Nurses at PeaceHealth SW in Vancouver drop notice to picket April 18

Nurses at PeaceHealth Southwest, a 450-bed hospital in Vancouver, Wash., announced they will picket outside the hospital April 18.

The 1,465 nurses represented by the Washington State Nurses Association, are in negotiations for a new three-year contract. After 13 bargaining sessions, management has not agreed to the Association’s proposed workplace protections, staffing commitments, or market-rate wages.

The picket will take place from 6 a.m. to 9 a.m. and 4 p.m. to 7 p.m. outside the hospital at 400 N.E. Mother Joseph Place, Vancouver.

Nurses say the hospital is operating on a lean model, which means management schedules as few staff members as possible in many areas, such as the emergency room and medical-surgical.

PeaceHealth SW is a Level II trauma center, so it receives complex patients with high needs – drug and alcohol issues, mental health emergencies, car crashes, strokes, and heart attacks.

“The hospital doesn’t currently staff for acuity, such as a violent patient or a patient with complex needs,” said Travis Elmore a WSNA nurse representative relaying concerns of nurses. “The post-COVID world is a new frontier. There’s a lot more anger in the world among patients and visitors, and that puts nurses at risk if we’re not staffed sufficiently to respond to it.”

In the past few months, nurses said the Emergency Department has treated 130 people at one time and up to 200 patients in a single day and were totally overwhelmed. Nurses are called on to wipe down Emergency Department rooms and, when hospital floors don’t have enough unit hosts, nurses are expected to pass trays of food to patients while managing their medical needs.

Since Jan. 1, 2024, nurses have filed 76 assignment despite objection forms (ADOs), which they use to document complaints over their work assignments. Most of the ADOs filed were about staffing, including working 16-hour shifts to keep up with the patient load and going without any breaks at all for a full 12-hour shift.

For example:

• A nurse reported that all floor nurses in the medical-surgical unit were given six patients and the charge nurse two patients. The safe ratio should have been four patients and the charge nurse none.
• A newly licensed nurse was scheduled to care for five high-acuity patients with supervision from a more experienced nurse. When a patient with significant and complicated care needs was admitted during the shift, the supervising nurse was pulled to work with that patient, leaving the new nurse with a full five-patient assignment with no supervision.
• Nurses reported sprinting from patient to patient on their unit to answer telesitter alarms, bed alarms, and chair alarms because there were not enough nurses on shift to answer each high-acuity patient’s alarms.
• A nurse described regular technology failures on the unit, including poorly functioning computers, medication scanners, and call boxes.
• Another nurse said there were nearly 30 patients in the Emergency Department lobby during a recent shift with just two nurses on the schedule. Multiple patients and visitors went up to the window yelling at nursing staff due to wait times.
• A nurse said at least four E.D. nurses worked 16-hour shifts because of high patient loads on a recent workday and that the majority of the staff could not take 15-minute breaks or meal breaks for their entire shift. The nurse added that two nurses who were still being trained were assigned four patients each and the nurse supervising them was assigned another four patients, giving the supervising nurse 12 patients to oversee at once.

Washington law does not mandate minimum nurse-to-patient ratios in hospitals, instead delegating to hospital-based staffing committees to develop facility-specific staffing plans for each patient care unit. Ten minutes away in Oregon, however, the state passed mandated nurse-to-patient ratios in the 2023 legislative session, enshrining in law the kinds of guarantees nurses are looking for at Southwest. Multicare Tacoma General, whose nurses are also represented by WSNA, is the only hospital in Washington state to have protected, enforceable ratios in their contract.

“Nurses want to see some enforceable safeguards around nurse-to-patient ratios and staffing plans in their contract,” said Kelly Skahan, WSNA Labor Counsel and lead negotiator for the Association. “We’re asking PeaceHealth to commit to standards that help us keep nurses on the job in Vancouver.”

PeaceHealth is a nonprofit Catholic health system based in Vancouver offering care through ten hospitals and several clinics in Washington, Oregon, and Alaska. Facilities in the PeaceHealth system have frequently been sites of labor unrest and the system itself is rated “below average” on the job-finding site Indeed in terms of employee well-being.

• On Feb. 12, 2024, PeaceHealth Home Care and Hospice Nurses in Springfield, Ore., went on strike after almost a year of negotiations and 40 bargaining sessions. Nurses were demanding a fair contract - citing a decline in wages, benefits, and overall support. PeaceHealth has yet to reach a deal with those nurses.
• In October 2023, more than 1,300 healthcare workers represented by OFNHP (respiratory therapists, licensed practical nurses, X-ray technologists, surgical technologists, and lab techs) at PeaceHealth Southwest and PeaceHealth St. John Medical Center in Longview, Wash., went on strike over staff shortages, low wages and “anti-union attacks.” PeaceHealth threatened to cut off health insurance for workers if the strike lasted into November. WSNA filed an unfair labor practice charge concerning that threat, citing its coercive and intimidating impact on nurses’ own exercise of protected activity. That charge remains pending before the NLRB’s Region 19.
• In July 2023, lab techs represented by OFNHP picketed outside PeaceHealth St. John over staffing and low wage.
• In early October 2022, healthcare workers (dietary workers, certified nursing assistants, and housekeeping staff) held an informational picketed at three PeaceHealth hospitals -- Sacred Heart Medical Center Riverbend in Springfield, Ore.; Sacred Heart Medical Center University District in Eugene, Ore., and St. John Medical Center in Longview, Wash – over staffing levels and working conditions.

According to a report by the U.S. Labor Department released Feb. 21, the year 2023 saw the highest number of strikes in two decades. Of the 33 major strikes (1,000 employees or more), half were in healthcare.