past year and a half to not to expect them to dig their heels in over mandates. If incentives had been tried rather than mandates I think we would higher numbers of vaccinated rather than new exemptions.

I do know of at least one young nurse who despite being given a medical  exemption has decided to resign.

I have no idea if any of the vaccinated HCW I work with have spread covid to others. Being that some of them have become infected it's entirely possible. I can say that none of my unvaccinated coworkers have been hospitalized for covid. Several of them had covid prevaccine. 

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6 hours ago, SeaConquest said:

It was more difficult for me to get into nursing school than it was for me to get into Stanford Law School (

Same experience for one of my siblings (though not Stanford). So competitive (and don't get me wrong, it's wonderful to have highly competent nurses, but the pool of such people is higher currently than the number of spots available for them).

3 hours ago, Fritz said:

Yes, there have always been exemptions for the flu etc. My point is that those that previously took those vaccines are now exempt from all vaccines. So not only do we now have HCW that are not taking the covid vaccine they are also exempt from vaccines they would have continued to get prior to the mandates.

Aren't the HCW making that irresponsible decision the ones responsible for that, and not their employers for "making them" not get vaccinated by requiring the covid vaccine? That seems like the kind of response one would expect from a child ("You can't make me").

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2 hours ago, Fritz said:

Yes, there have always been exemptions for the flu etc. My point is that those that previously took those vaccines are now exempt from all vaccines. So not only do we now have HCW that are not taking the covid vaccine they are also exempt from vaccines they would have continued to get prior to the mandates. I don't believe most of these HCF will fire their staff over this. They know they can't afford to so the threats were empty to begin with. There were better ways of encouraging HCW to be vaccinated. How about offering incentives (money, time off, etc..) rather than mandates and threats. HCW have had their fill of emails from administrators over the last 18 months of the latest crap like, no taking time off for the next X amount but, "thanks for all you do" over the past year and a half to not to expect them to dig their heels in over mandates. If incentives had been tried rather than mandates I think we would higher numbers of vaccinated rather than new exemptions.

I do know of at least one young nurse who despite being given a medical  exemption has decided to resign.

I have no idea if any of the vaccinated HCW I work with have spread covid to others. Being that some of them have become infected it's entirely possible. I can say that none of my unvaccinated coworkers have been hospitalized for covid. Several of them had covid prevaccine. 

I’m not sure where you are getting that now they will be exempt from all vaccines if they claim the medical or religious exemption for the covid vaccine? And if it is true, why would anyone want to employee someone in a healthcare setting who refused all vaccines? Plus, wouldn’t they already have all required vaccines if they are employed? The only one I know of that is additional is the yearly flu vaccine, and as I already stated, at least here the same exemptions already existed for it. 
 

As far as I know, here they wouldn’t even be able to get into any healthcare training program, let alone get a job in healthcare, if they refused all vaccines. Plus, unless their parents never vaccinated them, most would already have the majority of required vaccines.

As for not being fired, I don’t think that is an option here as the mandates are not from the employer, but the state. They will not be allowed to work. And they are not just for healthcare employees, but also educators and state government employees. Many places did offer $ incentives, flexible scheduling for the vaccine, on-site vaccination clinics, time off if needed for the shot and recovery, etc. Maybe it’s different where you live, but all of that and more (lottery for vaccinated) was available here.

Edited to add that both my husband and I are mandated to vaccinate, so this is not hypothetical for me. I used paid SL for both the shots and for recovery as needed. I also received a financial incentive (announced after I was already vaccinated). I was also automatically entered into the state vaccine lottery, but did not win one of the prizes. 
 

I have to say I find your views as a healthcare worker interesting. My husband and his close coworkers/friends were ecstatic when the vaccine became available and they were first in line and they were very proud that their employer led the way on vaccinating the public and happily volunteered for extra shifts to work at mass vaccination sites. Sure, as HCWs there have been lots of stressors and things they haven’t always liked during the pandemic, but the vaccine was most definitely not one of them. As for the mandate, it’s about time was the overwhelming response.

