Adam Willmann was born in Goodall-Witcher hospital in Clifton, a small town in central Texas. Now he's its CEO, and he's worried his hospital may have to stop delivering babies.

亚当·威尔曼出生在德克萨斯州中部小镇克利夫顿的古道尔-威彻医院。现在他是这家医院的首席执行官,他担心医院可能不得不停止接生婴儿。

That's because some of the experienced nurses in the Goodall-Witcher obstetrics department aren't vaccinated for COVID-19 and don't intend to be. But under a new federal mandate, hospitals will soon have to require their staff to be vaccinated.

这是因为Goodall-Witcher产科的一些有经验的护士没有接种新冠疫苗,也不打算接种。但根据一项新的联邦法令,医院很快将不得不要求其员工接种疫苗。

"They are also near retirement age and a few of them have already voiced that, 'I will just retire,' " Willmann said. "And then a couple other nurses said, 'Well, I'll just go work for my husband's construction company.' "

威尔曼说:“他们也接近退休年龄,其中一些人已经表示,‘我只想退休。’”“然后其他几个护士说,‘好吧,我就去我丈夫的建筑公司工作吧。’”
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Willmann's situation is not unique. Rural health providers across the country are sounding alarms about the new mandate that will start as soon as next month. The Biden administration wants every person working in a health care setting — from hospitals to nursing homes to dialysis centers — to be fully vaccinated for COVID-19.

威尔曼的情况并不少见。全国各地的农村医疗服务提供者对最早将于下个月开始实施的新规定发出了警告。拜登政府希望在医疗机构工作的每一个人——从医院到疗养院到透析中心——都能全面接种新冠疫苗。

But in rural areas where vaccination rates are low and hiring is already difficult, hospital directors are worried there could be staffing shortages that force them to turn patients away.

但在农村地区,疫苗接种率低,招聘已经很困难,医院负责人担心可能会出现人手短缺,从而迫使他们不得不拒绝病人。

Willmann has been pushing hard to get all of his 250 employees to take one of the COVID-19 vaccines, but staff vaccination has topped out at around 70%. That's well above the rate in the surrounding community, but still not enough.

威尔曼一直在努力让他的250名员工都接种一种新冠疫苗,虽然员工接种疫苗的比例最高达到了70%左右,这远远高于周围社区的比例,但仍然不够。

"We did not undertake this decision lightly"
That stagnation of vaccination rates in medical facilities all over the country is what drove the Biden administration to go for a mandate, said Chiquita Brooks-LaSure, the administrator of the Centers for Medicare and Medicaid Services.

“我们不是轻率地做出这个决定的。”
医疗保险和医疗补助服务中心(Centers for Medicare and Medicaid Services)的负责人奇基塔·布鲁克斯-拉苏尔(Chiquita Brooks-LaSure)说,全国各地医疗设施的疫苗接种率停滞不前,这促使拜登政府采取了强制措施。

"We did not undertake this decision lightly," Brooks-LaSure said in an interview with NPR.

“我们不是轻易做出这个决定的,”布鲁克斯-拉苏尔在接受NPR的采访时说。

The agency is expected to finalize details of the new requirement over the next month. It plans to withhold Medicare and Medicaid funding from facilities unless they follow the mandate.

预计该机构将在下个月敲定新要求的细节。它计划扣留医疗保险和医疗补助的资金,除非他们遵守命令。

Brooks-LaSure said she knows some hospitals and nursing homes, especially in rural areas, are worried the vaccine mandate will cause staffing shortages. But she said health care workers who aren't vaccinated and become sick or have to quarantine also cause staffing shortages.

布鲁克斯-拉苏尔说,她知道一些医院和疗养院,特别是在农村地区,担心疫苗规定将导致人员短缺。但她说,没有接种疫苗的医护人员生病或必须隔离,也会导致人员短缺。

The government is also concerned about safety. "It's very clear from the data that staff who remain unvaccinated are affecting both the patients who are coming in to the facilities as well as their colleagues," Brooks-LaSure said.

政府还担心安全问题。Brooks-LaSure说:“从数据中可以清楚地看到,未接种疫苗的工作人员正在影响进入医院的病人和他们的同事。”

Brooks-LaSure said staffing issues may not end up being as severe as some fear. She pointed to the experience in Maine, where Gov. Janet Mills already put a state mandate in place for health care workers.

Brooks-LaSure表示,员工问题最终可能不会像一些人担心的那样严重。她提到了缅因州的经历,该州州长珍妮特·米尔斯(Janet Mills)已经对医护人员实施了一项州强制令。

"Even though there was a lot of noise around what these mandates mean, the actual number of health care workers who quit was very limited," Brooks-LaSure said.

