Persistent staff shortages at Washington’s two state psychiatric hospitals continue to raise safety concerns for patients and staff, spurring calls for worker action in recent weeks and threatening accreditation at Eastern State Hospital in Spokane County.
Mental health staff at the state’s two hospitals — Eastern, which serves about 240 patients and Western State Hospital in Lakewood, which serves about 670 patients — sent 400 signatures to the administration in April asking for safer working conditions. On Friday, a Pierce County jury awarded more than $2 million to Western State nurses who filed a lawsuit after four workers were attacked by a patient in 2018.
Meanwhile, in the east, dangerously low staffing levels have put the hospital on the radar of The Joint Commission, a national nonprofit that accredits healthcare institutions.
In late April, after an unannounced visit, Eastern State received a notice from the commission, stating in a report that “there were not adequate personnel to support safe and quality care, treatment and services”.
In one case in March, the commission found: “The organization failed to protect a patient from abuse, as evidenced by a patient with a known history of physical assault … which led to significant injury and ultimately the death of that patient.” The commission did not specify the patients involved, but The Review spokesperson reported in March, Martay Ellis, 24, was charged with second-degree murder for attacking another patient, Daniel Zellmer, in a common area of his ward. Zellmer died of his injuries.
The hospital has until June 17 to provide evidence of compliance. On Friday, officials said they had not yet submitted a remediation plan to the Joint Commission.
According to data from the Department of Health and Social Services, which oversees the state’s psychiatric hospitals, Eastern has a 27% staff vacancy rate. The hospital needs more mental health technicians and nurses and nursing technicians, among other staff.
Interim CEO Tony Bowie said nurses are in high demand.
“It’s a competitive market. We are losing some of our nurses, many of them have become travel nurses and many hospitals are offering bonuses.”
The hourly wage for a licensed practical nurse at Eastern is $32.36, according to state job postings. At a recruitment agency, the same job costs $40.
Bowie took over temporarily in September 2021 after the former CEO of Eastern resigned. in the midst of an investigation about how the hospital handled allegations of domestic violence against a former nurse. A new CEO, Eric Carpenter, is expected to start June 1.
Salaries are up 3.5% as of July 1 for members of the Washington State Employee Federation, which includes hospital employees.
Bowie also added that the hospital is looking to sign short-term and long-term contracts with staffing agencies to provide more workers, but said Eastern cannot compete with higher wages offered elsewhere without more funding from the legislature.
Nancy Cruse, a recreation specialist at Eastern, said she’s witnessed administrative workers helping out in the wards when things are particularly tough: “They can help open doors for laundry or give people towels or iron [meal] trays.”
Cruse said patients need routine, and after being in various stages of lockdown in recent months, some are frustrated. This has led to a series of patient-to-patient assaults and patient-to-staff assaults, she said.
Cruse says that while the staff has increased in recent weeks, some of the new agency nurses arriving have limited experience with psychiatric patients.
“They’ve rushed these nurses through mentoring new hires so fast they don’t know how to react if there’s a problem with a patient,” Cruse said.
Eastern’s twin, Western State Hospital in Lakewood, Pierce County, withdrew from the Joint Commission’s credentialing program a few years before losing its certification at the Centers for Medicare and Medicaid Services in 2018 — and with that, $53 million in federal funding. It is now building a new hospital in an effort to recoup that funding.
So far, CMS has not visited Eastern State Hospital this year.
Both hospitals suffered from low staffing levels even before the pandemic.
As of September 2018, Bernia Garner was the only registered nurse on the team during her shift in the S7 ward at Western State. That’s when Christopher Adams Jones, a patient who had a history of harassing and attacking hospital staff, ripped off part of his ear.
The following month, four nurses caring for Jones filed a discrimination lawsuit in Pierce County Superior Court against Western and the Department of Health and Social Services, alleging harassment based on her gender, retaliation, and management’s failure to provide reasonable accommodations.
On Friday, after a six-week trial, a jury ruled in favor of the four nurses; three have already left the hospital and one still works at Western State.
The nurses’ attorney, James Blake, says the case is about the DSHS’s failure to protect its employees.
“What DSHS is representing to the state legislature annually through workplace safety plans that are required, versus what is actually taking place with regards to investigations and mitigation of aggressive issues, is in complete contradiction with one another. the other,” Blake said.
A spokesperson for Western State and DSHS said the agency is reviewing the matter and considering an appeal of the verdict, but did not provide further comment.
On a crisp spring morning in April, staff gathered for a memorial day for workers on the hospital grounds in Lakewood. More than 300 white plaques dotted the grass, each representing an employee injured on the job in the past year.
Hospital managers were there as workers shared their concerns.
“At the end of the day, it’s still about serving our patients again, really serving our state’s most vulnerable citizens,” said Mike Yestramski, Western social worker and local union president.
“We are all warning about this, because it is important, because we care. When we got the resources we needed to do our work… we had some amazing results.”