Nurses from Providence Centralia Hospital packed both the Chehalis and Centralia city council chambers Monday and Tuesday nights during the councils’ regular meetings to ask for support to address staffing, safety and pay issues.
Diane Stedham-Jewell, a nurse who has worked at Providence since 1978, told the Chehalis City Council on Monday night she believed the issues stemmed from the top in the Providence Medical Group, which now owns 52 hospitals throughout the southwest and northwest U.S. — 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 nation based on revenue.
“In the past 15 years, as Providence has grown and grown and grown, myself and many coworkers have become a number to them. The personalization of that small community hospital we once knew and loved is gone,” Stedham-Jewell said.
She said there is no longer an on-site hospital administrator. Stedham-Jewell said Providence Centralia is having trouble attracting new nurses because it refused to match salaries at competing hospitals in the region.
Those perceived problems were just the beginning of a number of issues multiple nurses brought up during their time speaking in the public comment periods at both meetings.
While the nurses acknowledged that the city councils have no immediate power to enact change at Providence Centralia Hospital, they asked the councils for support in pushing legislation at the state level to ensure safe staffing levels are maintained at hospitals.
Pandemic and Generational Effects
While COVID-19 placed a lot of extra stress on nursing staff around the country, another issue is now adding pressure to the overworked and understaffed nurses at Providence Centralia, they told the councils.
Many older nurses are retiring or have died. While the population continues to grow, there aren’t enough new nurses being trained to keep up with the loss of older nursing staff.
This, combined with the effects of COVID-19, has been quite noticeable, Stedham-Jewell said. Since January of 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 nursing population, the general population getting older is adding to nurse workloads, she said.
“We’ve known for decades that the baby boomers were going to reach an age where we were gonna need more health care for them. We’ve known this for a long time and we’re seeing that happen now with no changes, no improvement, no extra resources for this,” said Providence Centralia nurse Randi Bieker.
Need to Expand the Hospital and Improve Pay
This understaffing issue is being compounded even further by another problem — Providence Centralia Hospital’s size. The hospital hasn’t been expanded since the 2005 addition of the emergency room (ER), which has 22 beds. According to reporting from The Chronicle on that 2005 expansion, the goal was to reduce wait times.
It was estimated that before the expansion the ER system took on average 2.45 hours for patients to be seen and discharged and 3.68 hours for a patient to be admitted.
Now, whether you’re just seen and discharged or admitted, if you’re in the ER at Providence you can expect a wait time of at least 10 hours minimum, the nurses claimed.
The 22 beds the ER has are nowhere near enough to meet demand, the nurses said. At any given time, there are 60 or more patients in the ER waiting to be seen, some of the nurses stated.
“We used to have a patient-to-nurse ratio of four to one. Now we are taking patients eight to one nurse. It’s not viable for the long term. We’ve been doing it for a few years now,” said Providence Nurse Emilly Keller.
Bed shortages cause other ER issues besides the long wait times for patients, as now ambulances are being held up, they said.
“An ambulance brought a patient in yesterday and had to wait two hours to offload their patient. This is not uncommon and we’ll sometimes have ambulances stacked up at the door,” Bieker said. “This is a safety risk for our community as well because now you have ambulances that cannot respond to emergencies because they cannot offload their patient until we accept that patient. And when there’s no room, there’s no room.”
Pay is another issue. Aside from losing new nurses to competing hospitals with better salaries, those who choose to stay at Providence were also losing bonuses they used to get, some nurses claimed.
“We have asked for hazard pay and have been denied. We have asked for the return of bonuses when nurses picked up shifts. That too was denied even though these bonuses were actually working. We asked for a retention bonus to honor the years of service nurses have put in. That also was denied. We have repeatedly offered solutions and have been turned down every time,” said Providence Centralia Nurse Teela Murphy. “You may think this is personal. Yes, it is. We’re asking for action before reprehensible work conditions affect you or someone you love.”
Additionally, many nurses were angered when bonuses were offered to non-union nurses for picking up shifts recently, but withheld from members of the local union.
Privacy and Safety Issues
Nurses told the councils the bed shortage in the ER has become dire. Many of those who spoke out at the council meetings cited concerns of privacy loss for patients as well as safety concerns.
“For the past year, wait times have not only gone up but we now have patients littered in the hallways. One of my concerns is the Health Insurance Portability and Accountability Act of 1996, better known as HIPAA,” Bieker said. “We are putting curtains on wheels between patients in the hallway beds and you can definitely hear what’s going on with the person next to you. I’m worried we may be violating compliance with HIPAA.”
Because many nurses said they are being forced to take care of more than twice the normal workload of patients, they are worried the additional work is putting all patients at risk, as well as the nurses themselves who may lose their jobs due to a mistake.
“I have personally spoken to nurses who have been nurses for many years but recently obtained insurance on their nursing license,” Murphy said. “The unsafe working environment at Providence is causing nurses to seek external and additional nursing license insurance because of the distressing work environment and lack of support from hospital administration.”
Providence Is Working to Find Solutions
While he was not at the Chehalis City Council meeting on Monday night, Providence Centralia Hospital CEO Darin Goss did appear at the Centralia City Council meeting Tuesday and addressed the council after the nurses spoke.
“As said earlier, the wait times in our ER and volumes are stretched. This is not unique to health care and it’s not unique to just our own hospital here. But at Providence as a leadership team, we have addressed and continued to address the staffing challenges here. We recognize that as RSV, flu, COVID, delayed care and others are hitting our emergency room it also impacts our staff,” Goss said.
He acknowledged the concerns held by many of the nurses about not being able to provide quality care to patients because of short staffing and a lack of beds. Goss added that he, along with other administrators, were working with Providence Medical Group to better address the staffing and safety issues being seen at the hospital.
Providence nurses plan on attending the Lacey City Council meeting Thursday night to ask for the council’s support in fighting for safe hospital staffing legislation, according to UFCW 3000 union representative Stephen Benavides.