SUNY Downstate Medical Center Cancels Surgeries, Other Services Due To Vaccine Holdouts On Staff

A staffing crunch has squeezed services at SUNY Downstate Medical Center in Brooklyn, an unintended result of New York’s COVID-19 vaccine mandate for hospital and nursing home workers.

Since the requirement took effect on Monday, the hospital has had to postpone radiology appointments and cancel elective C-sections and inductions for pregnant patients, according to a spokesperson for the hospital, also known as SUNY Downstate Health Sciences University.

The medical center has also shifted outpatient surgeries from its Bay Ridge campus to its main campus in Prospect Lefferts Gardens. SUNY Downstate encompasses a collection of schools for health care professions and the University Hospital of Brooklyn.

Unions representing employees at SUNY Downstate say the hospital was experiencing staffing issues prior to the mandate and has not done enough to retain staff or fill vacancies during the pandemic. After the mandate took effect Monday, the hospital took 221 unvaccinated employees off duty, about 5.5% of its roughly 3,980-member workforce.

That number represents about one in every 18 staff members and is fluid, as many employees are opting to get a shot at the last minute to keep their jobs, a hospital spokesperson said.

“We continue to work with unvaccinated staff members to encourage them to get the vaccine,” the spokesperson added.

SUNY hospitals are state-run, and last week, Governor Kathy Hochul announced a boost in overtime pay at the facilities ahead of the mandate taking effect. Some staff at Upstate University Hospital in Syracuse, Stony Brook University Hospital on Long Island and Downstate will get 2.5 times their usual pay for overtime through the end of 2021, rather than the typical 1.5 rate bump. Critics say such a move isn’t enough to address the drop in staff.

“You can’t overtime your way out of this,” said Wayne Spence, president of the Public Employees Federation, which represents nurses at SUNY hospitals. He estimated about 90 nurses were taken off duty. A SUNY Downstate spokesperson disagreed with the number but did not offer a replacement.

“You can only do so many triples [triple shifts] before fatigue sets in,” Spence said. He added that more staff than usual are already working overtime at the hospital because employees have quit or retired in recent months.

A nurse who works at the hospital said staff were hit hard by the pandemic, especially given that Downstate was designated as a COVID-19-only facility between March and June of 2020. They said the team never received hazard pay during the worst periods of the pandemic, a common practice at other hospitals. Their supervisor retired, and others left without being replaced, making more work for those who remained.

“People are just so busy and trying to cover so many bases with not enough staff,” said the nurse, who asked for their name to be withheld due to fear of retribution.

Asked about efforts to retain staff, a SUNY Downstate spokesperson noted that the state has approved salary increases for people working at Downstate because of the higher cost of living in New York City and that the hospital is in the process of implementing that change, along with more overtime pay.

Spence said that he had also heard of service cuts elsewhere in the SUNY hospital system. Upstate University Hospital in Syracuse postponed elective surgeries ahead of Monday’s vaccination deadline in anticipation of staffing shortages, a spokesperson said. It has shut down more than half of its operating rooms, going from 35 to 13 in service.

“Medically necessary and time-sensitive surgeries and critical care trauma cases remain priorities,” the Upstate University Hospital spokesperson added. He said 113 employees of its 6,600-person workforce didn’t meet Monday’s vaccination deadline.

“Upstate continues to assess staffing and will make changes to operations and services as needed and will be back to full service as things improve,” the spokesperson said.

Meanwhile in Long Island, a rep for Stony Brook University Hospital said it has a 94.7% compliance rate so far and has suspended 133 unvaccinated employees.

“Stony Brook University Hospital has been open throughout the pandemic to serve the community and all services continue to operate as planned,” the spokesperson said.

A nurse manager at Stony Brook who asked not to be named said that in the units they oversee, the “vast majority of staff have done the right thing” and gotten vaccinated, although the decision has taken an emotional toll on those who were reluctant to do so. They said they received permission to expedite hiring permanent replacements for the handful of staff who have left—and that the biggest hurdle is having more new staff that need to be trained.

During a COVID-19 press briefing Thursday, Hochul said every hospital has its own emergency staffing plan that can be activated in case of a shortage. ”For some, that means delaying some elective surgeries on a temporary basis,” she said. “So, yes, I’m aware that’s going on.” About 92% of hospital staff statewide complied with the mandate as of Tuesday.

Gov. Hochul said no hospitals have closed because of resulting shortages and that a 24/7 Operations Center, led by the New York State Department of Health, is monitoring staffing trends.

“There are thousands of student nurses who easily could have been and still can be put into the situations to supplement the help needed, as well as the individuals who came forward to us to offer their assistance,” Hochul said Thursday.

To permit students, retirees and out-of-state professionals to practice medicine in New York, the governor signed an executive order on Monday that temporarily loosened rules around licensing and contracting during the staffing emergency.

“It freed up, even downstate, over 3,000 health care workers by removing the requirement of preauthorization for the next month,” the governor said. “We are hitting every possible way we can to make sure we are not short-staffed.”

Despite service cuts, fewer staff at Downstate were suspended over the mandate than anticipated. On Monday, hospital administrators told United University Professions (UUP), a union representing a range of clinical staff at SUNY hospitals, that about 175 members were expected to face disciplinary action and potentially get fired over the mandate, according to union President Fred Kowal. By Wednesday, the number was just 75. It’s unclear whether some of those employees simply resigned, Kowal said.

“We have no data that would suggest a quickening of retirements/resignations due to the mandate,” the SUNY Downstate spokesperson said.

So far, many New York hospitals say the fallout from the vaccine mandate has been manageable, with staff continuing to take advantage of the grace period afforded by their employers to get a shot and avoid losing their jobs. Some hospitals in New York City say they’ve been able to cover the loss of any unvaccinated staff without interrupting patient care.

The count of unvaccinated staff at NYC Health + Hospitals shrank from about 5,000 on Monday to a little over 3,000 by Wednesday. About 500 of those taken off duty were nurses, but the public hospital system was able to recruit an equal number to cover the gap, said Dr. Mitchell Katz, president of NYC Health + Hospitals. He said there would not be a significant impact on hospital operations in general.

The nurse at Downstate who said staff are overworked said she still ultimately supports the vaccine mandate.

“Some people have not been able to decide [whether to get vaccinated], and I think the mandate gave them a little kick in the behind to get off the fence,” she said.

This story was updated with a statement from Upstate University Hospital in Syracuse.