Health unions say Washington hospitals are “on the brink of crisis”
Washington hospitals have spent the last month enduring the biggest wave of COVID-19 cases to date, and the increase is prompting healthcare workers’ unions to issue new calls for hospitals to take action. additional measures to tackle burnout, retain existing caregivers and maintain their overall staff levels. .
In a joint press release last week, three unions representing Washington healthcare workers – SEIU Healthcare 1199NW, UFCW 21 and the Washington State Nurses Association – said hospitals were “on the brink of a crisis” and had need “immediate and impactful action to retain and attract critical workers.”
“Instead of fighting for a supply of nurses, we need to seek to retain the nurses who are there, to strengthen the staff and decent working conditions,” said Washington State Nurses Association executive director David Keepnews .
Union officials and local nurses said the widespread use of ‘traveling’ nurses – temporary contractors provided by recruitment agencies – has been a particular source of frustration in recent months as the tense work has caused contract pay rates to increase. Sign-up bonuses for new staff nurses are also becoming much larger and more common, Keepnews said.
The problem with these approaches is that permanent nurses feel left behind when they find themselves doing the same job for less pay, said Sarah Collins, intensive care nurse at PeaceHealth Southwest Medical Center.
Healthcare workers are grappling with burnout after 18 months of pandemic operating conditions, she said, and pay disparities amplify the problem, prompting nurses to quit their jobs or become travelers themselves – creating more staff shortages in the hospitals they leave. behind.
âIt’s kind of that vicious cycle,â Collins said. âI don’t see how it’s going to end well.
Beth Zborowski, senior vice president of membership and communications at the Washington State Hospital Association, acknowledged the disparity in travelers’ pay, but rebuffed broader claims about retention efforts.
Hospitals have offered multiple incentives to retain existing workers throughout the pandemic, she said, and they have worked to expand the training pipeline to bring new nurses and other healthcare workers into the world. industry. Hospitals across the state have also worked collectively to balance the flow of incoming patients and ensure that no place is overcrowded during the current wave.
But there is no quick or easy fix, she said, as the entire healthcare industry was already suffering from a chronic nursing shortage long before COVID-19 arrived – and the current increase in cases has far exceeded even the worst weeks of the last winter wave.
âThe healthcare system and the hospital system are always very stressed and our employees still have to do extremely hard work,â she said.
Burnout, compensation concerns
A nurse named Lauren, who requested that her last name not be used, worked at PeaceHealth Southwest until earlier this month when she resigned to become a traveling nurse. She described a heavy psychological toll inflicted by the large number of patient deaths, especially in the past month.
âThis is the ICU – you’re used to people dying,â she said, âbut the only reason we had room for patients is that a lot of them were dying. “
Nurses are constantly being pulled in too many directions at once, she said, as critically ill patients require near constant monitoring to make sure they remain stable. Nurses have traditionally been assigned to these types of patients on a one-to-one ratio, but the ratio currently tends to be two to one, Collins and Lauren said.
In an environment where nursing teams must increasingly rely on each other for instant support as they jump between patients, the high turnover rate adds to the pressure and stress of permanent staff.
Travel nurses are also qualified, Lauren said, but each hospital has its own procedures and familiarity among nurses, and it takes time for newcomers to fully assimilate, she said – which makes wage disparities harder to ignore.
âYou are sitting next to someone who earns three times as much as you, and you are the resource for them – this is a new hospital for them,â she said.
The situation is difficult in every hospital, and Collins and Lauren both said nurses who quit to become travelers did not expect the work environment to be less stressful or demanding wherever they land.
âIt’s the salary,â Collins said. “It could be just as morally painful in terms of COVID elsewhere, but elsewhere could pay me more.”
Lauren praised PeaceHealth for offering advice to employees and said the managers directly in charge of her unit have been supportive and understanding. She expressed regret at leaving her colleagues and moving to an unfamiliar work environment, but ultimately said the pay gap made “going to work seem financially unreasonable”.
PeaceHealth chief nurse Holley Tyler said in a statement that the hospital has made efforts to recruit and hire nurses throughout the pandemic in addition to bringing in travelers.
Staff nurses received expanded paid sick leave, an emergency fund to help cover living costs and improved compensation to take extra shifts, she said. The hospital board also presented financial awards to all caregivers last year.
âOur priority is always to provide patients with safe and quality care,â she said. “We express our deep gratitude to our nurses during this pandemic, and we will continue to make sure we stay in sufficient numbers for our nurses to continue to want to practice here.”
The pay gap for mobile nurses is a significant problem nationwide, according to Chelene Whiteaker, senior vice president of government affairs at the Washington State Hospital Association. Whiteaker, Collins and Keepnews all said it has become common for travelers to earn two or three times the wages of their permanent colleagues.
Some Washington hospitals have tried to offer retention bonuses for permanent staff, Whiteaker said, but current travel rates cannot be matched dollar for dollar.
“It would bankrupt hospitals – literally,” she said.
Hospitals are seeking a solution at the federal level to put an upper limit on contractual travelers’ rates, Whiteaker said, and want the US attorney general to step in to examine what she called “price gouging” by recruitment agencies that provide traveling nurses.
âThe reason I say it has to be national (is) because if a state takes action, travelers just won’t come to that state,â she said.
Keepnews acknowledged the retention bonus efforts, but said they were “not that prevalent” among state hospitals and not enough to address disparities caused by travelers and other “short-term fixes” . The ultimate goal must be to achieve and maintain safe staffing levels in hospitals across the state, he said, and “we are clearly not there yet.”