PORTLAND, Ore. (AP) — As the COVID-19 pandemic continues to overwhelm Oregon's health system — with hospital beds and intensive care units more than 90% full — the looming statewide vaccine mandate, which applies to healthcare workers, is the latest hurdle in a nursing shortage.

Oregon's hospital staffing issue has been significantly exacerbated during the pandemic. On Thursday, officials from the Oregon Nurses Association said 60% of nurses at the state's largest hospital — Oregon Health & Science University — indicated that they are considering leaving the profession entirely.

“The current nursing crisis the state of Oregon is facing … has been decades in the making,” Natasha Schwartz, a member on the Oregon Nurses Association Board of Directors, said during a news conference. “As we see a small number of nurses potentially leave the profession due to their decision to decline the vaccination, we are also concerned burnout will lead to an even larger number of nurses leaving the bedside — and in Oregon, we will not be able to educate a large enough number of nurses to replace them.”

Health care workers say the staffing crisis is a culmination of issues, including reliance on traveling nurses, pay disparities, “hospital executives who have consistently chosen to put profit ahead of patients” and the pandemic — which has resulted in overworked and exhausted employees.

The newest barrier to retaining nurses in Oregon is the statewide vaccine mandate, officials said.

In Oregon, teachers, state employees and health care workers are required to be fully vaccinated by Oct. 18 to keep their jobs. Monday was the final day for individuals to either get their second dose of a Pfizer or Moderna vaccine — or the single-dose Johnson & Johnson shot — to be considered fully vaccinated by the statewide deadline.

Currently, 90% of the members in the Oregon Nurses Association — the state's largest nursing union, which represents 15,000 people — are vaccinated.

“We know that a small amount of nurses across the state have made the decision to not get vaccinated and those nurses will likely be terminated from their jobs,” said Lynda Pond, the association's president.

KOIN reported last month that at Legacy Silverton Hospital 18 nurses, nearly half of the nursing staff in the labor and delivery department, are facing termination.

Although the number of nurses in Oregon who have decided not to get vaccinated is “tiny,” Pond said it will have a magnified impact.

“You lose one nurse at the bedside — and then other people have to step in and fill that nurse's shoes,” Pond said. “It perpetuates that cycle of continuous overtime, nurse exhaustion and mental health stress."

Last week, four Legacy-GoHealth Urgent Care clinics were forced to close due to “temporary staffing constraints.”

However, hospitals faced staffing issues long before COVID-19 or a vaccine mandate, the Oregon Nurses Association said.

On Thursday members of the labor union called on hospitals and the state government for help to “finally and seriously address our historic and catastrophic nurse staffing crisis.”

The organization proposed a loan forgiveness program for nursing students who agree to complete four years of work in areas of the state with the most serious staffing shortages.

In addition the union is urging hospitals to honor legally required meal and rest breaks for nurses and immediately put an end to all “buddy-break” system — the practice where if a nurse takes a rest break, they must pass all their patients onto another nurse, doubling that person’s workload.

Lastly, the association is calling on hospitals and state legislators to invest approximately $1.8 million bi-annually into an expansion of the Oregon Wellness Program, with a focus on nurses' mental health, and requesting a commission to engage in a systemic review of the state’s overall healthcare system staffing.

“To move beyond the current crisis, if we are to not only improve our system but literally save it, Oregon must take bold, decisive and immediate action,” the union's Nurse Practice Consultant Matt Calzia said. “We don’t have all the answers, but we are looking at a range of options and we strongly encourage our elected officials, hospital administrators, coordinated care insurance organizations and public sector agencies to accept our challenge to think big and bold — the future of Oregon’s healthcare system depends on it.”

Sara Cline is a corps member for The Associated Press/Report for America Statehouse News Initiative. Report for America is a nonprofit national service program that places journalists in local newsrooms to report on undercovered issues.

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