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1 hour ago, KSera said:

Aren't the HCW making that irresponsible decision the ones responsible for that, and not their employers for "making them" not get vaccinated by requiring the covid vaccine? That seems like the kind of response one would expect from a child ("You can't make me").

So much this. The same for her phrase of “digging in their heels” over mandates. It seems like a pretty childish reaction to something they should already have done anyway to protect the health and well being of themselves, their coworkers, their patients, etc.

It’s the same feeling I have when I hear about unvaccinated people who aren’t subject to a mandate saying that no one can tell them what to do. Of course that is true, but it sure seems like a pretty immature way to view the overwhelming advice of medical and public health officials to get vaccinated.

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1 hour ago, Frances said:

I’m not sure where you are getting that now they will be exempt from all vaccines if they claim the medical or religious exemption for the covid vaccine? And if it is true, why would anyone want to employee someone in a healthcare setting who refused all vaccines? Plus, wouldn’t they already have all required vaccines if they are employed? The only one I know of that is additional is the yearly flu vaccine, and as I already stated, at least here the same exemptions already existed for it. 
 

As far as I know, here they wouldn’t even be able to get into any healthcare training program, let alone get a job in healthcare, if they refused all vaccines. Plus, unless their parents never vaccinated them, most would already have the majority of required vaccines.

As for not being fired, I don’t think that is an option here as the mandates are not from the employer, but the state. They will not be allowed to work. And they are not just for healthcare employees, but also educators and state government employees. Many places did offer $ incentives, flexible scheduling for the vaccine, on-site vaccination clinics, time off if needed for the shot and recovery, etc. Maybe it’s different where you live, but all of that and more (lottery for vaccinated) was available here.

Edited to add that both my husband and I are mandated to vaccinate, so this is not hypothetical for me. I used paid SL for both the shots and for recovery as needed. I also received a financial incentive (announced after I was already vaccinated). I was also automatically entered into the state vaccine lottery, but did not win one of the prizes. 
 

I have to say I find your views as a healthcare worker interesting. My husband and his close coworkers/friends were ecstatic when the vaccine became available and they were first in line and they were very proud that their employer led the way on vaccinating the public and happily volunteered for extra shifts to work at mass vaccination sites. Sure, as HCWs there have been lots of stressors and things they haven’t always liked during the pandemic, but the vaccine was most definitely not one of them. As for the mandate, it’s about time was the overwhelming response.

You may be right that it is just the flu vax. I assumed that if you won't take one vax religious or medical reasons you would be exempt from others. I know I have heard some of them saying they won't be required to take the flu vax any more. I don't agree with mandates and would prefer that they, and all HCW, be allowed to make their own decisions regarding these vaccines. I feel like if they had not made the mandates that, in time, they may decide to get the vaccines. Now with exemptions in hand it's not likely. As far as you finding my views as a healthcare worker interesting. I don't think it's really my business whether or not my coworkers take the vaccine. I will be wearing my PPE all day every day anyway. It's worked well for me so far. No covid here.

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1 hour ago, Fritz said:

I don't agree with mandates and would prefer that they, and all HCW, be allowed to make their own decisions regarding these vaccines. I feel like if they had not made the mandates that, in time, they may decide to get the vaccines. Now with exemptions in hand it's not likely. As far as you finding my views as a healthcare worker interesting. I don't think it's really my business whether or not my coworkers take the vaccine. I will be wearing my PPE all day every day anyway. It's worked well for me so far. No covid here.

The evidence is exactly the opposite. They've had almost a year to do the right thing. 5.2 billion shots have been given worldwide, enough to fully vaccinate 34% of the global population and yet these lunatics continue to prefer cattle dewormers and fringe conspiracy theories on YouTube to practicing evidence-based medicine. There have been tons of incentives to coax people, and it is insanity to keep doing the same thing over and over and expect different results while people are dying everyday and our healthcare system is collapsing. The carrots haven't worked; time for the stick. 

