Local hospital leader: Bill would force service cuts

A bill in the state Legislature that seeks to force hospitals to abide by set staffing levels — to address burnout and an already serious nursing shortage made worse by the pandemic — would likely force cuts in local service, a local hospital leader says.

An amended form of House Bill 1868 passed the state House of Representatives Sunday. Its companion bill in the Senate, Senate Bill 5751, seems likely to pass, according to Ramona Hicks, chief executive officer at Coulee Medical Center in Grand Coulee.

The bipartisan legislation, supported by labor unions, may have a laudable purpose but is flawed from a one-size-fits-all approach, Hicks says.

The bills would impose staffing levels that Hicks says might make sense at the state’s largest hospital in Seattle but would tie the hands of both management and staff at places like Grand Coulee, where nurses cover for each other across departments when needed to care for patients the best way possible.

The legislation defines nurse-to-patient ratios for various departments, makes paying nurses and providers on-call fees illegal and would force cuts in service, Hicks says.

“Essentially, I would have to double the staff that I have,” she says.

Two nurses at CMC say the current system, in which a staffing committee sets up a plan, is working well and that the kinds of ratios being considered wouldn’t work at that 25-bed “critical care,” rural facility.

Rachel Seekins, a registered nurse employed there since 2017, said she’s never been forced to accept overtime — another concern the law addresses — and the patient ratio is well within reason.

“The most I’ve ever had is one-to-five, which is perfectly within like what they teach you in nursing school and what a nurse is capable of handling,” she said.

Beth Goetz, nurse/manager for CMC’s obstetrics, emergency and outpatient departments, says the bills don’t fit CMC’s team approach. “We do OB, we do acute care. You float. You help each other. When somebody is overwhelmed, you go and help them. … I think these bills, unfortunately, are making hospitals seem like a one size fits all.”

Asked what would happen If forced to comply with such strictures, Hicks said: “I would first recommend that we have a meeting with all of the medical staff, everybody that’s involved, because this is going to affect everybody’s lives, and really look at what do we do. What can we give up? And what are we willing to give up?”

CMC might have to stop delivering babies, a service that the hospital is only able to provide by paying health care professionals for “on-call” time, then switching to active pay when a baby is on the way.

Just offering this obstetrics service means CMC pays for five highly trained health care professionals to remain on call 24/7 in case a C-section surgery is needed for delivery. “That is an orchestra of people to make sure mom and babe are safe,” which is why many small hospitals no longer offer obstetrics service, Hicks says.

Hicks is also on the board of the Washington State Hospital Association, which estimates there are about 6,000 unfilled nursing jobs in the state currently. There was already a shortage in 2019, she said, and about 12,000 are actually needed.

She will address a meeting Thursday, Feb. 17 at 1:30 p.m. at PK’s Culinary Banquet Room and on Zoom to talk with the public about the situation.