Oregon nurses are asking state lawmakers to put minimum hospital staffing standards in place amid a shortage of nurses.(Christine Torres Hicks/OHSU)
Oregon nurses want lawmakers to put minimum staffing standards in place for hospitals, saying it’s critical as the nursing workforce faces burnout, staff shortages and unsafe conditions for patients.
The push comes on the heels of a three-year pandemic that carried nurses to the breaking point of exhaustion. Nurses have exited the field in droves and retired. Hospitals have struggled to recruit and retain them. That creates a situation in which patients get shuffled elsewhere or their medical care is delayed. In times of crises, like a COVID-19 or influenza outbreak, shortages are even worse.
For Oregon’s nurses unions, House Bill 2697 offers a path forward in addressing the state’s nursing shortage. The bill would put minimum safe staffing standards into Oregon law. For example, a registered nurse in a hospital’s intensive care unit would be assigned only one or two patients, depending on their severity.
The bill would put Oregon on the forefront of a national labor movement for better working conditions and staffing levels for nurses in hospitals. The American Federation of Teachers, a national health care union, is launching a $1 million campaign, dubbed “Code Red,” that includes a radio and social media blitz and legislative advocacy that initially targets Oregon and Connecticut, New Mexico and Washington.
“We need to save lives,” said Randi Weingarten, president of the union, in a press conference on Friday. “Our health care providers who have helped us for generations, helping at the bedside, they are crying out for help.”
An airing of differences is expected. The hospital industry doesn’t support the bill in its current form, saying more flexibility is needed.
Meanwhile, nurses say those who have left Oregon hospitals would be willing to return with better working conditions.
Oregon has more than 80,000 registered nurses licensed with the state though not all of them are working. Thousands more are needed in the field. A 2021 Oregon Employment Department survey labeled three-fourth of registered nurse positions among 2,099 openings as difficult to fill.
Oregon labor leaders: standards needed
Legislators and representatives of two of the state’s nurse unions, both local affiliates of the national union, spoke about the push in Oregon.
“I am burned out, exhausted, frustrated, scared and, yes, angry,” said Tamie Cline, a registered nurse and president of the Oregon Nurses Association, which represents more than 15,000 nurses in Oregon.
Cline said she left her job at an Oregon hospital several months ago. Nurses, she said, are departing from bedside care positions because of unsafe staffing conditions.
“Nurses who take care of more patients than is safe report constantly that they are unable to perform their care duties,” Cline said. “Those who care for more patients are more likely to experience medication errors. We see increased patient mortality or pressure ulcers, more infections, more cases of pneumonia, longer hospital stays, more hospital readmissions, more respiratory failure and more preventable deaths.”
The Oregon Federation of Nurses and Health Professionals, which represents 2,300 nurses, also supports the bill.
“The bill will make Oregon’s hospitals safer for both staff and patients and is the only appropriate answer after the crisis we’ve seen across our public health system these past few years,” said Jonathon Baker, a registered nurse and president of the federation.
Oregon has a law that requires staffing plans, but labor leaders say it lacks an adequate enforcement mechanism, which this bill includes through the Oregon Health Authority.
Minimum staffing standards would be a starting point as nurses and hospital managers negotiated staffing plans.Those plans could be more rigorous.
During the pandemic, out-of-state traveling nurses have filled the gaps, but Oregon nurses and health care leaders recognize that’s expensive – and not a long-term solution to the state’s workforce crisis.
The bill will be discussed Tuesday in the House Committee on Behavioral Health and Health Care. One of its chief sponsors is the committee chair, Rep. Rob Nosse, D-Portland.
Nosse and another chief sponsor, Rep. Travis Nelson, D-northeast Portland and a registered nurse, visited with dozens of nurses Friday morning before the press conference.
“We are facing a tremendous staffing and turnover crisis like we have not ever experienced,” Nosse said. “We heard from dozens of nurses about their exhaustion, their burnout. Frankly, some of them shared tales of sadness, even one about suicide and fear and frustration.”
Nelson said he left bedside nursing nearly 10 years ago and stressed burnout is real.
“I also know what it feels like to have a patient die, a patient with a spouse, a patient with children, a patient with loved ones, and to know that they died in part because I didn’t have the support that I needed as a nurse,” Nelson said. “That was a heartbreaking experience. And it’s an experience that continues to live with me to this day.”
Debate and negotiations ahead
The bill faces scrutiny from the hospital industry. The Oregon Association of Hospitals and Health Systems, which represents the state’s 62 hospitals, opposes the bill.
“While OAHHS agrees the current nurse staffing law is not working, we cannot support HB 2697 as currently written,” Lisa Goodman, a spokesperson for the hospitals association, said in an email to the Capital Chronicle. “We need a law that supports the hospital workforce, preserves access to care and acknowledges the dynamic, local environment of hospitals and the staffing shortages they face.”
The bill could always change in negotiations.
With the first hearing planned, hospitals and the nurse unions are at the table, talking about parameters of the bill and “what they can live with and what maybe doesn’t make sense,” Nosse said.
For example, it’s possible the final bill may have different requirements for an intensive care unit in a rural hospital compared to one in a busy urban hospital, Nosse said.
The hospital industry and nurses union have found common ground on other bills to bolster the workforce. Those bills would offer tax breaks for nurse instructors, incentives and scholarships for nursing students and money to hospitals that offer clinical training for nurses.
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