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Nurses union cries foul as staffing law takes effect

Five days after a high-profile statute took effect, hospitals deny violating its new rules while the union claims deliberate violations
Staff care for a COVID-19 patient at Oregon Health & Science University. | COURTESY OF OHSU
June 5, 2024

Oregon’s largest nurses union is accusing some hospital executives of a “coordinated attempt” to undermine a new state law that guarantees minimum staffing levels. 

The Oregon Nurses Association made the accusations in a letter to Oregon Health Authority Director Sejal Hathi sent on June 4 and made public Wednesday. In it, the union’s executive director Anna Tan Piazza, claimed hospitals are ignoring the law by assigning nurses more patients or adopting staffing plans without obtaining input from nurses as the new law requires. She asked the agency to respond to complaints filed by nurses at hospitals across the state.

“It is unclear what could possibly motivate hospitals to ignore the law so shamefully and intentionally, but there is no question that they are doing so and, as a result, they appear to be deliberately worsening working conditions for nurses,” Piazza wrote. 

The politically influential union successfully pushed for the passage of House Bill 2697 during the 2023 session, faulting  inadequate hospital staffing for burning out nurses at alarming rates. The hospital staffing bill's passage was lauded as a carefully crafted deal between unions and hospitals. The law went into effect on June 1. 

The Hospital Association of Oregon responded to the accusations from the nurses union with a statement from Sean Kolmer, the association’s executive vice president of external affairs. 

In it, Kolmer stated that the association is proud of its work with the nurses union and Service Employees International Union to pass the law.  “We disagree with ONA’s recent characterization of hospitals’ implementation of this law,” Kolmer said. “We believe any differences in interpretation of the law should be addressed by working together with patients at the center, rather than fostering conflict and division. We hope ONA will seek to address these differences constructively, and we welcome future dialogue that upholds our agreements and works to resolve these issues.” 

Piazza wrote that she had also contacted Gov. Tina Kotek and legislative leaders. 

The nurses union press release announcing the letter also included a statement from state Rep. Rob Nosse, a Portland Democrat who chairs the House Behavioral Health and Health Care Committee. He called the allegations troubling, adding that he was committed to working with the governor’s office, health authority and hospitals to enforce the law. 

Health authority spokesperson Jonathan Modie told The Lund Report in an email that the agency received 37 complaints per day between June 1, when the staffing law went into effect, and June 4. 

The health authority has completed 12 investigations that covered 42 complaints and involved six hospitals, according to Modie. Investigators found noncompliance in 13 of the 42 complaints. The agency has another 31 open investigations from 110 complaints that involve 23 hospitals. 

The staffing law requires hospitals to form committees of management and staff to come up with staffing plans. If a committee can’t agree to a staffing plan, the hospital would have to adopt a minimum patient-to-registered-nurse ratio that varies by unit. For example, a registered nurse can only be assigned up to five surgery patients.

Piazza wrote in her letter that members have reported actions by hospitals that “are in direct violation.” Those include adopting staffing plans that weren’t agreed to by the committee and hospitals disavowing previously agreed upon plans. 

Hospitals are also limiting assistance by certified nursing assistants to certain patients, resulting in increased workloads for some registered nurses, she wrote. She described nurses being passed sticky notes in the middle of administering sensitive medications to tell them they must take their scheduled break immediately. 

Piazza wrote that executives at Providence Health & Services hospitals are “unilaterally” abandoning staffing plans “in favor of bare minimum staffing ratios,” which she called “an unequivocal violation of the law which is having a direct impact on nurses’ ability to deliver patient care.”

Providence spokesperson Gary Walker responded with a statement: “It’s been five days since Oregon’s law requiring nurse-to-patient ratios took effect. Providence teams have been working for months to prepare for implementation. Providence is committed to making it work.”

Thomas Doyle, general counsel for the nurses union, sent a “cease and desist” letter to Liz Dunne, CEO of Vancouver-based PeaceHealth, over alleged violations at its Sacred Heart Riverbend Medical Center in Springfield. He accused PeaceHealth of adopting a staffing plan that wasn’t agreed to by the staffing committee. 

“As described throughout this letter, it is apparent that PeaceHealth has begun a systematic violation of the Oregon Nurse staffing law through unilateral adoption of unit staffing plans,” he wrote. “PeaceHealth’s efforts appear to be designed to increase nurse patient loads, jeopardize patient safety, increase nurse burnout, and hollow out the Oregon healthcare system.”

PeaceHealth spokesperson Joe Waltasti told The Lund Report in an email that like other new laws, "there will be some back and forth" on its implementation. 

“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," he wrote. "We  will continue to work collaboratively with our Nurse Staffing Committee members on the implementation of this new law.”

You can reach Jake Thomas at [email protected] or via Twitter @jthomasreports