Persistent staffing shortages at Washington’s two state psychiatric hospitals continue to raise concerns about patient and staff safety, prompting calls to action from workers in recent weeks and threatening accreditation at Eastern State Hospital in Spokane County.
Mental health staff at the state’s two hospitals, Eastern, which serves about 240 patients, and Western State Hospital in Lakewood, which serves about 670 patients, submitted 400 signatures to management in April calling for safer working conditions. On Friday, a Pierce County jury awarded more than $2 million to Western State nurses who filed a lawsuit after four workers were attacked by a patient in 2018.
Meanwhile, at Eastern, dangerously low staffing levels have put the hospital on the radar of The Joint Commission, a national nonprofit organization that accredits healthcare institutions.
In late April, after an unannounced visit, Eastern State received a notice from the commission, which stated in a report that “there were not adequate staff to provide safe and quality care, treatment and services.”
In one case in March, the commission found: “The organization failed to protect a patient from abuse as evidenced by a patient with a known history of physical assault…resulting in significant injury and ultimately the death of that patient.” . The commission did not specify the patients involved, but The Spokesman-Review reported in March that Martay Ellis, 24, was charged with second-degree murder for attacking another patient, Daniel Zellmer, in a common area of his ward. Zellmer died from his injuries.
The hospital has until June 17 to submit evidence of compliance. As of Friday, officials said they had not yet submitted a correction plan to the Joint Commission.
short staff
According to data from the Department of Health and Social Services, which oversees the state’s psychiatric hospitals, Eastern has a 27% staffing vacancy rate. The hospital needs more mental health technicians and registered and practical nurses, among other employees.
Acting CEO Tony Bowie said nurses are in especially high demand.
“It is a competitive market. We are losing some of our nurses, many of them have become itinerant nurses, and many hospitals offer bonuses.”
The hourly wage for a licensed practical nurse in Eastern is $32.36, according to state job postings. At an employment agency, the same job starts at $40.
Bowie took over the role temporarily in September 2021, after Eastern’s former CEO resigned. in the middle of an investigation about how the hospital handled domestic violence claims against a former nurse. A new CEO, Eric Carpenter, is expected to start June 1.
Salaries increase 3.5% effective July 1 for members of the Washington State Federation of Employees, which includes hospital staff.
Bowie also added that the hospital is looking to sign short- and long-term contracts with staffing agencies to provide more workers, but said Eastern can’t compete with higher wages offered elsewhere without more funding from the legislature.
Nancy Cruse, a recreation specialist at Eastern, said she has witnessed administrative staff help out in rooms when things are particularly dire: “They can help open doors to do laundry or give people towels or pass [meal] trays.”
Cruse said patients need a routine, and after being in different stages of lockdown for the past several months, some are feeling frustrated. It has led to a series of patient-on-patient assaults and patient-on-staff assaults, she said.
Cruse says that while staffing has increased in recent weeks, some of the agency’s new nurses coming in have limited experience with psychiatric patients.
“These nurses have been rushed through new hire orientation so quickly that they don’t know how to react if there’s a problem with a patient,” Cruse said.
ongoing challenges
Eastern’s twin, Western State Hospital in Lakewood, Pierce County, withdrew from the Joint Commission accreditation program a couple of years before it lost its certification with the Centers for Medicare & Medicaid Services in 2018, and with it, $53 million in federal funding. now it is building a new hospital in an effort to recover that funding.
So far, CMS has not visited Eastern State Hospital this year.
Both hospitals suffered from low staffing levels even before the pandemic.
As of September 2018, Bernia Garner was the only RN on staff during her shift in Ward S7 at Western State. That’s when Christopher Adams Jones, a patient who had a history of harassing and attacking hospital employees, tore off part of her earlobe.
The following month, four nurses caring for Jones filed a discrimination lawsuit in Pierce County Superior Court against Western and the Department of Health and Social Services, citing gender-based harassment, retaliation, and lack of reasonable accommodation by of the management.
On Friday, after a six-week trial, a jury found in favor of the four nurses; three have since left the hospital, and one still works at Western State.
The nurses’ attorney, James Beck, says the case is about DSHS failing to protect its employees.
“What DSHS represents annually to the State Legislature through required workplace safety plans, compared to what is actually occurring with respect to investigations and mitigation of assault issues, is in complete contradiction to each other,” Beck said.
A spokesman for Western State and DSHS said the agency is reviewing the matter and considering appealing the verdict, but did not provide further comment.
On a crisp spring morning in April, staff gathered for a workers’ memorial day on the hospital grounds in Lakewood. More than 300 white signs dotted the lawn, each involving an employee injured on the job in the past year.
Hospital managers were there as workers shared their concerns.
“At the end of the day, it’s still really about getting back to serving our patients, really serving the most vulnerable citizens of our state,” said Mike Yestramski, a Western social worker and local union president.
“We are all sounding the alarm bells around this, because it is important, because we care. When we get the resources we need to do our jobs… we’ve had some amazing results.”
