By Owen Sexton / [email protected]
Nurses from Providence Centralia Hospital filled both Chehalis and Centralia council chambers Monday and Tuesday evenings during regular council meetings to plead for assistance to address personnel, safety and wage issues.
Diane Stedham-Jewell, a nurse who has worked at Providence since 1978, told Chehalis City Council Monday night she believes the problems originated at the top of the Providence Medical Group, which now owns 52 hospitals in the Southwest and Northwest — including Providence Centralia Hospital – and more than 1,000 medical clinics.
According to Stedham-Jewell, Providence Medical Group is now the 10th largest medical group in the United States by revenue.
“Over the past 15 years, as Providence has grown and grown and grown, I and many colleagues have become numbers to them. The personalization of this small community hospital we once knew and loved is gone,” said Stedham-Jewell.
She said there was no longer a hospital administrator on site. Stedham-Jewell said Providence Centralia is struggling to attract new nurses because it has refused to match salaries at competing hospitals in the area.
These perceived issues were just the beginning of a series of issues raised by several nurses during their speaking time in the public comment periods at both meetings.
While the nurses acknowledged that city councils have no direct authority to enact changes at Providence Centralia Hospital, they asked councils for assistance in enforcing state-level laws to ensure safe staffing levels are maintained at the hospitals.
Pandemic and generational effects
While COVID-19 has taken a toll on nursing staff across the country, another issue is now increasing the pressure on Providence Centralia’s overworked and understaffed nurses, they told councils.
Many older nurses are retiring or have died. As the population continues to grow, not enough new nurses are being trained to keep up with the loss of older nurses.
This was quite noticeable when combined with the effects of COVID-19, Stedham-Jewell said. Since January 2020, 102 nurses have left Providence Centralia while only 85 have been hired to replace them, she said.
Stedham-Jewell said the problem has become so pervasive that there are now 120 open shifts waiting to be picked up in January.
Aside from the aging caregiver population, the general population, which is aging, contributes to the workload of caregivers, she said.
“We’ve known for decades that baby boomers would reach an age when we would need more medical care for them. We have known this for a long time and we see this happening now, with no changes, no improvements, no additional resources for it,” said Randi Bieker, Providence Centralia Nurse.
The hospital needs to be expanded and pay improved
This staffing shortage is compounded by another issue – the size of Providence Centralia Hospital. Since the addition of the 22-bed Emergency Department (ER) in 2005, the hospital has not expanded. According to reports from The Chronicle about this 2005 expansion, the goal was to reduce waiting times.
It was estimated that prior to the expansion of the emergency room system, it took an average of 2.45 hours to see and discharge patients and 3.68 hours to admit a patient.
Whether you’re just seen and discharged or admitted, when you get to the Providence emergency room, you can expect a wait of at least 10 hours, nurses claimed.
The 22 beds the emergency room has are nowhere near enough to meet the needs, nurses said. At any given time, 60 or more patients are waiting in the emergency room to be seen, some of the nurses said.
“We used to have a four-to-one patient-to-care ratio. Now we take patient care to a nurse. It is not sustainable in the long run. We’ve been doing this for a couple of years now,” said Providence Nurse Emilly Keller.
Bed shortages are causing other problems in the emergency department, in addition to long waits for patients, as ambulances are now being held up, they said.
“An ambulance brought in a patient yesterday and had to wait two hours to unload its patient. It’s not uncommon, and we’ve had ambulances stacked out front at times,” Bieker said. “This is also a safety concern for our community because now you have ambulances that cannot respond to emergencies because they cannot offload their patient until we accept that patient. And if there is no place, there is no place.”
Payment is another issue. Aside from losing new nurses to competing hospitals with better salaries, those who chose to stay with Providence also lost bonuses they used to receive, some nurses claimed.
“We asked for hazard pay and were turned down. We have asked for bonuses to be returned when nurses have taken shifts. This too was denied, although these bonuses actually worked. We have asked for a loyalty award to recognize nurses’ years of service. That too was refused. We have repeatedly offered solutions and have been turned down each time,” said Providence Centralia Nurse Teela Murphy. “You might think this is personal. Yes it is. We demand action before you or someone you love is impacted by reprehensible working conditions.”
In addition, many nurses have been upset when non-union nurses have recently been offered shift work bonuses that have been withheld from members of the local union.
Privacy and security issues
Nurses told councils the emergency room bed shortage had gotten bad. Many of those who spoke at council meetings raised concerns about loss of patient privacy and security concerns.
“Over the past year, not only have the waiting times increased, but we have now scattered patients in the hallways. One of my concerns is the Health Insurance Portability and Accountability Act of 1996, better known as HIPAA,” Bieker said. “We put curtains on wheels between the patients in the corridor beds and you can definitely hear what’s going on with the person next to you. I am concerned that we may be violating HIPAA compliance.”
With many nurses saying they are forced to take care of more than twice the patients’ normal workload, they fear the extra work puts all patients at risk, as well as the nurses themselves, who could lose their jobs due to a mistake.
“I’ve personally spoken to nurses who have been nurses for many years but recently acquired health insurance,” Murphy said. “The unsafe work environment at Providence leads nurses to purchase external and supplemental nursing license insurance due to the stressful work environment and lack of support from hospital administration.”
Providence works to find solutions
While he was not at the Chehalis City Council meeting Monday night, Providence Centralia Hospital CEO Darin Goss appeared at the Centralia City Council meeting on Tuesday and addressed the council after the nurses spoke.
“As previously mentioned, our ER wait times and volumes are increased. This is not just for healthcare and not just for our own hospital here. But at Providence as a leadership team, we have addressed and will continue to address the people challenges here. We recognize that as RSV, influenza, COVID, delayed care and others hit our emergency department, it will impact our staff as well,” Goss said.
He acknowledged the concerns of many nurses that they could not provide quality care to patients due to staff shortages and bed shortages. Goss added that he, along with other administrators, is working with Providence Medical Group to better address the hospital’s staffing and safety issues.
According to UFCW 3000 union representative Stephen Benavides, Providence nurses plan to attend Thursday night’s Lacey City Council meeting to ask the council for support in the fight for safe hospital staffing legislation.