Are pandemic-related worker shortages affecting your urology practice?

“Idaho is in crisis standard-of-care [mode]. COVID-19 is finally decreasing in our hospitals, but PACUs are still being used for COVID-19 wards, so not all hospitals are resuming normal operations.

In our practice, we’ve had a nurse position open since August that nobody’s applied for. Adult urology has had a position open for a year. There is a big shortage.

Nurses, MAs, and LPNs left because they didn’t want to get vaccinated, a requirement now to work in our hospitals. In Boise, every hospital except 1 requires it. When cases started ramping up in September, people walked off the job to avoid vaccinations. They ‘don’t believe in them, don’t think they’re researched enough, don’t want government telling them what to do.’ As a result, traveling nurses were hired to prepare for the shortage.

Luckily, at Children’s Hospital, we have a float pool that helps. Actually, when ORs [operating rooms] shut down, nurses assigned to the OR floated up to keep our clinics going.

We’ll see what happens when ORs reopen. We may have to see fewer clinic patients so we don’t burn our current nurses out.

As deaths increased, there was another push to get people vaccinated. I’m very outspoken. When people ask, ‘What can we do to make sure our child can get surgery?’ I tell them, ‘Get vaccinated, get your neighbors vaccinated.’ Some people do; others refuse.

Traveling nurses are great, although they get paid so much to stay. In a good way, it will probably raise nursing salaries, but it could have an effect on medical inflation.”

Kara Saperston, MD

Boise, Idaho

“Staffing isn’t as much of an issue here as in other practices. Our hospital doesn’t have a [COVID-19 vaccination] mandate. A mandate would cost us a handful of nurses. We’re pretty isolated, providing care for a 2½-hour radius. We can’t go down the street and hire new nurses.

Several of our nurses had [adverse] effects, including myocarditis, from their first [COVID-19] shot and hesitate to get another. Technically, they’re not fully vaccinated. A mandate could make some walk. Hospital administrators considered how many they would lose with the mandate.

The administration looked at mandates because a potential penalty is through [the Centers for Medicare & Medicaid Services (CMS)], and we can’t afford a CMS penalty because our Medicare population is too high.

Like a lot of places in the South, we had a pretty bad COVID-19 spell earlier this summer. It slowed us down surgically because we had major staffing issues. Since then, it hasn’t been a problem. We don’t want it to happen again.

COVID-19 came through our office early last year. We had to shut down for a short period because pretty much everyone in our office had it. Most of our staff and I feel this is what we signed up for in medicine. We’re exposed to things all the time and have to protect ourselves.

Going back to your original question, we’re OK on staffing because we got hit by COVID-19 early, before the vaccine was available. Our symptoms were fairly mild, and it desensitized us to the whole thing. Not that we can’t get it again, but we hope we developed antibodies from the virus itself. And the people we’re surrounded by, our elderly, high-risk patient population, is maybe 80% to 90% vaccinated, providing further protection.”

Daniel Decker, MD

Mountain Home, Arkansas

“We’re definitely seeing health care worker shortages—certainly in ORs [operating rooms]. It’s difficult just adding a case. We haven’t had many nurses leave our clinic but it’s a big issue within the hospital ORs. Where we generally did 10 cases a day, now we do maybe 8 or 9, so patients must wait a little longer.

In Pittsburgh, people are jumping ship to the other hospital system in town because everyone’s short-staffed. Hospitals are offering sign-on bonuses to entice people to switch. Remaining staff feel underappreciated because there are no retention bonuses. So they’re going 10 minutes across town to another hospital.

It’s interesting. I just did a case with a new circulator nurse and a new scrub tech recruited came from another hospital. The case before that I had a CRNA who’s leaving to go to the other hospital.

With the dependence on traveling nurses, people where I used to work feel underappreciated. They’ve been there 10 to 20 years. Travelers come in—they still live locally but had quit their job and came back as travelers—and make 3 times what they did when on staff and what their coworkers make.

We use more medical assistants than nurses in our clinic. There doesn’t seem to be as much burnout. They’re well-compensated and have a good work life.

To cope with the staff shortages, a smaller hospital here is being innovative, getting more surgical patients in and out the same day. Physical therapists are taking patients straight from PACUs to therapy units.”

Jordan Allen, MD

Pittsburgh, Pennsylvania