Maggie Simpkins starts her workweek at 6:30 a.m. Sundays at Oregon State Hospital, where the registered nurse dispenses medication to patients, goes over their treatment plans and maps out the day’s schedule, including appointments, meals and care.
Her shift is supposed to end at 5 p.m. But most Sundays, Simpkins has to work mandatory overtime, which can stretch until about 10 p.m.
For Simpkins and her colleagues, mandatory overtime has caused a wave of fear and concern about the exhaustion compromising safety for staff and more than 500 patients at the state-run psychiatric hospital in Salem. Oregon’s American Federation of State, County and Municipal Employees, which represents about 300 registered nurses at the hospital, has filed 225 grievances on their behalf in the last four weeks, alleging the mandatory overtime violates their labor agreement and the state’s nurse staffing law.
“Toward the end of the shift, I’m more exhausted, and my worry is that the more tired I am, the risk of making an error increases,” Simpkins said. “It’s very scary when you deal with the mentally ill and making poor judgment calls or medication errors. Fortunately, that has not yet happened, but part of that is because I have a great crew who look out for me.”
Registered nurses and licensed practical nurses worked more than 2,500 hours of mandatory overtime between June 3 and Aug. 4, hospital data show. Grievances are up as nurses have racked up mandatory overtime. Most months, the union usually files only two to four grievances on any matter.
Amber Shoebridge, a spokesperson for Oregon State Hospital, said a combination of factors are driving the mandatory overtime. Those include staff turnover, the national nurse shortage and increased needs of patients, Shoebridge said. Additionally, the hospital needs more nursing staff to implement changes after federal inspectors flagged violations.
The hospital is looking for ways to recruit more nurses.
Yet nurses and their union are unsatisfied amid lingering fears.
‘Scared to death’
David Lynch, president of Oregon AFSCME Local 3295, which represents about 300 nurses at the state hospital, said the increase in grievances and mandatory overtime is a “jarring change” for nurses.
“People are calling me and they’re crying,” said Lynch, also a nurse at the state hospital. “They’re scared to death that they or their coworker or their patient will be killed.”
The union says the hospital is violating the state nurse staffing law and contract provisions that limit mandatory overtime. Under its contract, the state hospital cannot require a registered nurse to work more than 48 hours in a workweek or more than 12 hours during a 24-hour period.
Lynch said the hospital needs more accountability.
“Once people know this is what happened, they will just be in disbelief,” he said. “I feel like whoever made that decision, they need to apologize to all the staff, all the patients and all their families, and then give us a detailed plan as to how this is never going to happen again.”
Waiting for a solution
Shoebridge, with the hospital, declined to comment on whether the hospital’s actions violate the contract and state law.
In response to 35 grievances filed in July, Angie Johnson, the hospital’s director of nursing and staffing wrote to the union: “We do acknowledge a violation.” The hospital, however, denied the grievances, which sought an extra hour of paid leave for every mandated hour.
Johnson said the hospital is making changes but may not be able to avoid future violations to “account for patient and staff safety.”
Shoebridge said the hospital’s goal is to bring relief to overworked nurses.
“They cannot be expected to continue at this pace,” she said.
About one-fifth of nearly 500 budgeted licensed practical nurse and registered nurse positions at the hospital are vacant, hospital data show. Efforts to recruit include job fairs, relationships with nursing schools and a mentorship program, Shoebridge said.
Twelve temporary agency nurses are currently going through orientation and another 19 start work next week, Shoebridge said.
But the hospital has not granted the union’s request to end the excessive mandatory overtime and give each nurse an extra hour of paid leave for every hour of mandatory overtime.
Stressful yet rewarding
As for Simpkins, the long Sundays leave her tired for much of the remaining workweek, making it difficult to keep up.
On Saturday night – before her workweek starts – her anxiety level is high as she anticipates a long day ahead.
“I know I’m going to get mandated on Sunday, and my anxiety level before I go to bed has shot up,” she said. “But when I get up in the morning on Sunday morning to get ready for work, I know I’m frustrated, I’m anxious, and that ruins my whole week.”
Yet the job has its rewards.
Simpkins, 53, started her nursing career in 2016 at the state hospital after changing her career from the banking industry. And nursing is fulfilling work that allows her to help people learn skills, return to their communities and lead productive lives, she said.
“I was really excited about that,” she said. “Once I started at the hospital, I continued to enjoy the work. That’s why I stay.”
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