May 1, 2023 -- MultiCare Good Samaritan nurses in Puyallup held a powerful rally outside the hospital April 26 after negotiations for a new contract stalled (see photos). Two days later, dozens of Good Samaritan nurses voiced their concerns over staffing directly to MultiCare executives at a public hearing over a proposed new patient tower.
Nurses say they are being driven to the brink. They love their jobs. They love their colleagues. But they cannot take the escalating patient loads.
Ashley Eubank, a registered nurse at the hospital since 2020, told the crowd at the rally that staffing has deteriorated in the past year and the workload has increased.
“Nursing is my passion, and I have become mentally, emotionally, and morally exhausted,” she said.
Nurses are asking MultiCare for better staffing and for dedicated break nurses. As it stands now, nurses have “break buddies” – a nurse who would take on another nurse’s patients in addition to their own to allow a fellow nurse to take a rest or meal break. Nurses say that this method spreads them too thin and is not in a patient’s best interest.
“We tried negotiating. It didn’t work. We have tried a petition. It didn’t work. We are out here picketing. We hope it works,” Atalia Lapkin, a registered nurse, told the crowd. “We deserve better. Our patients deserve better.”
Lapkin said ICU nurses should have no more than two patients. But when someone goes on break, that nurse is now responsible for four.
An overwhelming majority of the 750 nurses represented by the Washington State Nurses Association supported the information picket and hundreds of Good Sam nurses took part, joined by nurses from other hospitals, community members, and patients.
Cherika Carter, secretary-treasurer of the Washington State Labor Council, which represents more than 500,000 workers in the state, offered the labor council’s full support.
“The Washington State Labor Council has your back, and I’m here to let you know that today,” she said. “The hospital administration must know that safe patient ratios and a safe job serving the community where you live are not luxuries, they are necessities.”
David Keepnews, executive director of the Washington State Nurses Association, said there is something clearly wrong with MultiCare’s priorities.
“Clearly it’s not providing the staffing patients need,” he said.
Nurses don’t feel heard
At MultiCare Tacoma General, meanwhile, WSNA nurses bargained for and won nurse-to-patient ratios in 2016 which cap the number of patients a nurse cares for, and they operate with break nurses. MultiCare Tacoma General nurses came to the brink of a strike vote to win ratios and designated break nurses.
Good Samaritan nurses said they are frustrated because they don’t feel they have a voice. Staffing plans created in committee alongside the chief nursing officer and other nursing managers are often vetoed by MultiCare leadership. Nurses say decisions on patient care are made without bedside nurses present, such as so-called team nursing and virtual nursing (in which a nurse from off-site, sometimes from out-of-state, appears in a patient’s room on a screen).
Team nursing, nurses explained, doubles the patient load of a registered nurse and expects much of the patient’s care to fall on ancillary staff (such as certified nursing assistants). While team nursing works in some departments like outpatient rehabilitation, the nurses said, it doesn’t work well for in-patient care.
WSNA has filed six Unfair Labor Practice charges with the National Labor Relations Board regarding MultiCare’s violations of federal labor law at Good Samaritan.
Public hearing over new tower
On Friday, the Washington State Department of Health held a hearing on MultiCare’s application for a Certificate of Need to build a new 160-bed patient tower at Good Samaritan. The hearing had been requested by WSNA. Over 70 community members, including dozens of nurses from Good Samaritan, attended the hearing. Most of the questions came from the nursing staff at the hospital who asked MultiCare executives how the tower will be staffed since there aren’t enough nurses to handle existing patient loads. Nurses described triage tents in the parking lot and hallway beds in the ER. Nearly 50 nurses also submitted comments expressing their concerns over staffing the facility. In a letter to the Department of Health, WSNA offered several concerns over MultiCare’s plan to staff the new tower:
- The annual RN turnover rate at Good Samaritan was 25.6% as of February 2023, an unsustainable level for a high functioning healthcare facility.
- MultiCare’s projected RN staffing levels for the expanded facility are far too low.
- The virtual nursing company that MultiCare has contracted with, Banyan Med, employs out-of-state nurses who may not be licensed to practice in Washington state and who earn less per hour than a Washington nurse right out of nursing school. “While we are not opposed to advancements in nursing practice, without the proper checks, we are concerned that MultiCare will begin using them as a substitute for adequate in-person staffing,” the letter stated.