Strategic priority — safe staffing

This story was published in the Spring-Summer 2021 issue of The Washington Nurse magazine.

This story appears in Biennial Report of Achievements.

Achieving safe staffing has long been a top concern of our members and a strategic priority for WSNA’s Board of Direc­tors. In this past biennium, WSNA won a landmark bill to protect breaks and end the abuse of manda­tory overtime for nurses.

Achievements #

  • Won passage of the landmark Breaks and Overtime Protec­tions bill
  • Worked to improve enforce­ment of the 2017 Nurse Staffing Law by filing numerous complaints with the Washington State Depart­ment of Health and working with stake­holders to make recom­men­da­tions in the required Dec. 31, 2020 report to the legislature.

Unprecedented member engagement drove passage of landmark legislation #

2104 wa nurse shb 1155 tall

Hundreds of nurses and other health care workers filled the Capitol steps on April 24, 2019, for a rally supporting passage of a clean rest breaks and over-time protections bill.

2104 wa nurse cards memes

An unfortunate remark from one state senator that nurses in rural hospitals “probably play cards for a considerable amount of the day” created a firestorm of memes online.

This was the legisla­tive fight that launched a thousand memes.

When our 2017 – 2019 Biennial Report of Achieve­ments went to press, we were still awaiting the final outcome of our push to secure legis­la­tion to ensure breaks for nurses and end the abuse of manda­tory overtime.

After a tumul­tuous final couple of weeks that included beating back two bad amend­ments, the Breaks and Overtime Protec­tion law (SHB 1155) passed both houses of the State Legis­la­ture on April 24, 2019 and was signed into law by Governor Inslee on May 8, 2019.

This followed an intense legisla­tive campaign, with cooper­a­tion between the three biggest unions repre­senting health care workers in Washington state: WSNA, SEIU Health­care 1199NW and UFCW 21. Nurses from around the state held one-on-one meetings with their elected repre­sen­ta­tives, testi­fied in Olympia and sent thousands of emails to legis­la­tors to encourage passage of SHB 1155.

An unfor­tu­nate remark from one state senator that nurses in rural hospi­tals probably play cards for a consid­er­able amount of the day” made inter­na­tional news after a WSNA blog post went viral. The blog post was shared on Facebook more than 50,000 times, gener­ating more than 176,000 comments, and spawned memes and related posts across the social universe.

The story was picked up by more than 200 news outlets located in three countries in the first seven days after the blog was posted and had more than half a million social media inter­ac­tions. News outlets included CNN, Fox News, The New York Times, The Daily Mail (UK), CBS News, Mother Jones and The Hill.

WSNA and our members were able to channel that outrage into an effec­tive online and on-the-ground advocacy campaign that put nurses and other health care workers center stage. Thousands of nurses called their legis­la­tors and even sent packs of playing cards to the senator who made that unfor­tu­nate remark.

2104 wa nurse swarm

Nurses swarm into the Capitol building and file into the House and Senate chambers to watch as the bill is passed.

On April 24, 2019, hundreds of nurses and other health care workers filled the Capitol steps for a rally supporting passage of a rest breaks and overtime protec­tions bill that excluded the two bad amend­ments tacked on at the last minute.

That after­noon, nurses and techs crowded the Senate galleries and silently watched with bated breath as the vote count ticked up to 32 – 16. The House took up the bill shortly there­after and passed it off the House floor by a vote of 70 – 24. Cheers broke out in the hallway outside the gallery after the bill finally passed.

The bill codifies uninter­rupted breaks and says that manda­tory presched­uled on-call may not be used in lieu of sched­uling employees to work regularly sched­uled shifts. This bill took effect for most hospi­tals on Jan. 1, 2020 and will go into effect for Critical Access Hospi­tals and sole commu­nity hospi­tals on July 1, 2021.

WSNA, SEIU 1199NW and UFCW 21 issued a joint state­ment following passage of the Breaks and Overtime Protec­tion bill:

After nearly a decade of work by thousands of hospital nurses, techs, patients and supporters, Washington is joining many other states, including Oregon and California, in better protecting hospital patients. By guaran­teeing rest breaks to nurses and other front­line caregivers during their long shifts, and prohibiting manda­tory overtime, Washington hospi­tals will reduce the chances for medical errors.”

WSNA shared details of the bill and imple­men­ta­tion steps with members at a series of educa­tion events held across the state in fall 2019 and spring 2020.

WSNA works to improve enforcement of the 2017 nurse staffing law #

The passage in 2017 of House Bill 1714, which added more struc­ture and oversight to the Nurse Staffing Law, was a big victory. But, as with all legis­la­tion, it’s only as effec­tive as it works in the field.

The bill included a require­ment for the Washington State Depart­ment of Health (DOH) to submit a report to the legis­la­ture on Dec. 31, 2020. WSNA worked to ensure that the report addressed key concerns from nurses about staffing commit­tees and hospital compli­ance with the law. Our experi­ences illus­trated deficien­cies in enforce­ment of the law, and WSNA filed 22 complaints with the DOH by the end of 2020, supported by the Staffing Concern/​Assignment Despite Objec­tion (ADO) forms our members filed to call out problems in their facilities.

The Nurse Staffing Law also required that DOH convene a stake­holder group prior to the submis­sion of the Dec. 31, 2020 report to the legis­la­ture and named the partic­i­pants of that group as WSNA, the Washington State Hospital Associ­a­tion, SEIU Health­care 1199NW and UFCW 21. The group of stake­holders was able to reach agree­ment on two recom­men­da­tions to be included in the report: 1. Nurse Staffing Commit­tees should develop and adopt charters, defining the process they will use to review complaints and document decisions, and 2. DOH should clarify the proper agency and proce­dure to inves­ti­gate complaints of retal­i­a­tion specif­i­cally prohib­ited in the law.

WSNA, along with our union partners, made several additional recom­men­da­tions that will be included in the report’s appendix, including a recom­men­da­tion that hospi­tals be required to submit staffing plans to DOH annually using a standard template and making hospital-level nurse staffing committee meetings open unless in execu­tive session.

The current Nurse Staffing Law sunsets in 2023. Over the next biennium, WSNA and the other unions that repre­sent nurses will be working to deter­mine recom­mended adjust­ments and next steps.

Biennial Report of Achievements

Strategic priority - association vitality

Much of our work in this arena is behind the scenes: strengthening operations and infrastructure. In 2020, the WSNA Board of Directors added a focus on addressing issues of diversity, equity and inclusion in our organization and our work.

Strategic priority - quality and safety

At its core, our work is about promoting behaviors and practices that positively impact the safety of registered nurses and patients and lead to improved quality outcomes for all residents of Washington. After the coronavirus pandemic hit our state, much of our focus was on ensuring the safety of nurses and their patients.