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1 hour ago, Fritz said:

You may be right that it is just the flu vax. I assumed that if you won't take one vax religious or medical reasons you would be exempt from others. I know I have heard some of them saying they won't be required to take the flu vax any more. I don't agree with mandates and would prefer that they, and all HCW, be allowed to make their own decisions regarding these vaccines. I feel like if they had not made the mandates that, in time, they may decide to get the vaccines. Now with exemptions in hand it's not likely. As far as you finding my views as a healthcare worker interesting. I don't think it's really my business whether or not my coworkers take the vaccine. I will be wearing my PPE all day every day anyway. It's worked well for me so far. No covid here.

At least in my state, the covid vaccine mandate is not linked to any other vaccines and the process for getting a medical or religious exemption is through the state and not related to any other vaccine mandate/exemption an employer might institute like the flu vaccine. It’s also the state saying that unvaccinated employees cannot work, not the employer. I suppose it is up to the employer whether the unvaccinated are fired or placed on unpaid leave, but they can’t allow them to work unvaccinated per state regulations.

Among our unvaccinated coworkers, my husband and I hadn’t seen any indication that people would eventually get vaccinated. With Delta surging and vaccine approval, if not now, when, especially for HCWs? The reasons we heard were all of the misinformation and conspiracy theory type, so this far into it, the chance of them accepting factual information seems slim. We do fully expect the majority to lie to get exemptions, just as the majority of unvaccinated people here lied and stopped wearing masks when the mandate was lifted for the vaccinated.
 

 

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1 hour ago, Frances said:

It’s the same feeling I have when I hear about unvaccinated people who aren’t subject to a mandate saying that no one can tell them what to do. Of course that is true, but it sure seems like a pretty immature way to view the overwhelming advice of medical and public health officials to get vaccinated.

The NYT did a short (7-8 minute) video piece called Dying in the Name of Vaccine Freedom. One of the people interviewed was a covid patient in an Arkansas hospital who, when asked why he didn't get the vaccine, literally said "Well I'm more of a libertarian, and I don't like being told what to do." He died a few days later, at the age of 53. Because nothing says "you're not the boss of me" like choosing to die a slow, painful, easily preventable, and totally pointless death. 

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6 minutes ago, Corraleno said:

The NYT did a short (7-8 minute) video piece called Dying in the Name of Vaccine Freedom. One of the people interviewed was a covid patient in an Arkansas hospital who, when asked why he didn't get the vaccine, literally said "Well I'm more of a libertarian, and I don't like being told what to do." He died a few days later, at the age of 53. Because nothing says "you're not the boss of me" like choosing to die a slow, painful, easily preventable, and totally pointless death. 

I saw the same piece, and it was so sad. And what you say is what I can't get over. People think they are some how showing they won't be "owned" by holding out and not getting vaccinated, but in the end, it's the ultimate, most tragic owning of them by the politicians and conspiracy theorists who influenced them. They're dying for those people. Just awful 😞.

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4 hours ago, Fritz said:

You may be right that it is just the flu vax. I assumed that if you won't take one vax religious or medical reasons you would be exempt from others. I know I have heard some of them saying they won't be required to take the flu vax any more. I don't agree with mandates and would prefer that they, and all HCW, be allowed to make their own decisions regarding these vaccines. I feel like if they had not made the mandates that, in time, they may decide to get the vaccines. Now with exemptions in hand it's not likely. As far as you finding my views as a healthcare worker interesting. I don't think it's really my business whether or not my coworkers take the vaccine. I will be wearing my PPE all day every day anyway. It's worked well for me so far. No covid here.

Hm.  Since health care workers have been mandated to have all the other vaxxes for years, including the yearly flu shot, how can they suddenly claim a religious exemption when they've been fine with all the others.  As you say, if it's a religious thing they should either be all fine, or all not fine. You think they're going to en masse claim a brand-new relgious conversion?  To what religion would that be, anyway?  

They're not going to en masse get medical exemptions.  There just aren't that many people that need them for these vaccines, and you need an actual medical reason.  My kids have actual medical exemptions to some (but far from all!) other vaccines, but happily and without incident got vaccinated for Covid (as well as the other ones that aren't contraindicated for them).  Medical ex. are based on actual health issues and how different vaccines may or may not interact with them.  "I don't wanna" will not get you a medical exemption to a vaccine.

