Vaccine mandates, staff 'burnout' thin healthcare workforce, as states turn to National Guard

Governors deploy teams to fill both clinical and non-clinical roles.

Updated: December 19, 2021 - 5:48am

National Guard teams are being used as a stopgap to fill both clinical and non-clinical roles.

Critics attribute the spreading shortages of trained healthcare personnel to involuntary employee terminations for noncompliance with harsh public and private vaccine mandates, while healthcare administrators and Democratic officials tend instead to cite voluntary departures triggered by pandemic-related "burnout." 

In New Hampshire, the National Guard was deployed to provide nonclinical support at medical care facilities whose staff are suffering primarily from "burnout," according to local news reports. With the majority of healthcare workers having received both COVID-19 shots and the state having a new "medical freedom" law, shortages appear to stem from increased retirements and those leaving the profession. 

In addition to the National Guard, FEMA medical professionals are also providing support, and the state is spending $6 million of federal relief money to recruit healthcare workers from other states and hire new staff. 

In July, Republican Gov. Chris Sununu signed into law a medical freedom bill ensuring that unvaccinated residents wouldn't be denied access to public facilities and services, essentially banning vaccine passports. The law allows state hospitals and county nursing homes, schools, childcare providers, and private businesses to impose vaccine requirements, as long as they offer exemptions for religious beliefs.

In Indiana, the National Guard was called up to provide clinical and nonclinical support at 13 facilities within the Indiana University Health system, the state's largest hospital system. IU Health is left to face what officials are calling "all-time highs" of COVID and non-COVID patients with a reduced staff after the network fired roughly 125 employees for not complying with its vaccine mandate. 

The loss of workers to vaccine mandate noncompliance was contributing to the state's staffing crisis, the Tribune Star reported. The state's hospitals are also having difficulty hiring temporary staff due to staffing agencies charging at least three times more than their normal rates due to the high demand, the outlet found. 

Republican lawmakers introduced a bill to limit vaccine mandates to address the staffing problem. Democrats oppose the bill, which is expected to be considered in January when the Legislature convenes.

IU Health is downplaying the significance of staff losses to mandate noncompliance. Dr. Chris Weaver, the system's chief clinical officer, "said that only about 125 of the health care system's 36,000 employees left because of the vaccine mandate," the IndyStar reported. "Most of those, he said, were part-time or less than part-time, so the total full-time employee impact came closer to 60 and of those only 'a very small number' were clinical staff."

In Kentucky, Democratic Gov. Andy Beshear last week declared a state of emergency due to the state's chronic nursing shortage — primarily caused by retirements and those leaving the profession due to burnout or stress. 

Kentucky needs an additional 16,000 nurses by 2024 to fill the gap, Beshear says, with its nursing workforce operating at a 12%-20% lower capacity. In response, he signed an executive order to address the problem. 

The order allows state nursing schools to enroll more students and the Kentucky Board of Nursing to approve requests for enrollment increases. It also directs schools and the Board of Nursing to implement policies to help publicize and refer people to programs with vacancies, prioritizes faculty needs, enables existing schools to open new campuses more quickly, and allows nurses licensed in other states to practice in Kentucky during the emergency. 

Beshear's announcement came after he'd already deployed multiple National Guard teams to hospitals across the state starting Sept. 1 to help with coronavirus-related cases and hospital staffing shortages. At the time, between 21 and 25 of the state's regional hospitals reported critical staffing shortages.

In Maine, Democratic Gov. Janet Mills activated 75 additional National Guard members to provide nonclinical support to health care facilities. Maine is suffering from a healthcare worker shortage that critics charge stems largely from her vaccine mandate, which prompted more than 2,000 healthcare workers to sue the state. 

Maine's healthcare worker shortage has gotten so bad that its largest hospital system, the Maine Medical Center, had no critical care beds available for a week and the hospital had to shut down six operating rooms in addition to six that were already closed, WABI News 5 reported.

New York Democratic Gov. Kathy Hochul also called up the National Guard to cover healthcare worker shortages, deploying 120 Army medics and Air Force medical technicians to 12 long-term facilities and nursing homes.

They were called up shortly after thousands of New York-based healthcare workers were placed on unpaid leave or fired for not complying with Hochul's COVID-19 vaccine mandate as a condition of employment. Many of them had worked tirelessly over the last nearly two years during a state of emergency, even contracted the coronavirus and acquired natural immunity, and were considered heroes, but are now out of a job. 

As the healthcare worker shortage grew, Hochul issued a statewide disaster emergency in September allowing healthcare workers from other states and countries "to practice in New York State without civil or criminal penalty related to lack of licensure."

Hochul also revoked religious exemptions that had been granted under the Cuomo administration and stripped eligibility to receive unemployment benefits for those who refused to get the COVID-19 shots.

In October, the Republican Caucus in the New York Legislature tried to address healthcare worker shortages through a comprehensive legislative package. 

"There is no denying that the vaccination mandate is putting added stress on our healthcare system," said state Sen. Peter Oberacker (R/C-Schenevus). "I have consistently called for vaccine availability, particularly in the underserved rural areas I represent. However, leaving our healthcare heroes with no testing option or other means of remaining on the frontlines helps no one." 

A group of 20 doctors and nurses sued, arguing Hochul's mandate violates the First Amendment because it excludes a religious exemption. On Monday, the U.S. Supreme Court denied their request for an emergency injunction seeking to halt it.

Unlike the governors of New Hampshire and Indiana, who've openly opposed the Biden administration's vaccine mandates, the governors of Maine and New York issued their own vaccine mandates that deny religious exemptions and impose fines and revoke licenses for businesses that don't comply.

"The governors of Maine and New York are to blame for the current health care shortages," argues Mat Staver, founder and chairman of Liberty Counsel, a religious freedom legal nonprofit, which has sued on behalf of Maine healthcare workers. "Calling up the National Guard will not solve the health care crisis. Mills and Hochul openly ignored the law and forced employers to terminate those health care workers who have sincere religious beliefs against these COVID shots. They have now created a crisis in their health care system." 

Both governors argue their states' healthcare worker shortages are due to other factors, including increased coronavirus-related cases and burdens related to working through a pandemic for nearly two years.