South of Milwaukie, Oregon, at a bend in the river that bears its name, Willamette View is a 27-acre long-term care community that provides its 480 residents a range of programs and services, residential housing, and levels of healthcare. It offers a modern fitness center, support for the creative arts, dining options, varied wellness programs, and more.

But Willamette View offers something else, too—something that sets it apart from other Oregon long-term care facilities: the fact that as of last week, 84% of its 310 employees have been vaccinated against coronavirus. For comparison, the Oregon Health Authority reports that as of May 9, just 62% of similar employees were.

“I think it has to do with the culture here,” suggests David Kohnstamm, Willamette View’s director of wellness. “A lot of our residents are former educators, and our staff trusted them. When they saw how anxious they were to get vaccinated, it became kind of contagious.” In Kohnstamm’s case, “culture” turns out to be a mix of practical and emotional factors and an enormous respect for individual choice. And Willamette View’s managers’ ability to manage its staff’s vaccination choices could serve as a model for other healthcare facilities.

They began by gathering data, polling employees who weren’t planning to get vaccinated and finding that while half of them seemed closed to further discussion, the rest weren’t. So they created a 40-minute internal video addressing the pros and cons of vaccination—which, by late December, was starting to happen at clinics on-site.

Employees have never been pressured to get their shot. “Staff respect that we want them vaccinated but aren’t overbearing about it,” Kohnstamm says. “There is no ‘us–them’ mentality. We’re all in it together.”

This type of a “person-centered” approach is endorsed by the Oregon Health Care Association. “Each individual has their own perspective about the vaccine, so it’s important to address each one in a way that’s meaningful to them,” explains OHCA Senior Vice President of Quality & Services Linda Kirschbaum, adding that folks choose not to vaccinate for several reasons, including medical contraindications, personal beliefs, religious beliefs, or fear. “If someone is fearful, that’s a different conversation than if they simply have misinformation,” she says.

At Willamette View, unvaccinated staff also face practical concerns, since nonvaccinated employees exposed to COVID must isolate for 14 days. “Quarantining sucks,” Kohnstamm says. “If you’re vaccinated, you don’t have to go through all that.”

What seems the biggest factor in achieving these high rates, however, is Willamette View’s powerful sense of community. From kitchen crew to executive team, those who work there evidently care deeply about the well-being of those who live there. Staff and residents often exercise or take classes together; staff are welcome at—and often attend—resident parties.

Emily Gebhart, a staffing coordinator who’s been at Willamette View for five years, was on the fence about vaccination: she felt she hadn’t learned enough about its effects and didn’t want to feel sick afterwards. “But none of my co-workers and I wanted to be the one to bring COVID into the facility,” she says. “We would’ve felt horrible.”

Kohnstamm is proud that this sense of community pervades all aspects of the organization. “We did a lot of work before the pandemic to bring staff and residents together, which helped bear fruit when it came to vaccinations,” he says. “People were like, ‘let’s do this together.’”

OHCA’s Linda Kirschbaum notes that in Oregon, where mandating vaccines for health care employees is not allowed by law, increased vaccination rates—whether for residents or employees at long-term care communities—reflect individual choice, not to mention tremendous efforts by those who run them to promote and inform staff to build confidence. “We’re very enthused with what we’re seeing,” she says.

From his office at Willamette View, David Kohnstamm confesses feeling immense relief to work in a facility where so many have chosen to vaccinate. To be certain, the community experienced significant challenges during its COVID year: several residents died, and employees found to be infected were sent home. But like so much about the virus these days, things are starting to look better, and he takes comfort in another piece of admirable data: Willamette View’s residential vaccination rate of 99.3%.

OCN is a nonprofit organization created by nursing leaders in 2002. OCN facilitates research and collaboration for Oregon’s nursing workforce to support informed, well-prepared, diverse and exceptional nursing professionals. Recognized by the Oregon state legislature as a state advisor for nursing workforce issues, OCN fulfills its mission through nurse workforce researchbuilding partnerships, and promoting nursing and healthcare. 

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