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15 hours ago, KSera said:

Same experience for one of my siblings (though not Stanford). So competitive (and don't get me wrong, it's wonderful to have highly competent nurses, but the pool of such people is higher currently than the number of spots available for them).

Aren't the HCW making that irresponsible decision the ones responsible for that, and not their employers for "making them" not get vaccinated by requiring the covid vaccine? That seems like the kind of response one would expect from a child ("You can't make me").

If someone is afraid of doing something mandating that they do it anyway doesn't seem like a good way to convince them to do so. Yes, I think it made them dig in their heels more. You may choose to judge them for that.

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11 hours ago, SeaConquest said:

The evidence is exactly the opposite. They've had almost a year to do the right thing. 5.2 billion shots have been given worldwide, enough to fully vaccinate 34% of the global population and yet these lunatics continue to prefer cattle dewormers and fringe conspiracy theories on YouTube to practicing evidence-based medicine. There have been tons of incentives to coax people, and it is insanity to keep doing the same thing over and over and expect different results while people are dying everyday and our healthcare system is collapsing. The carrots haven't worked; time for the stick. 

None of the HCW I know "prefer cattle wormers" or any of the other ignorant BS you have ascribed to them. 

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41 minutes ago, Fritz said:

If someone is afraid of doing something mandating that they do it anyway doesn't seem like a good way to convince them to do so. Yes, I think it made them dig in their heels more. You may choose to judge them for that.

If the HCW and support staff at the hospital where I volunteer decide to dig in their heels they will be fired unless they have a legitimate medical or religious objection. There is a review board that reviews all exemption requests and they make the decision as to whether or not the exemption will be granted. That is the same way all vaccines are handled. The deadline for immunization is set several weeks out & during that time occupational health is hosting several talks about the vaccine to educate anyone who wants more information. All hospitals within a one hour drive have adopted the same policy. This means not only will they lose their job, they also will not be able to get a job at another nearby hospital. 

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4 minutes ago, TechWife said:

If the HCW and support staff at the hospital where I volunteer decide to dig in their heels they will be fired unless they have a legitimate medical or religious objection. There is a review board that reviews all exemption requests and they make the decision as to whether or not the exemption will be granted. That is the same way all vaccines are handled. The deadline for immunization is set several weeks out & during that time occupational health is hosting several talks about the vaccine to educate anyone who wants more information. All hospitals within a one hour drive have adopted the same policy. This means not only will they lose their job, they also will not be able to get a job at another nearby hospital. 

I am aware of the protocol. I think you will see many new religious and medical exemptions given. 

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28 minutes ago, Fritz said:

I am aware of the protocol. I think you will see many new religious and medical exemptions given. 

I highly doubt it. There aren’t many medical reasons to decline, nor are there faiths that shun vaccination. The reason the review board is there in my particular instance is to cut through the crap. 
 

 

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On 8/30/2021 at 6:55 AM, Fritz said:

None of the HCW I know "prefer cattle wormers" or any of the other ignorant BS you have ascribed to them. 

Well, thank G-d for small favors. Calls to poison control have skyrocketed because of this Ivermectin nonsense. Good to hear your HCW friends aren't among that crowd. I do find it ironic, however, that I'm the ignorant one in this scenario, and the HCW refusing the vaccine are a-ok by your standards. But, whatever.

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On 8/30/2021 at 9:37 AM, TechWife said:

If the HCW and support staff at the hospital where I volunteer decide to dig in their heels they will be fired unless they have a legitimate medical or religious objection. There is a review board that reviews all exemption requests and they make the decision as to whether or not the exemption will be granted. That is the same way all vaccines are handled. The deadline for immunization is set several weeks out & during that time occupational health is hosting several talks about the vaccine to educate anyone who wants more information. All hospitals within a one hour drive have adopted the same policy. This means not only will they lose their job, they also will not be able to get a job at another nearby hospital. 

