Tacoma ER doctor says lucrative contracts not enough to lure hospital staff

The battle to slow the spread of COVID-19 and the delta variant is getting new weapons as King County’s top health officer updates the mask mandate to include all outdoor gatherings of more than 500 people. That order kicks in Tuesday.

Dr. Jeff Duchin also strongly urged people to mask up regardless of event size.

Masks required indoors and outdoors at Washington State Fair

Jefferson and Clallam counties will also start requiring everyone entering a bar or restaurant to show proof of vaccination, as those counties are seeing a dramatic spike in cases from the delta variant linked to those businesses.

But the biggest overall problem is that not enough people are getting vaccinated, according to the Dr. Nathan Schlicher, a Tacoma ER doctor and president of the Washington State Medical Association.

“I think the hard thing is that, right now, is we’re trying to straddle that idea of getting back to life and having people make the right decisions themselves rather than the government telling you what to do, ” Schlicher said. “Most people, I don’t think it matters regardless of party, would like to feel like they can make their own decisions and that you don’t need government to tell us what to do.”

“The hard thing is that people also feel like this isn’t impacting their lives,” he explained. “They don’t see firsthand the damage it’s doing to the health care system, unless they’re one of the unfortunate people that needed a surgery that got cancelled this week. And that’s not any single system. That’s every health system in the state.”

While we often hear that 70% number when it comes to the amount of vaccinated people in Washington state, that number refers to the percent of the population who have received at least one dose. According to data from the state Department of Health, 55% is the percent of the total population that’s been fully vaccinated.

Schlicher says while some people refuse to get vaccinated because it is mandated, out of fear, or they feel it’s being forced on them as part of some larger conspiracy, the bulk of the people he treats who are unvaccinated offer different reasons.

“The people I’m treating for COVID, there is always a very, very small sliver that is the truly anti-vax or conspiracy theory, mark of the beast, infertility, you name it, theory — there is a small slice of that,” Schlicher said. “But many people I treat are in the camp of, ‘I just didn’t get around to it.’ ‘I was worried because it wasn’t fully approved.’ ‘I didn’t think I’d get that sick from it.’ So, I tell everybody now, it’s fully approved so you need to make the time [because] this is as important as anything else in your life.”

That’s because, Schlicher says, the delta variant is causing every metric the health care system monitors to jump higher than they ever have — including hospitalizations – and that impacts all of us.

The good news?

“I think we’ve got enough ventilators right now, we’ve got enough PPE,” he said.

“The challenge is people. And we’re struggling to recruit people because this is 18 months of our being on the frontlines of the pandemic, of doing double time, and extra shifts, and working harder and longer hours, and doing the extra four to get to 12 or 16 hours of a shift,” Schlicher said. “People are tired, and what we’re seeing is that no amount of money you throw at them is necessarily going to make the difference.”

In the past, when Washington’s hospital systems needed more staff, they made short-term, lucrative contract offers to traveling medical personnel from other states. But this time, that’s not working.

”Usually, we just pay people a little bit more, we give them double time, give them overtime. We bring in a traveler, an exorbitant rate, and we can find people,” Schlicher said. “[Right now] we can’t find people, and it’s not any single system in the state. It is across the state. Now you see organizations offering 13-week contracts, the traveling nurses that are offered $160 an hour, some [hospital systems] offering $20,000 sign on bonuses for a 12 or 24 month contract. So huge incentives, and those are still out there and they’re still not getting filled. So if you have a passion to go into nursing right now, it’s a great time to go on the frontlines with us.”

The big concern?

“If we don’t figure out how to get this under control, I worry that in 18 to 24 months when you’re going to be out of school, we’re still going to be battling it,” Schlicher warned.

Hospital rates in Washington are higher now than at any other time during the pandemic. Cases continue to soar, with about 4,400 new cases reported by the state on Sept. 2.

Schlicher’s has a message to those still unwilling to get vaccinated:

“If it hasn’t settled in that we’ve got to do more than we’re doing now, if you ask somebody who’s supposed to get surgery for cancer, heart disease, their hip, or anything else, or ask the next person you know that gets in a car accident and has to go to a hospital, and ask them if that’s the level of health care that they want for their family member,” he said. “Because the reality is, it’s not just COVID that’s getting impacted anymore. It is impacting everyone who touches the health care system. It’s impacting our ability to get blood, to get people to provide care, to be able to have space to care for you.”

“So don’t just say, ‘I won’t die from COVID, it’s no biggie.’ You’re going to die, potentially, because you get in a car accident on I-5 and there’s nowhere to provide care to you,” he warned.

Doctors: Washington likely needs 85-90% vaccination to defeat delta

On top of all that, many health experts are now leaning into it being a “when” not an “if” that a new mutation arrives that fully escapes the vaccine — meaning the current vaccine will not protect against it, making everyone vulnerable once again.

“I really had hope — and I’m still hopeful — that [Dr. Anthony] Fauci ends up being correct and that by March of 2022, we’re done with this thing. But it’s going to depend upon how many people take it seriously and whether or not we get lucky,” Schlicher said. “At the end of the day, that’s what it comes down to, is the more that the virus is breeding out there, and mutating, and trying out new trips, we’re just giving it the opportunity to mutate out of control and escape our vaccines.”

“It’s kind of like that old Clint Eastwood line,” he said. “‘Do I feel lucky? Well do ya, punk?'”

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