Nurses Report Repeated Staffing Violations at St. Charles Medical Center

(BEND, Ore.) – Nurses at St. Charles Medical Center in Bend have filed a formal staffing complaint against the hospital with the Oregon Health Authority, the Oregon Nurses Association (ONA) announced today. The staffing complaint centers on St. Charles Bend’s repeated violations of its own staffing plans and Oregon’s Hospital Nurse Staffing Law through its controversial use of a “buddy system” to provide legally-required rest breaks for nursing staff. St. Charles “buddy system” routinely requires nurses to care for twice as many patients as outlined in the hospitals’ staffing plans.

ONA represents more than 800 registered nurses at St. Charles Bend and more than 13,500 nurses throughout Oregon.  

Oregon law requires that nurses and other workers take occasional rest breaks during long work shifts to reduce workers’ risk of injury and counteract the negative effects of fatigue on job performance. State law mandates hospitals account for these legally-required breaks in hospital staffing plans.

St. Charles Bend’s staffing plans routinely fail to provide appropriate break relief. Instead St. Charles Bend relies on a “buddy system”, where nurses are assigned, or must recruit, a coworker to oversee care for their patients so one nurse can take a legally-required break. This system typically doubles the number of patients the ‘buddy’ nurse is responsible for.

For example, in a medical-surgical unit, St. Charles Bend’s “buddy system” could require a nurse to be responsible for 10-12 patients for an hour or more during their shift. A typical medical-surgical staffing plan at St. Charles Bend calls for a nurse to only be responsible for 5-6 patients at a time based on patients’ care needs. 

“Nurses at St. Charles are regularly caring for twice as many patients as the hospital’s staffing plans allow for,” said emergency department nurse John Nangle, RN, CEN, chair of ONA’s St. Charles Bend bargaining unit. “St. Charles is consistently violating its own staffing plans, state law, and basic common sense. Simply put, it’s impossible for one nurse to effectively care for 10 patients at a time.”

The controversial use of “buddy systems” to provide break relief in hospitals has been successfully challenged at Tacoma General Hospital in Washington. In a 2015 arbitration decision between MultiCare Health System—the owners of Tacoma General Hospital—and the Washington State Nurses Association, arbitrator Douglas P. Hammond ruled, “Nursing requires knowledge, experience, dedication and concentration, tempered with compassion and patience, to successfully care for patients in need. The related stress, both physically and mentally, warrant occasional time away from their assigned task. The nurse on break should be free from worry and concern, with the knowledge that the nurse’s colleague is providing the necessary attention to the assigned patients. If that nurse has her/his own patients, doubling the potential workload, even for 15 minutes, the time away from work is not really a break.”

“Ending St. Charles failed ‘buddy system’ will set a new precedent for better patient care in Bend and throughout the state,” said Nangle. “Patients deserve the best care we can provide. They’re not getting that right now. Hospitals have been papering over this problem for decades. It’s time to acknowledge it and make sure all our patients receive the high-quality care they deserve.”

The Oregon Nurses Association (ONA) is Oregon’s largest nursing union and professional association. ONA’s mission is to advocate for nursing, quality health care, and healthy communities. For more information visit

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