At my child's college, permanent exemptions are running less than 1% of students and faculty. There are some short term exemptions due to things like recent COVID infection or recent arrival in the USA from a country that is not yet vaccinating young adults or does not have a WHO approved vaccine.  Religious exemptions require a religion that has a stated, practiced doctrine that does not allow vaccination. There aren't many faiths that fit that category. Medical exemptions would require having a reason to be unable to take ALL currently available in the US COVID vaccines, and the formulations are different, so the number of people who qualify for permanent exemptions from the vaccine are few and far between. 

 

 

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1 hour ago, Dmmetler said:

Medical exemptions would require having a reason to be unable to take ALL currently available in the US COVID vaccines, and the formulations are different, so the number of people who qualify for permanent exemptions from the vaccine are few and far between. 

I read something from a hospital saying there were only two reasons for people to be medically exempt. I’m trying to find it again to see what the first one was. The second was a known allergy to a specific ingredient in the vaccine. I read another thing that said that other than a known allergy, there were no specific medical contraindications, and in fact most conditions that people might think would make it contraindicated are ones that doctors particularly think important for such people to be vaccinated. Such as People with cancer or who are immunocompromised. 
 

I’ve been looking for the specific thing that I was reading yesterday, but instead found a lot of other similar things but nothing quite as succinct. This one is the most succinct I found: 

https://dailynews.mcmaster.ca/articles/ask-a-mcmaster-expert-medical-conditions-and-covid-19-vaccine-exemptions/

“While there may seem like many vaccine exemptions, in reality there are very few.

Allergy to a component of the vaccine or allergy to the first dose of vaccine, while considered an exemption, can often be mitigated with the help of an allergist or immunologist.

Individuals who develop myocarditis (inflammation of the heart), Guillain-Barre Syndrome or Bell’s Palsy (inflammation of the nerves) after the first dose should not receive a second dose until better data becomes available. These are all incredibly rare side effects and are very unlikely to happen to the average individual.”

 

Apparently, there have been no reported cases of GBS in either of the mRNA clinical trials, and just one in J&J. It’s not considered a contraindication. Bell’s palsy has not been found to occur any more commonly than the rate expected and the general population and it’s also not considered a contraindication.

All that to say, it seems like there will be vanishingly few people who have an actual medical contraindication.

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Unfortunately here it appears that the religious exemption is very broad and very general. As someone who is covered under one of the three vaccine mandates in my state, from everything I’ve heard the chances of having a religious exemption turned down are almost zero and basically anything goes. 
 

On the other hand, the medical exemption at least requires specific information about the reason for the exemption and the signature of a medical provider.

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7 minutes ago, Frances said:

Unfortunately here it appears that the religious exemption is very broad and very general. As someone who is covered under one of the three vaccine mandates in my state, from everything I’ve heard the chances of having a religious exemption turned down are almost zero and basically anything goes. 

Out of curiosity, do you know what body or bodies is/are making the decision on what qualifies as an exemption? Is it at the state, local or employer/school level? I think to get such a uniform response the decision would have to be fairly high level. I am just wondering if I'm going in the right direction with that line of thought.

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46 minutes ago, TechWife said:

Out of curiosity, do you know what body or bodies is/are making the decision on what qualifies as an exemption? Is it at the state, local or employer/school level? I think to get such a uniform response the decision would have to be fairly high level. I am just wondering if I'm going in the right direction with that line of thought.

The mandate is from the state and primarily covers state and local government employee (executive branch employees and all k12 staff) plus healthcare workers (some of whom would also be government workers). So state agencies have developed forms and processes.  I’m guessing that a private employer such as a hospital or nursing home who already had a system in place for other vaccines could possibly interpret the religious exemption more narrowly, but I don’t know for sure.

I do know that outside of covid, we have a very broad and general non-medical exemption for other vaccines required for school attendance that covers religious, philosophical, and personal reasons. So again, basically anything goes unfortunately.

