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In a time of staffing shortages and exploding needs, the power structure may be shifting…

It’s time for me to get my flu shot. I don’t mind. I’ve done it for years now and I have never had an adverse outcome. Also, I can’t remember the last time I had influenza. Which, in medical circles, may seem a lot like walking into the ER and saying in a loud voice, ‘sure is quiet in here tonight!’ A bit like tempting fate. But I’m not particularly superstitious so there you go.

In like manner I dutifully received my COVID-vaccinations. Two shots of Moderna and one booster. A lifetime in medicine and it’s easy to become a rule-follower. Especially when one’s income is tied to the rules.

But I was thinking about mandatory immunizations, mandatory education modules, mandatory meetings, mandatory signing of Standards of Behavior’ documents. And I was wondering just how much weight they can carry in the current healthcare climate. Or in what I have so fondly started called our ‘rolling healthcare disaster.’

Untold numbers of physicians, nurses and others were fired or quit during COVID, in response to vaccine mandates. In the US and Canada, while I don’t know the totals (and we probably won’t for a while) a quick Google search showed that thousands and tens of thousands were either dismissed by employers or simply hung up their scrubs in response.

(It’s not just healthcare, mind you. Thanks to vaccine mandates, tens of thousands of US military service-members were given their walking papers in a time when 1) recruiting is far below needs and 2) there are any number of conflicts looming in the world. I’m not expert on defense, but that seems like a bad idea too.)

While I have always been pro-vaccine (but disappointed in the COVID vaccine public-health messaging), it doesn’t take a particular political spin to suggest that our current crisis levels of staffing shortages might just, maybe, possibly be tied to the fact that critical staff were fired or quit. How did that work out? Not so well from my perspective, where there are not enough nurses, physicians, medics, beds or anything else.

Which brings me back to the idea of all of the mandatory things required in hospitals. It seems to me we may have reached a tipping point where it’s going to be tough to make anything mandatory.

From the standpoint of influenza vaccines there’s a kind of funny conundrum here. The rule used to be ‘get your flu vaccine or you’ll be forced to wear a mask at work all day for the entire season.’ Of course, that’s what we all do now anyway. So that threat doesn’t really hold a ton of weight now.

Furthermore, just how many more staff can we lose because they didn’t get their flu shot? Or their COVID booster? Because they’re behind on some education module? Because their charts, generated on painfully inefficient electronic medical systems, are delinquent?

The folks in the offices can keep generating memos and but at some point there will be hard decisions to make. Send the nurse home or let him keep providing the excellent bedside care he’s known for, despite being in violation of a particular requirement? Send the doctor home or let her keep seeing patients and saving lives, vaccines aside?

I think that necessity may be creating a shift in the power structure. And it’s probably time for the adjustment.

A more rational view of what we do, what we’re mandated to do and what we really need to do is long overdue. And it seems likely that giving more power to clinical staff will ultimately be better our patients; the very reasons we tolerate what we do already.

So grab your popcorn and pay attention. As we enter flu and COVID season, things are going to get a lot more entertaining in our hospitals.






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