A historic Oregon law that’s supposed to prevent nurses from taking on heavy workloads is proving to be a letdown for hospital staff.
Gov. Tina Kotek signed House Bill 2697 last year, making Oregon the first state to cap nurse-to-patient ratios in state statute. Considered a compromise between labor unions and hospitals on a thorny issue, the law was intended to protect nurses and other hospital staffers from caring for too many patients at once, which lowers the quality of care and burns out staff. The new protections for nurses went into effect on June 1 and cover operating rooms, emergency rooms and other settings. The law also takes into account the “acuity,” or level of need, of patients who are under the care of nurses.
Since June 1, the Oregon Health Authority has received more than 360 complaints – more than 10 times the usual amount – from nurses alleging that hospital managers are violating the law by cutting staff and ignoring workers. The Oregon Nurses Association (ONA), which helped write the law and applauded the governor’s signature last year, has filed complaints about five Providence hospitals and one PeaceHealth hospital in the Eugene area, while pressuring the agency to investigate violations.
The Oregon Health Authority is currently investigating 110 complaints about 23 hospitals, said spokesperson Jonathan Modie. However, the agency can’t issue fines for violations until next year. At this point, the agency can only issue warnings, he said.
“It’s just sad that we have to fight so hard to keep what is safe and right for our patients,” said Michelle McSherry, a registered nurse who works in a surgical oncology unit at Providence Portland Medical Center.
A spokesperson for Providence did not respond to requests for comment. PeaceHealth spokesperson Jim Murez threw cold water on the complaints.
“In alignment with our continued work to improve safety, quality and the patient and caregiver experience, PeaceHealth is complying with all nurse staffing ratios set forth in State of Oregon House Bill 2697,” Murez said.
In its scathing letter to the health agency, the nurses association says that at least six hospitals are ignoring committees of nurses, hospital staff and managers who, under the law, are charged with writing and adopting fair staffing plans. The result: higher ratios for working nurses since the law passed, according to the union.
“Providence’s current staffing plans, which have been safely maintained for some time, are now being unilaterally abandoned by hospital executives in favor of bare minimum staffing ratios,” the union’s letter says.
Specifically, the union says the law has been violated at Providence hospitals in Portland, Seaside, Newberg, Hood River and Milwaukie, as well as PeaceHealth Riverbend Medical Center in Springfield.
At Providence Portland, McSherry says that staffing managers had agreed to lower ratios for nurses about three years ago, giving her unit a staff-to-patient ratio of 1-to-3. McSherry is a member of the hospital’s staffing committee. In May, she was surprised when managers bypassed the committee and implemented 4-to-1 ratios for most nurses — a disappointing return to the old days, she said.
“The nurses were actually in shock that they were going to pass this without our votes and our opinions,” McSherry said. “The law was put in place to give us safe staffing, not increased ratios.”
The nurses association has asked Gov. Kotek and state Rep. Rob Nosse, (D-Portland), to intervene. Nosse, the law’s chief sponsor, used to work as a union rep at ONA. In an email, Nosse said he was aware of the situation and searching for more information. A spokesperson for Kotek did not respond to requests for comment.
Last year, Nosse brokered a compromise on the bill between ONA, Oregon Federation of Nurses and Health Professionals (OFNHP), Service Employees International Union Local 49 (SEIU) and the Oregon Association of Hospitals and Health Systems (OAHHS).
Hospitals had expressed worry about being required to beef up staffing during a national shortage of nurses. The compromises included exceptions for rural hospitals and home health care workers. Originally, the ONA called the law a “game changer” and “historic.”