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https://www.kevinmd.com/blog/2021/09/physicians-have-gone-from-being-heroes-to-villains.html?fbclid=IwAR37_7RMcJ8wvrPKJFby9sikDyeqS3OlAzCL5xikUHtPrcfRpYYSEneO94I

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Every day, I gently and patiently try to dispel misinformation one by one in discussions with my patients and their families. I try to share the AAP, CDC, MDH, etc. school recommendations with a school mom’s group in response to another post against safe return to school recommendations (only to be shut down and told it is inappropriate for a physician to share accurate medical data). I tell my patients that my family is vaccinated, including my older son, and as soon as it is available for my younger kids, they will be too. I explain why wearing a mask is a way their child can protect themselves and learn the valuable lesson of caring about and protecting the people around them. I took my son and my goddaughter to volunteer with me at community vaccine clinics, putting love of and service to our community in action. I try to explain complex scientific concepts in simple language to dispel the rampant misinformation circulating and keep people from accepting lifesaving preventative measures. I try to appeal to a sense of community by asking people to protect themselves and those around them.

In the end, though, I feel increasingly demoralized as I am buffeted by the epic storm of the dual pandemic – that of a deadly virus and deadly misinformation. Some days it feels like trying to bail water out of the Titanic with a teaspoon. Every day, it feels like we are losing the battle anew.

I am exhausted and sad and disappointed and discouraged.

I am losing faith in humanity. Where is the “love your neighbor as yourself”? Where is the willingness to help each other? Where is the solidarity of those first days? Physicians have gone from being heroes to being villains. We have dedicated decades of our lives to learning how to care for you, but now our knowledge and expertise are being thrown back in our faces as not good enough and not as believable as your cousin’s friend who saw something on social media.

It is hard to keep going. But we do. We keep going because we have dedicated our lives and careers to our patients. We follow our Hippocratic Oath, and we do the best we can for every patient no matter who they are, what they believe, or what choices they make. But many of us are barely clinging to our passion to serve.

 

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I just found out from dd#1 that her ambulance company isn’t mandating vaccines. I found out because she is now in quarantine for contact with a positive coworker. They’ve recently had 3 or 4 employees hospitalized for Covid (only 1 for more than a couple days.)   
Reason given is fear of people quitting.  

I can’t even be bothered to share my feelings about it. 

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1 hour ago, Carrie12345 said:

I just found out from dd#1 that her ambulance company isn’t mandating vaccines. I found out because she is now in quarantine for contact with a positive coworker. They’ve recently had 3 or 4 employees hospitalized for Covid (only 1 for more than a couple days.)   
Reason given is fear of people quitting.  

I can’t even be bothered to share my feelings about it. 

We have three current positives for Covid.  All those people are quarantining for ten days.  All 3 though were fully vaccinated and we’ve been told that if we were in contact with them we don’t have to quarantine if we’re vaccinated(we only have 1 employee holdout who isn’t, and she’s also an ER nurse, go figure).   But having 3 people out for ten days at an ambulance company that only has around 60 employees is a big deal, even if(fortunately) none of them are sicker than the common cold.
 
My bosses are finally starting to think what this is going to look like long term.  People get sick every year, of course, but they don’t miss almost two weeks of work usually.  It’s another aspect of Covid we never considered(I honestly think my bosses had put too much hope that fully vaxxed people wouldn’t catch Covid).  now that we know it does happen, they’re trying to figure out how the quarantines affect us long term.  It’s another aspect that a lot of people hadn’t considered.

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7 hours ago, Plum said:

I have questions for CA nurses. I’ve read some things and want to get some clarification.  
 

CA has the nations only nurse to patient ratio mandate. They were allowing hospitals to waive the ratios due to the emergency. Are those waivers still in effect? If so what happens when there are too many patients and not enough nurses? Do the nurses take the extra patient or are they left in the ED until a bed/nurse can be assigned? 
 

Also prepandemic were nurses sent home frequently because of low census numbers? Or furloughed? 
 

