St. Charles nurses file labor complaint; hospital defends ‘buddy system’

(Update with ONA comments, info on number of complaints filed)

Nurses at St. Charles Bend have filed a formal staffing complaint against the hospital with the Oregon Health Authority, the Oregon Nurses Association announced Thurs day . The hospital defended its use of a “buddy system” for nurses taking breaks that is the focus of the complaint.

The staffing complaint claims St. Charles Bend has repeatedly violated 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, according to the ONA, which represents more than 800 registered nurses at St. Charles Bend and more than 13,500 nurses throughout Oregon.

St. Charles Health System, which operates all four Central Oregon hospitals, is, by far, the region’s largest employer, with more than 3,000 workers as of last year, according to Economic Development for Central 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.

The ONA claimed in its complaint that 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.”

Kevin Mealy, communications manager for the Oregon Nurses Association, said the ‘buddy system’ needs to be addressed,

“There’s a growing recognition that doubling up the number of patients, and hoping that the outcomes are just as good, doesn’t make sense,” he said. “So it’s really unfair to both nurses and patients.”

According to the ONA, more than 300 staffing complaints have been filed against St. Charles Bend since 2015.

The only hospitals that have received more staffing complaints are OHSU and Peace Health Sacred Heart Medical Center, both of which are much larger facilities. OHSU employs more than 15,000 people.

The Oregon Health Authority was unable to confirm the number of complaints, but did say they are investigating complaints into St. Charles Bend.

St. Charles Health System issued a response Thursday from Pam Steinke, the organization’s chief nursing executive, defending the “buddy system” practice.

“Patient safety is St. Charles Health System’s top priority,” Steinke said. “The buddy system is just one of the strategies we use to ensure staff receive the meal and rest breaks they need to take good care of themselves and their patients.

“We’re constantly evaluating the needs of our patients and making sure appropriate resources are available for their care,” Steinke continued. “We consistently work with our front-line nurses to develop unit-based staffing plans that are in compliance with state laws. “

The ONA noted that 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.”

Nangle added, “Ending St. Charles failed ‘buddy system’ will set a new precedent for better patient care in Bend and throughout the state.”

“Patients deserve the best care we can provide. They’re not getting that right now,” he said. “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.”

NewsChannel 21’s Lauren Melink is in contact with all parties in the dispute and will have a report on NewsChannel 21 Fox at 4 and at 5, 6 and 7 on KTVZ.