St. Charles Bend submits plan to fix staffing violations

(Update: Comments from Bend nurses, hospital on findings)

The Oregon Health Authority uncovered numerous staffing violations at St. Charles Bend during a months-long investigation this summer, according to a recent report by the OHA’s Office of Health Care and Quality Improvement released Thursday by the Oregon Nurses Association.

The hospital, in turn, said it has filed a state-required corrections plan and is working to improve lines of communication with nurses about staffing issues.

The investigation was initiated after nurses at the hospital, represented by the ONA, “alerted the state to the hospital’s repeated violations of Oregon’s hospital nurse staffing law and its effects on patient care,” according to the nurses union’s news release.

The ONA filed a formal staffing complaint with the state back in May against the hospital, which defended its use of what the union called a controversial “buddy system” for nurses taking mandatory staff breaks.

The union stated, “St. Charles buddy system forces nurses to care for twice as many patients as the hospital’s staffing plan allows.”

For example, under St. Charles buddy system, the union says a nurse can be forced to care for 10-12 patients at a time, despite the hospital’s staffing plan specifically prohibiting nurses from caring for more than 5-6 patients at a time.

That concern was echoed Thursday St. Charles nurse Tammi Jo Virgil , who told NewsChannel 21 that there simply are not enough nurses to alow for others to take their required breaks.

Virgil sits on the hospital’s staffing committee, and she said that she is committed to finding a solution to this problem.

“I think that it’s important that we get our 30-minute breaks away from our patients, and that we get those allotted 15-minute breaks that we are supposed to have,” Virgil said. “But it’s definitely not the norm, by any means.”

The ONA Research shows doubling the number of patients’ nurses are responsible for increases patients’ risk of infection and missed care and increases nurse injury and burnout.

“This level of systemic hospital violations is unprecedented,” said emergency department nurse John Nangle, RN, CEN, chair of ONA’s St. Charles Bend bargaining unit. “If nurses didn’t recognize and report a problem, patients would continue being forced to take unnecessary risks. I’m proud of nurses for standing together and speaking up to protect our patients’ health.”

The nurses union said the state’s findings corroborated nurses’ reports that St. Charles Bend regularly failed to provide appropriate staff to care for patients during legally mandated staff breaks.

The investigation also found dozens of other hospital violations, including inadequate recordkeeping, misuse of mandatory overtime by hospital managers and hospital staffing plans that were unapproved, incomplete and lacked a foundation in national standards or input from staff nurses. (A link to the report is at the end of this story.)

Over the course of the state’s investigation, more than 200 nurses at St. Charles reported that the hospital-wide staffing plan did not meet their patients’ needs, the ONA said.

“This report proves once and for all that when hospitals ignore nurses’ input, patient care suffers,” Nangle said. “St. Charles needs to reevaluate every aspect of its operations and bring staffing and patient care up to Oregon’s standards. It’s not just the law, it’s also the right thing to do.”

St. Charles was required to submit a detailed plan to the state showing how it will correct its numerous staffing violations by Friday.

“St. Charles says patient safety is its top priority. That needs to be reflected in its corrections plan. The first step is pledging to work with ONA nurses who’ve proven they know how to recognize and respond to patient safety risks,” Virgil said. “Change is necessary to ensure safe patient care. Working together is the only way we can give patients the high-quality care they deserve and begin rebuilding the relationship between the hospital and health care providers.”

St. Charles has responded to the report, completing and submitting its plan to correct the issues. That plan was sent to OHA on Wednesday, officials said Thursday.

Pam Steinke, the hospital’s chief nurse executive, told NewsChannel 21 they want to find a solution to the issues by making sure nurses working on the front lines have their voices heard.

“We will continue to address those deficiencies, and we have done our plan of correction, and we are working on our plan of correction actively,” Steinke said. “We will continue to go down that path, and communicate and work with our front line to make sure that we have the best solution.”

According to Oregon Health Authority policy, they will visit St. Charles again in 60 days to make sure the hospital is in compliance.

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

The Oregon Nurses Association 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 www.OregonRN.org.