WSNA and your officers are disappointed that the CEO, Andrew Jones, MD, MBA, has rejected the staffing plan that was submitted by the staffing committee. The hospital is required by law to work jointly with staff nurses to develop plans. Your staffing committee members work tirelessly to create these plans and also spend hours each month reviewing the many ADOs that have been submitted by you all. The CEO is required to provide an explanation for rejection of the plan but his letter did not explain his rationale for rejecting the plan.

In Dr. Jones’ letter he mentions the administration plan for staffing and states, “This plan is based on the median staffing for like units from national benchmarks and is considered industry standard,” yet the questions raised by your representatives about staff and patient safety, as well as the increased mortality and morbidity thirty years of research has shown to occur when nursing staff is reduced were not addressed.

To date we have not been given raw benchmarking data which we believe does not accurately represent what is needed to provide strong patient care and provide staffing at appropriate levels to allow for uninterrupted meals and rest periods without utilizing increasing patient loads within “buddy system” break strategies.

To date we have not been given quality indicators, which a staffing committee must consider when formulating a staffing plan. This is not in accordance with RCW 70.41.420 which states, “skill mix, level of intensity for all patients, level of experience or certification of nurses performing care, assistive personnel, strategies that allow nurses to take meal and rest periods, and a review of the plan against patient need and known evidence based staffing information including nursing sensitive quality indicators collected by the hospital.” To read the full law go to RCW 70.41.420.

We understand the hospital is now unilaterally implementing an alternate plan which, according to reports from nurses, appears to be substandard ratios even beyond those that nurses have been working under for months. It is unclear at this time what ratios are being adopted. Information provided by staff in real time via ADOs and verbal reports to WSNA officers, is not congruent with the staffing plan submitted to the Department of Health.

Your officers and WSNA will be responding to Dr. Jones and will share that communication when it is available. It will include the petition signatures from Central Washington Hospital Nurses supporting their nurse staffing committee representatives, select ADOs which have been filed that detail the conditions that have been submitted between Jan 1, 2022 to Jan 1, 2023.

Those ADOs continuously describe nurse’s belief they have been unable to provide the standard of care to their patients, i.e. turning patients when indicated, delivering medication and other care on time, inability to receive rest breaks as required by state law etc.

Furthermore there is additional language within the collective bargaining agreement in article 14, particularly 14.4.7 we believe has been violated as the nurse staffing committee was asked to adopt the hospital staffing plan as it was submitted on 12/15/2022 and members stated that could not adopt without speaking to nurses who would be affected by change. At no time was a vote held, and the representatives were not allowed the time to follow up with those they represent. Regardless of this your voices were heard, and your nurse staffing committee representatives held strong in their resolve to not agree to a staffing plan which erodes the nurse-to-patient ratios without clear answers on plans to address the staffing needs and safety concerns as reported by nurses within the organization.

If you face an unsafe staffing situation, please continue to fill out ADOs. ADOs continue to serve to put management on notice that they have unsafe staffing conditions. ADOs assist WSNA with our legislative efforts to improve staffing laws in the state. ADOs demonstrate the need for the Department of Health to increase their resources to deal with staffing complaints and compliance to the existing law. ADOs are discoverable in a lawsuit so they may prove useful if there is a poor patient outcome and nurse is sued.

WSNA also strongly recommends that each nurse facing a dangerous situation, consider taking the following action(s):

File a Department of Health complaint if you feel unsafe conditions exist or harm has occurred – See DOH complaint filing documentfor instructions.

File a complaint with Labor and Industries if you feel unsafe (pt violence, no lifting equipment/resources), deprived of rest and/or meal breaks, mandatory overtime -See the L&I info to go page for more information.

In solidarity, your local unit officers Sara Bergenholtz, Paul Stamilio, Karla Bourgeois, Stefanie Gates, Brittney Lamb, Jasmine Hutchinson, Paul Molenaar, Blaine Wuertz

WSNA Nurse Representative Shawn Mork (Reed), RN, SANE sreed@wsna.org