Kaiser nurses issue warning: Short staffing could diminish patient care

A June 21 rally to protest short staffing at Kaiser Permanente drew members and staff from OFNHP and two other Kaiser unions, United Food and Commercial Workers (UFCW) Local 555 and SEIU Local 49, as well supporters from Portland Jobs With Justice. Holding the bullhorn is Kaiser nurse (and OFNHP president) Adrienne Enghouse.

By Don McIntosh

Nearly 1,000 employees of Kaiser Permanente’s Northwest Region have signed a petition raising concerns about understaffing — and calling on the health maintenance organization to hire additional staff. The petition was circulated by Oregon Federation of Nurses and Health Professionals (OFNHP) and signed by 803 of its members and nearly 200 other employees, including members of other unions at Kaiser.

Kaiser Permanente tele support agent Krista Lehan carries the rolled up petitions to Kaiser management signed by nearly 1,000 of her co-workers.

Taped together and unfurled at a highly visible June 21 rally on the corner of Northeast Grand Avenue and Multnomah Street outside Kaiser Northwest headquarters, petition sheets stretched 70 feet long at two-and-a-half feet high, and took 10 people to hold them up. OFNHP leaders rolled up the petitions, wrapped them in a bow, and headed inside to present them to Kaiser top brass.

But the union had no appointment to see the health system’s executives, and coming at lunch time, they found that Kaiser Northwest region president Andrew McCulloch, patient safety vice president Janet O’Halloren, and HR vice president Frank Hurtarte had all gone to lunch.

“Whether they are willing to climb out from under the lunch table or not, I think they got the message,” OFNHP president Adrienne Enghouse told about 100 rally participants back on the street.

“Our patients complain about long waits for care and our coworkers are reaching a breaking point,” the petition reads. “We understand that Kaiser expects to add 30,000 new members in 2017. … Kaiser must hire sufficient frontline staff to address this spike in patient volume.”

OFNHP spokesperson Megan Hise says a trend toward “lean” staffing is pervasive in the health care industry, but OFNHP wants Kaiser to be a leader, setting a standard for adequate staffing levels.

In its Northwest region, which extends from Eugene to Longview, Kaiser is the most unionized and some might say most beloved health insurer/provider by local unions — for offering affordable high-quality care that saves money for union health and welfare trusts and union employers, and for keeping union members healthier than they might be at other providers. Kaiser has also had the least contentious labor relations of any health system in the region. A national coalition of unions representing 115,000 Kaiser workers is now 20 years into an official “Labor-Management Partnership” with Kaiser, in which unit-based teams of workers and managers collaborate to reduce waste and improve the workplace.

“We have a great opportunity to serve even more Kaiser members in the region — if we staff up,” said organizer Gabriel Erbs, who works with OFNHP members at Kaiser’s new Westside Medical Center in Hillsboro. “At the end of the day, our working conditions are patients’ healing conditions.”

Erbs says understaffing at Westside is causing longer waits for planned appointments, particularly among respiratory therapists and in the operating room, where Kaiser is extending hours, adding new types of surgery, and increasing the caseload — without adding more staff.

“Saving lives is our daily mission,” said UFCW Local 555 member JoAnn Grugan. “Safe staffing saves lives.”

At the rally, UFCW Local 555 member JoAnn Grugan, a special procedure technologist at the Sunnyside Cath Lab, said half the nurses in her department have left in the past two years due to overwork.

“We’re losing experienced nurses and bringing in inexperienced nurses,” Grugan said. “That reduces patient care.”

Deadlocked staffing committees

OFNHP’s collective bargaining agreements with Kaiser aren’t set to expire until September 2018. But the disagreement that motivated OFNHP members to gather outside Kaiser HQ isn’t taking place at the bargaining table. It’s taking shape within hospital safe staffing committees that were set up under a 2015 Oregon law that Oregon Nurses Association, OFNHP’s sister union, helped to pass. That law requires each hospital to form a committee to draw up a plan for minimum nurse staffing levels in each unit — in order to ensure adequate patient care and safety. The plans were supposed to be developed by January 2017, but no plans have yet been agreed to for any Kaiser hospital.

The committees are composed equally of frontline nurses and nurse managers, and at Kaiser and elsewhere, that’s leading to deadlock.

Enghouse, the OFNHP president, says at the March 2 meeting of Sunnyside Medical Center’s staffing committee, nurse manager Tonya Roth said the hospital would not consider any staffing plan that calls for an increase in staff. That provoked an immediate reaction from the frontline nurse members of the committee.

“I said, ‘That is totally inappropriate for you to say,” Enghouse said.

On June 8, labor-side committee members wrote to the Oregon Health Authority to complain about Roth’s statement, and to protest delays in approving the hospital’s staffing plan.

Kaiser, for its part, made it clear there are two sides to the story.

Understandably enough, the non-profit health provider would prefer to discuss proper staffing levels in the staffing committees, and not in the newspaper, said Kaiser Northwest spokesperson Mike Foley.

But Foley did email the following statement, reprinted here in its entirety:

Hospital leadership and staff are working together on nurse staffing plans. Patients and members are at the center of our Value Compass, which guides Kaiser Permanente’s decisions and operating strategy. Patient safety is always a top priority. 

Our hospitals are nationally recognized for safety. For example:

  • “A” patient safety ratings for KSMC and KWMC from the Leapfrog group in 2016 and Spring 2017. Sunnyside achieved Leapfrog’s Top Hospital Recognition for 2016.
  • Sunnyside named one of America’s 100 Best Hospitals by Healthgrades, placing it in the top 2% of nearly 4,500 hospitals nationwide. KSMC earned 8 quality award distinctions from Healthgrades in the last 12 months.
  • Highest rating for KPNW from the Society of Thoracic Surgeons for seven consecutive years.

As for OFNHP, they’re going to try again to deliver those signed petitions. Word is that Kaiser’s national CEO, Bernard Tyson, will be attending the groundbreaking ceremony for a new clinic in Beaverton June 23, and nurses hope to be able to present it to him while he’s in town.

[MORE: Photos of the rally here.]

OFNHP’s petition to Kaiser Permanente

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