Washington hospital workers filed a record number of workplace safety complaints last year, the state's health care unions reported Thursday — another reminder of the exhaustion and burnout nurses, technicians, therapists, aides and other health care staff have struggled with during the pandemic.
The complaints add to ongoing tensions between many hospital leaders and their staff, who for months have said they don't get enough support from their employers. They have called on hospitals to do more, particularly around overtime policies and financial aid.
Hospitals, meanwhile, acknowledge the state is barreling toward a health care crisis made worse by short staffing, delayed care and a recent spike in COVID-19 hospitalizations as the omicron variant takes hold in the region. But many have been slow, or unresponsive, to address their workers' demands, unions say.
"The crisis was bad with delta. It's even worse with omicron," Jane Hopkins, vice president of SEIU Healthcare 1199NW and former Harborview Medical Center nurse, said in an interview Thursday. "Morale is low — lowest it's ever been."
In 2021, hospital workers — represented by UFCW 21, SEIU Healthcare 1199NW and the Washington State Nurses Association — filed more than 8,600 workplace safety complaints, according to the three labor unions.
In comparison, in 2019, the unions' hospitals workers submitted 2,865 complaints.
The complaints largely reference a lack of staff safety, shortages or inadequate equipment, and other patient concerns, the statement said.
"People are quitting because of dangerous staffing practices that have gone ignored for far too long," Hopkins said in the statement. "There's no use in increasing our workforce if they're just going to burn out within a year. We need to recruit more health care workers to the bedside, but we also need to make sure they can do their jobs safely."
Hospital leaders, in a regularly scheduled Thursday news conference, again recognized how overburdened many of their staff members are, calling them the "backbone" of health care, but provided few details in response to workers' ongoing requests.
"It has been an extraordinary time in health care and we have not been providing care under normal circumstances," Taya Briley, vice president of the Washington State Hospital Association, said in the briefing. "Earlier in the pandemic, for example, we were very stretched for personal protective equipment. We have been stretched for staff. We have been stretched for other resources, like beds.
"To that end, it's maybe not surprising that staff are expressing concerns," she continued.
Some short-term help from the state is on its way — Gov. Jay Inslee on Thursday announced the Washington National Guard will help staff hospitals and testing sites across the state, including in Everett, Spokane, Wenatchee and Yakima, to help with nonmedical tasks in order to help relieve crowded situations in emergency rooms. But many health care staffers say long-term aid is needed.
Many Washington hospitals have started offering retention or COVID bonuses to staffers asked to work extra shifts, including Virginia Mason Franciscan Health, Swedish Health Services and Overlake Medical Center in Bellevue. But other large health care systems, like UW Medicine, have yet to do the same.
Other hospital leaders in Thursday's briefing pointed to food-related support, like free meals or organizing mobile food trucks to visit hospital campuses. Swedish chief executive Elizabeth Wako said the hospital is "focusing on mental health and wellness," and is providing child and elderly care for staff.
Other health care systems, like EvergreenHealth in Kirkland, have implemented mindfulness programs to try and limit worker burnout, including a Code Lavender initiative, which provides employees with "emotional first aid."
Still, many of the state's hospital workers say they're desperate for more specific changes to hospital care policies, like limiting nurse-to-patient ratios or better enforcing the state's existing break and overtime laws.
"Our health care workers don't need taco trucks right now," Hopkins said. "They need safe staffing standards."
Legislative solutions
The state's three largest health care worker unions endorsed a bill this week aimed at improving worker and patient safety by creating new staffing standards in Washington, though the state hospital association said Thursday it has some concerns.
Senate Bill 5751 — introduced by Sen. June Robinson, D-Everett, and Rep. Marcus Riccelli, D-Spokane — proposes nurse-to-patient ratios limited to one emergency department nurse to three noncritical patients, or one nurse to one trauma or critical care patient, and one ICU nurse to one to two patients, depending on their stability.
Other units, like oncology, psychiatric or pediatric, have higher proposed ratios, such as one nurse to five or six patients.
All hospitals, with a few exceptions, would have two years to implement the minimum staffing standards, according to the bill.
The bill also proposes hospital staffing committees develop plans for patient-care units, shift schedules must have at least 50% of members be nonsupervisory staffers, employers must better enforce meal and rest breaks, and ending mandatory overtime policies.
"The safe staffing bill makes it so hospitals can respond to emergencies like the one we're experiencing right now," Hopkins said Thursday. "This has to be the foundation for us to be able to keep health care workers safe."
The state hospital association, however, is concerned the proposed legislation "has a lot of different ways restricting how staff can work," Briley said Thursday, referring specifically to the proposed nurse-to-patient ratios.
"We are very concerned about the potential of [a] type of restriction that means some patients simply won't be able to get the care that they need," Briley said.
California is currently the only state in the country to require staffing ratios, though the state's governor approved a temporary relaxing of the staffing standards during the winter 2020 COVID-19 surge, allowing nurses to take on higher patient loads, NPR reported.
"This has been an issue and it continues to be an issue," Hopkins said. "This pandemic has really shown that hospitals over the years ... made the system so inflexible that when there's a crisis, we don't have the staff to look after patients."
