OLYMPIA — A fierce legislative fight over staffing levels and worker protections in hospitals is over.
A bill that would have limited the number of patients assigned to a nurse and imposed hefty fines on hospitals that failed to comply with staffing plans died in a Senate committee earlier this week.
Nurses and health care workers, many physically and emotionally wiped out by the coronavirus pandemic, pushed hard for House Bill 1868. They viewed it as crucial to improve job safety by addressing staffing shortages they say create dangerous conditions for themselves and patients.
“I am very concerned and somewhat shocked and disappointed” that the bill didn’t advance, said Maria Goodall, a vascular ultrasound technologist at Providence Regional Medical Center Everett. “We cannot sustain this chronic short staffing burnout, and this bill was a direct way to address the staffing crisis. Hospital executives have ignored our voices on short staffing issues for several years, and now some state lawmakers have, as well.”
Hospital executives pushed back hard, in turn, arguing that to comply with ratios would require hiring thousands of nurses, an improbability in the midst of an industry-wide staffing crisis. Hospitals would wind up leaving beds unfilled, they said.
“While we share lawmakers’ desire to support health care workers, this legislation would not solve any of the root causes of the strain on our workforce and would make permanent many of the worst parts of pandemic health care, including long delays in care,” Darcy Jaffe, senior vice president of safety and quality at the Washington State Hospital Association, said as the bill progressed last month.
Disappointed backers will renew the debate next session.
“Our health care workers need real solutions to the staffing crisis and resulting burnout,” said Jack Sorenson, spokesman for a coalition of unions representing nurses and hospital employees. “It’s getting worse, and hospital executives have provided no answers. We’re absolutely not done fighting for the safety of health care workers and patients.”
Goodall said the current conditions are unsustainable.
“We need immediate solutions,” she said. “Hospital executives have not ensured adequate staffing levels in many of the departments needed for patient care. Now several lawmakers have let us down.”
Ratios will still be a nonstarter for hospitals if that approach is revived in 2023.
But there are avenues for conversation on other topics, such as developing and carrying out hospital staffing plans and expanding education and training programs to increase the number of nurses, said Chelene Whiteaker, the hospital association’s senior vice president of government affairs.
“We are glad the bill is not moving forward in its present form. The association and hospitals around the state had significant concerns about what it would do in terms of impacts on patient care,” she said.“Our concerns remain high.”
Ill-fated House Bill 1868 proposed far-reaching changes inside hospitals. Most notable were the patient-nurse ratios and added rigor for hospital staffing plans. It would have shifted responsibility for enforcement of those plans and investigation of complaints from one state agency, the Department of Health, to another, Labor and Industries.
Sen. June Robinson, D-Everett, sponsor of the bill’s Senate companion, tried to keep the legislation alive with a rewrite that removed the controversial ratios. A separate amendment eased limits on some hospitals’ use of on-call hours for nurses, something that also concerned hospitals.
It still didn’t receive a vote in the Democrat-led Senate Ways and Means Committee before a Feb. 28 deadline.
“I thought the striker I put on was very reasonable,” Robinson said. “At the end of the day, it didn’t have the votes. The hospital association put out quite the opposition. We’ll keep working on it.”
Rep. Marcus Riccelli, D-Spokane, the bill’s author, tracked the changes as it moved through the Senate. He would have signed on to the revamped wording.
“I thought it had the bones for a good bill to help our frontline workers. Both sides were not willing to talk on the ratios,” he said. “I think it’s disappointing and disheartening for our front-line workers.”
Rep. Mike Sells, D-Everett, the chair of the House Labor and Workplace Standards Committee, helped steer the bill through the House, where it passed on a 55-43 on Feb. 13.
He called the setback disappointing, “especially for those who have worked so hard in our hospitals to keep the system going in a particularly precarious time.”
”We already have people leaving in large numbers from health care facilities due to stress,” he said. “Failure to address scheduling issues will only add to problems.”