布鲁克斯-拉苏尔说:“尽管对于这些规定意味着什么有很多争议,但实际辞职的医护人员数量非常有限。”
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Mandates mean more vaccinations. But also, hate mail
In New Hampshire's rural Coös County, Tom Mee has been working through the issues of putting a mandate in place. He's the CEO of North Country Healthcare, which decided to require vaccines for people who work at its three hospitals after the Food and Drug Administration gave its full approval to the Pfizer vaccine.

授权意味着更多的疫苗接种。但也有恶意邮件
在新罕布什尔州的农村Coös县,汤姆·梅(Tom Mee)一直在努力解决实施强制令的问题。他是North Country Healthcare的首席执行官,在美国食品和药物管理局完全批准辉瑞公司的疫苗后,该公司决定要求在其三家医院工作的人接种疫苗。
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Staff have 60 days to get the shot. "Our D-Day is Oct. 23, and one way or another, our workforce will be 100% compliant with the vaccine," Mee said.

工作人员有60天的时间来打针。梅伊说:“我们的诺曼底登陆日是10月23日,无论如何,我们的员工将100%遵守疫苗规定。”
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Mee said the decision was the right thing to do to protect the health of patients and employees. But it has been difficult to implement. He has received hate mail. But the mandate is working: A month ago, 78% of staff were vaccinated, but now it's up to 90%.

梅伊表示,为了保护病人和员工的健康,这一决定是正确的。但实施起来很困难。他收到了恐吓信。但这一要求正在发挥作用:一个月前,78%的员工接种了疫苗,但现在这一比例高达90%。

But, he said, it's inevitable that the mandate will mean a handful of employees will quit or are forced to leave, gaps he expects to be able to fill by shifting staff around.

但他说,这一强制要求将不可避免地意味着少数员工将辞职或被迫离职,他预计可以通过调动员工来填补这一空缺。

"It's a scene that you're going to see repeated throughout the United States," said Mee. "I've been in health care for 34 years, and I've never seen anything like this before."

“你会在美国各地看到这样的场景,”梅说。“我在医疗保健行业工作了34年,从来没有见过这种情况。”

Rural hospitals want help from Biden administration

农村医院希望得到拜登政府的帮助
原创翻译:龙腾网 http://www.ltaaa.cn 转载请注明出处


In many regions, there's not a deep bench of qualified people to fill vacant health care jobs,
especially during a pandemic, said Alan Morgan, CEO of the National Rural Health Association.

美国国家农村卫生协会(National Rural health Association)首席执行官艾伦·摩根(Alan Morgan)表示,在许多地区,没有足够多的合格人才来填补医疗保健岗位的空缺,尤其是在疫情期间。

Morgan is urging the Biden administration to come up with a plan to help with expected staff shortages once the mandate goes into effect, similar to the federal strike teams sent in to communities struggling to handle surges of COVID-19 cases that overwhelm local medical resources.

摩根敦促拜登政府制定一项计划,帮助解决强制令生效后可能出现的人员短缺问题,类似于联邦小组被派往社区处理新冠病例激增导致当地医疗资源不堪重负的情况。

Morgan suggested that teams could be drawn from the U.S. Public Health Service, the National Guard or the Federal Emergency Management Agency to help rural hospitals.

摩根建议,可以从美国公共卫生服务、国民警卫队或联邦紧急事务管理局(Federal Emergency Management Agency)抽调团队,帮助农村医院。

Rural hospitals and clinics may be able to hire temporary relief nurses to come to their communities and use federal funding to help offset the expense, Morgan said. But city hospitals typically offer more attractive pay. Morgan also worries about a gap between the time the mandates take effect and the time a new tranche of federal funding becomes available.

摩根说,农村的医院和诊所可以雇佣临时的救济护士到他们的社区,并利用联邦资金来帮助抵消这些费用。但城市医院通常提供更有吸引力的薪酬。摩根还担心指令生效的时间和新一批联邦资金到位的时间之间存在差距。

Morgan has been asking administration officials, hoping for some signal that contingency planning is underway and so far hasn't gotten a reassuring response.

摩根一直在询问政府官员,希望能得到一些应急计划正在进行的信号,但到目前为止还没有得到令人放心的回应。

He is concerned that even small numbers could create outsized problems for rural hospitals. "Even if it would impact only 2% to 5% of the hospital staff, that's going to create a service disruption," Morgan said.

他担心,即使离职医护人员数量很少,也可能给农村医院带来巨大的问题。“即使它只会影响2%到5%的医院员工,也会造成服务中断,”摩根说。

"Are we going to have to transfer existing patients? Are we going to have to put a halt on incoming patients?"

“我们必须转移现有的病人吗?”我们是否必须停止接收新患者?”这些都是问题。