There’s a severe nursing shortage in WA hospitals. This bill would make the crisis worse

Working as a nurse at St. Joseph Medical Center in Tacoma is an intense job. As a Level II trauma center, we are prepared to handle almost every type of medical emergency that comes through our doors, and we routinely handle the highest level of care across the Virginia Mason Franciscan Health system. Caring for our patients on an ideal day entails long shifts, quick thinking and laser focus.

In an ideal setting, hospital capacity should be about 85%. This provides flexibility to surge and contract on demand. In my tenure as chief nursing officer, the lowest capacity I have ever seen is 92%. Most people don’t realize it, but almost every hospital in the Interstate 5 corridor routinely operates at between 95% and 105%, pandemic or not.

Right now, we have over 200 nursing vacancies in our hospital alone. I am proud of all our hospital staff for the work they do for our patients, and proud of how St. Joseph’s works to recruit and retain the best talent possible. Even with competitive wages, bonuses, incentive packages, tuition reimbursement and more, we cannot hire enough nurses. This is because there simply are not more nurses to hire. When we do hire nurses, the majority are brand new to the field and need additional education to care for patients in many of our specialty areas. This adds time to having more nurses at the bedside. On top of this, nurses are leaving for non-hospital positions, to move near family for childcare support, or are hanging up their badge and retiring.

The legislature’s proposal to mandate strict nurse-to-patient ratios could not be more misguided nor come at a worse time. All of our staff work hard to ensure our patients have the best care, even when we are at capacity. Currently, our nurses are supporting our most critical patients at a ratio of one nurse for every one or two patients. In our medical-surgical department, we are staffed at one nurse for every four to six patients, depending on the patients’ needs. HB 1868 would create rigid nurse-to-patient ratios that would not allow us to respond to the ever-changing needs of our patients.

It is impossible to achieve these ratios without closing beds, consolidating care and turning away patients. If this law were to go into effect tomorrow, we would need to close at least 36 beds on the first day. It’s heartbreaking seeing patients lining up in our emergency rooms or having care delayed due to COVID capacity impacts. This would become our new reality.

Mandated ratios in California have been a 15-year experiment with no positive outcomes in patient safety or satisfaction. St. Joseph’s has been trusted to serve the community for over 130 years. We can’t cancel flights like an airline or close for a week like a restaurant. Our only option will be to face the fines associated with the bill or turn away patients.

Our nurses need support more than ever. The legislature deserves credit for taking up the issue of our nursing crisis and trying to help us recover. This bill is not the answer, as it takes patients out of the center of our existence and places their needs at the mercy of this bill. What we need instead is long-term investment in nursing education and workforce to lead to meaningful change.

Ruth Flint is Chief Nursing Officer at St. Joseph Medical Center. She has over 43 years of experience in healthcare.

This story was originally published February 10, 2022 at 5:00 AM.