Vaccine mandate to potentially reduce staffing at SF General by hundreds

With the long-awaited state vaccine mandate scheduled to kick in at midnight, hundreds of employees at the already short-staffed Zuckerberg San Francisco General Hospital stand to be fired. 

Some 234 Department of Public Health employees remained unvaccinated as of Sept. 29, and an additional 75 failed to report their vaccination status. Of those, 152 unvaccinated employees work at General Hospital, alongside 64 who have failed to report their status. 

These numbers are a small fraction of overall Department of Public Health employees. Some 95.6 percent of DPH workers are vaccinated. But the minuscule percentage of unvaccinated employees still represents a significant number of people because DPH is big: 7,474 employees. 

It’s also significant because the hospital is already deeply understaffed — and, as the city’s trauma center, it cannot scale back its offerings without dire consequences. 

“We are already on 12-hour shifts without lunch, meals, or rest breaks. That happens on the regular,” says Heather Bollinger, an emergency room nurse at SFGH since 2007. “We are offering overtime in the emergency department on every single shift. They are starting to mandate people work overtime.” 

With fewer workers to fill the gaps, Bollinger predicted “mandatory overtime, burnout, and undue burden.” 

Mission Local is informed that the bulk of unvaccinated Department of Public Health employees work as nurses, nursing assistants, medical assistants, licensed vocational nurses, eligibility clerks, and in housekeeping. 

Separate and apart from the wisdom or righteousness of vaccine mandates — and everyone contacted for this story supported them, in principle — the resultant firing of potentially hundreds of health workers figures to exacerbate a bad situation at the hospital. Front-line workers wondered whether the Department of Public Health had planned adequately in advance.

“We can do the best we can, and also make it clear that it’s not going to be helpful for us to work with people who are making others sick and making patients vulnerable,” said longtime nurse Sasha Cuttler. 

Regarding the Department of Public Health’s plan to make up for what figures to be a sudden exit of many frontline workers, Cuttler says he and his fellow nurses haven’t been kept in the loop. 

“They have had a very difficult time following the safe staffing ratios that have been on the books and in our contracts — for a very long time,” he said. “So, I don’t know what their plan is as far as whether they’re planning to do something about it.” 

Multiple calls and emails to the Department of Public Health querying how gaps will be filled in the coming days and weeks have not been returned. City sources have mentioned Mayor London Breed’s recent extension of an emergency proclamation that smooths out the city’s normally sclerotic hiring practices: The Department of Public Health, in 2019, reported that it required up to 220 days to hire a nurse and 419 to land a behavioral health technician. The hiring process contained no fewer than 34 steps. 

There are purportedly plans in the offing to undertake accelerated mass-hiring events, such as the onboarding of 150 nurses in a few weeks at the onset of the pandemic. 

Certainly, that could be done again. But even with the rosiest and most accelerated of timelines, the next several weeks could be even more difficult than usual at SFGH. 

And, considering the demand for healthcare workers across the nation, it may not be easy to lure workers into San Francisco’s notoriously difficult trauma hospital. 

Potential hires are “faced with the option of working mandatory overtime in a critically understaffed setting with an extremely challenging patient population and incredibly thin resources or taking a $20,000 sign-on bonus in Idaho or Pennsylvania or New York,” sums up Bollinger. 

The city is banking that the nearly 500 people on its potential hires list do not want to relocate to Idaho or Pennsylvania or New York. It’s also banking that, as the clock ticks down to 11:59 p.m. on Sept. 30, reluctant employees will opt to take the shot. 

The pending deadline is for “employees who are assigned to or routinely work onsite in High-Risk settings or other Health Care Facilities.” Workers who do not receive a vaccination or disclose their status will be terminated for “failing to meet a work condition.” 

As of yesterday, 32,412 city employees were vaccinated (92.2 percent). Some 2,252 were unvaccinated (6 percent) and 337 had declined to report (1 percent). 

Desk-bound city employees are mandated to return to the office on Nov. 1. As that date approaches, city sources anticipate a goodly number of resignations and retirements from workers who have grown accustomed to working remotely and will search for new jobs that allow for that to continue. 

For front-line nurses, that’s not an option. So they will continue coming to work — which, they say, grows harder every day.

“During the HIV-AIDS pandemic, misinformation was shared on tightly hand-written leaflets posted on telephone poles,” said Cuttler, who’s worked on and off for the Department of Public Health since 1987. 

“Now we’ve put the author of pandemic misinformation’s name on Zuckerberg San Francisco General Hospital.” 

Update, Oct. 1: From the Department of Public Health: “As of September 30, there were 113 staff employed by SFDPH at the hospital who remained unvaccinated for COVID-19 and 54 who had not reported their vaccination status. These numbers combined represent 5% of the SFDPH workforce at this facility.”