PORTLAND — The Oregon State Hospital’s critical staff shortage reached a new level this week, and officials have called for the National Guard to help fill roles vacated by staff on coronavirus-related leave, the hospital announced late Wednesday.
The announcement was a sudden change from a plan released to the public Tuesday, when the psychiatric hospital said it would pull in managers from around the Oregon Health Authority and other state agencies to help with emergency staffing. The hospital still plans to use those managers for temporary staffing.
State hospital spokesperson Rebeka Gipson-King said Thursday the Office of Emergency Management had received the request for 30 registered nurses from the Guard, with a preference for those who have behavioral health experience. Those nurses would be assigned to 10 or 10.5-hour shifts four days a week, and would help fill in behind the hospital’s own licensed nursing staff, Gipson-King said.
Gipson-King said the hospital had not heard as of Thursday afternoon whether the request has been approved.
The call for the National Guard is the final step in a five-step emergency plan that the state hospital created in November as the number of staffers on coronavirus-related leave grew.
The first three steps of the emergency plan redirected employees from around the hospital, in areas such as social work, vocational rehabilitation or even office staff, to assist with day-to-day care of patients. Each step denoted that a certain percentage of the hospital’s more than 900 full-time equivalent nursing staff was on coronavirus-related leave.
Kim Thoma, an administrative specialist and president of the SEIU Local 503 union, which represents many hospital employees, expressed concern over possible delays with external contractors.
“It takes time to get people ready to work the floor,” she said. “It’s a different kind of work — working with people who are severely mentally ill. It does take a special skill set to be able to talk our patients down if they’re struggling, and I think not just anyone can come in and do that job.”
As the hospital deals with an unprecedented staffing crisis, administrators also requested a pause on admissions for the week, citing an inability to get patients discharged from the hospital fast enough to make room for new ones. A federal judge granted the request. Since the pandemic began, the hospital has been admitting patients on a restricted basis, quarantining cohorts of new patients for two weeks and then placing the newcomers in the general population.
Hospital administrators have successfully made at least four other requests to halt admissions since last April, each time citing coronavirus concerns.
The call for help from the National Guard, the fifth and final wave of the hospital’s emergency plan, means that the hospital is now without 50 percent of its full-time equivalent nursing staff, or approximately 460 employees. Those metrics were released by the state hospital in November when it first implemented the emergency staffing plan.
The hospital houses about 650 patients and has about 2,300 employees across its two campuses, in Salem and Junction City. Many of the patients have been civilly committed, found guilty except for reason of insanity, or found unable to aid and assist in their own defense in a criminal case.
As the hospital has dealt with the growing staffing crisis over the past few months, employees have expressed fear about increasingly fraught work conditions. Staff have said they’re exhausted from being mandated to work extended hours, deal with increasingly violent patients, and incidents that regularly end with staff and patients injured.
Recent staff injuries included one person going to the hospital after a patient attacked them with a plastic chair, leaving them with facial lacerations and a patient breaking a staff member’s arm.
“Our staff are feeling the strain of that because there aren’t as many people to respond to emergencies,” Thoma said. “People are quitting who’ve been here for a long time — it’s just progressively getting worse with morale because people are so exhausted.”
Gipson-King said managers within the hospital will be asked to fill weekend shifts immediately, because those shifts are the most difficult to cover, and internal managers can start immediately without the training required for people outside the organization. Gipson-King said the hospital will begin holding training for Oregon Health Authority managers as soon as possible.
She said on Thursday that hospital managers will not be mandated to work weekend shifts, as staff currently are, but will be asked to volunteer for one to two shifts between now and July 4.
So far, Gipson-King said, two people from external state agencies had volunteered to work hospital shifts, and they would start training June 7 or 14 — two weeks after the initial call for help was put out.
An email from OHA Director Patrick Allen to agency managers said those who take on emergency assignments at the state hospital will receive six days of new employee orientation, nine days of training in basic nursing tasks and 40 hours of on-unit orientation with a mentor.
Allen described the emergency shifts as a “temporary reassignment,” and said managers and supervisors who volunteer for those shifts will continue to be paid at their current salaries.
Meanwhile, hospital superintendent Dolly Matteucci in her email to state hospital supervisors said that Oregon Health Authority managers, as well as supervisors from all other state agencies, will be asked to help with staffing.
While Oregon Health Authority managers are not being required to assist with the state hospital, Allen in his email strongly encouraged “anyone who has good people skills” to volunteer.
Matteucci said that supervisors would be assigned to work depending on the skills they have. Someone who has never worked with patients might be asked to serve meals, escort patients to treatment activities or help hospital staff provide activities for patients.
But despite Matteucci’s assurance, several hospital employees have said that the emergency staffing plan has placed people from around the hospital in unsafe situations, for which they don’t have adequate training.
While the state hospital did have several coronavirus outbreaks among staff and patients, most of those on leave are not sick with the virus, but taking childcare leave. The COVID-19 crisis has impacted childcare centers and in-person schooling.
The state hospital staffing crisis is also a subject of discussion in this legislative session, with a package of bills related to the state hospital currently being considered — including one that would fund over 200 staff positions, according to State Rep. Rachel Prusak, who is on the Oregon State Hospital Advisory Board.
Ben Morris, with Local 503, said the latest stage in the staffing shortage illustrated the inadequacies of the Oregon Legislature’s budget for the state hospital.
“Right now the Legislature has an almost unprecedented amount of money from the American Rescue Plan and from the budget surplus,” he said. “What better time to actually fund Oregon State Hospital at a level that meets its needs?”
He said the package of bills in the current session that address OSH is the first of many necessary steps.
“It’s really about the staffing,” he said.