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Dangerous assignments are being reported at record rates by hospital workers at PeaceHealth Southwest Medical Center in Vancouver.
The number of reports made to the Washington State Nurses Association, which represents nurses at PeaceHealth Southwest, rose from 32 in 2019 to 242 in 2020 and 302 in 2021, according to Jayson Dick, the union’s director of labor advocacy. Fifty reports have already been filed in 2022.
Staffing shortages are leading to more dangerous assignments for nurses, Dick said, and more reports to the union. He did not comment on specific complaints because the reports are confidential.
“This is a very real situation,” Dick said. “Nurses don’t submit these lightly. These are the assignments that were so bad that nurses felt compelled to file them after a long, grueling shift. These are exactly the kinds of conditions that are driving nurses away from the field.”
But Clark County isn’t alone: Critical staffing shortages are plaguing hospitals statewide, leading to safety concerns and high levels of burnout among nurses.
There is a shortage of some 6,000 registered nurses across the state, according to a survey conducted by the Washington State Hospital Association in November.
Hospital workers represented by Washington’s three largest health care unions — UFCW 21, SEIU Health-care 1199NW and the Washington State Nurses Association — filed 8,600 workplace safety complaints in 2021, a record number, according to the three unions. For comparison, 2,685 complaints were filed in 2019.
The complaints from 2021 largely reference a lack of staff safety due to staffing shortages, equipment shortages and patient concerns, according to a statement from the Washington State Nurses Association.
Safe-staffing standards
To address the staffing shortage, Washington’s three largest health care unions formed a coalition in support of two bills — House Bill 1868 and Senate Bill 5751— that would implement hospital staffing standards across the state.
The two bills would mandate strict nurse-to-patient ratios that would lower patient mortality rates and reduce nurse burnout, according to David Keepnews, executive director of the Washington State Nurses Association.
To back up that claim, Keepnews pointed to a report written by Patricia Pittman, a national nursing researcher at George Washington University’s Fitzhugh Mullan Institute for Health Workforce Equity, that analyzes nurse-patient staffing level research conducted between 1992 and 2022.
Pittman’s report was commissioned by the health care union coalition but conducted independently.
“The principal findings of the report is that there’s a significant body of research showing the relationship of higher nurse staffing levels to lower patient mortality,” Pittman said at a Feb. 1 press conference.
California is the only state in the country that mandates staffing ratios, and much of the research Pittman analyzed looked at outcomes there. According to Pittman, the rate of growth of nurse staffing between 2003 and 2018 was 55 percent in California and 6 percent in Washington.
Pittman also analyzed hospital staffing legislation in 14 other states and concluded that directly mandating safe-staffing standards like California is the only way to effectively improve health care staffing and patient outcomes.
“This is the way out of Washington’s staffing crisis and toward better quality care,” Keepnews said. “Quite literally, safe staffing saves lives, and 30 years of research proves it.”
If passed, hospitals would have two years to implement minimum staffing standards, according to HB 1868.
Opposition
The Washington State Hospital Association opposes mandating staffing standards.
In a statement, the association argues that a staffing mandate would require hiring at least 15,000 registered nurses and certified nursing assistants across the state, increasing state health care costs by an estimated $1 billion.
“Implementing these strict staffing ratios would require hospitals to temporarily shut down services, including emergency departments, whenever they did not have enough staff to meet the state requirements,” the statement read.
Members of the health care union coalition refute those claims.
Keepnews argues that opposition to the legislation rests on anecdotal evidence instead of data and research. He said that improving nurse staffing levels quickly is critical because nurses are leaving the field in droves. Staffing standards would bring more nursing students to the state, he said, and help retain current nurses.
According to a survey conducted by the health care union coalition in December, 49 percent of health care workers in Washington said they’re likely to leave the field in the next few years. Of that 49 percent, 71 percent cited short-staffing as their reason for wanting to leave.
“It’s a vicious cycle,” Keepnews said. “The worse staffing gets, the worse it gets. Focusing on keeping nurses and other health care workers working, keeping them at the bedside and ensuring adequate staffing, is the key component that will help turn that around.”
Dick, who regularly consults with the nurses at PeaceHealth Southwest, said safe-staffing standards would make a positive impact.
“We didn’t have the staffing we needed going into this pandemic,” he said. “Without staffing standards, we’re going to continue to see this problem get worse.”