There was a bill introduced to Congress to mandate nurse to patient ratios except in cases of an emergency. It doesn’t sound like there is a plan to work on increasing capacity in nursing programs at the same time. Hospitals and other facilities would have a few years to comply (assuming covid doesn’t get in the way). But I would think they would already be increasing capacity in these programs. No? 

https://www.healthleadersmedia.com/nursing/congressional-bill-seeks-set-federal-nurse-patient-staffing-requirements

https://www.congress.gov/bill/117th-congress/senate-bill/1567/text#toc-HFCAC2FA1CFED4ED1AC9D3A35AAAD2500

https://calmatters.org/health/coronavirus/2021/08/california-nurses-shortage/

 

failing miserably at my board break…

27F53E9E-F4A6-4A71-8C78-E3B743A3D7D1.png

I am in total agreement with these ratios. It will save lives, and it will also produce better long term outcomes for patients. But, without increased capacity in RN programs and tuition incentives/scholarships in order to fill those slots because it is NOT cheap to get a BSRN, I do not see how on earth it can be achieved in the next 5-10 years. We need to take the AMA and other organizations out of the driver's seat on this. We need docs, nurses, OR techs, respiratory therapists, you name it.  The situation is out of control, and too many qualified students cannot get into these programs. How do we, as everyday citizens, get this point across? I am at a loss.

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14 hours ago, Plum said:

I have questions for CA nurses. I’ve read some things and want to get some clarification.  
 

CA has the nations only nurse to patient ratio mandate. They were allowing hospitals to waive the ratios due to the emergency. Are those waivers still in effect? If so what happens when there are too many patients and not enough nurses? Do the nurses take the extra patient or are they left in the ED until a bed/nurse can be assigned? 
 

Also prepandemic were nurses sent home frequently because of low census numbers? Or furloughed? 
 

There was a bill introduced to Congress to mandate nurse to patient ratios except in cases of an emergency. It doesn’t sound like there is a plan to work on increasing capacity in nursing programs at the same time. Hospitals and other facilities would have a few years to comply (assuming covid doesn’t get in the way). But I would think they would already be increasing capacity in these programs. No? 

https://www.healthleadersmedia.com/nursing/congressional-bill-seeks-set-federal-nurse-patient-staffing-requirements

https://www.congress.gov/bill/117th-congress/senate-bill/1567/text#toc-HFCAC2FA1CFED4ED1AC9D3A35AAAD2500

https://calmatters.org/health/coronavirus/2021/08/california-nurses-shortage/

 

failing miserably at my board break…

27F53E9E-F4A6-4A71-8C78-E3B743A3D7D1.png

So, these federal proposed ratios are actually better than what AB 394 requires in California.

This is our requirement:

https://www.nationalnursesunited.org/what-does-california-ratios-law-actually-require

The waiver was in effect earlier in the pandemic, but the Governor received a ton of pushback from the nursing unions for having done so, especially since we did not utilize all the Health Corps resources that were available, so the waiver was rescinded in Feb 2021.


https://www.nationalnursesunited.org/press/california-nurses-declare-victory-safe-staffing-standards

With the Governor facing a recall election, there has been zero discussion about reimposing the waiver. Without the waiver, hospitals bring in travel nurses to make up the difference in staffing. California pays a lot of money to nurses and is generally a nice place to visit, so we get lots of travelers who come for the great pay. I make double what a staff nurse in Florida or Texas makes and travelers can make 4X what a staff nurse makes. Add in our lower patient ratios and mandatory meal and rest breaks and it's not usually a hard sell.

No matter where you go, nurse staffing is always driven by the census. When some units were temporarily shut down, there were some crappy hospitals that furloughed nurses. They later regretted that decision when they opened back up and had a bunch of pissed off nurses. The better ones moved nurses around. 

But, the evidence is clear that better ratios save patient lives and reduce nurse burnout and turnover. California has paved the way with this legislation for years and I am shocked that no other state has followed our lead. Clearly, we need to do more to increase the pipeline of new nurses and there are many ways to do that. Hopefully, once we are out of the fog of war with this virus, we as a nation will take a serious look at the many issues with our healthcare system. We need a comprehensive overhaul. The nursing shortage is just one of so many things that we **must** address. 

 

Edited by SeaConquest
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On 8/30/2021 at 9:37 AM, TechWife said:

  unless they have a legitimate medical or religious objection.  

I don't understand granting religious exemptions for anything related to public health. The chances of getting and/or spreading certain diseases are not changed by someone's personal beliefs. 

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