Inadequate staffing, interrupted rest breaks and retirement benefit changes impact patient care and nurse safety

Washington State Nurses Association (WSNA), representing more than 1,500 registered nurses at Sacred Heart Medical Center, held an informational picket today to highlight issues critical to patient safety. Contract negotiations have stalled over several key issues including the ability to take uninterrupted rest breaks, inadequate nurse staffing levels, and changes to retirement benefits.

To protect patient and nurse safety, the nurses are demanding that the administration continue providing nurses with a 15-minute uninterrupted block of time for their rest breaks while the administration has proposed switching to intermittent breaks. The administration claims that brief interruptions in work activities, such as going to the bathroom, getting a sip of water, or talking with colleagues, constitute a break despite the fact that these intermittent breaks never give nurses the opportunity to completely stop work duties. Research confirms that nurses working long hours have decreased alertness and vigilance which leads to an increase in medical and medication errors. Full, uninterrupted rest and meal breaks are essential in order for nurses to recharge and regain the mental alertness and focus required to provide safe and quality patient care for the duration of a shift. 

"We're out here today because we care about the safety of patients at Sacred Heart. As a nurse, I'm constantly managing critical life and death situations for my patients. I want to be at my best when I care for you or your loved ones. Towards the end of a 12-hour shift when I haven't had a break, I've been on my feet all day, and I've maybe had just enough time to grab a snack on the go, I'm concerned about my ability to concentrate and provide the excellent patient care I strive for every day. Intermittent rest breaks will create a fatigued work force ripe for medical errors and near misses," said Kathy Ormsby, a registered nurse at Sacred Heart.

"Unfortunately, this is just part of a larger problem here and that's a lack of adequate staffing levels. When the hospital hasn't scheduled enough nurses to work, you can't take a rest or meal break because there isn't anybody qualified to care for your patients when you step away. Inadequate staffing is a chronic problem that Sacred Heart needs to fix by adding more nurses to shifts and not taking shortcuts that force nurses to work longer hours, be on call without notice on their days off, or work fatigued. If the hospital scheduled enough nurses, these extreme measures wouldn't be necessary," added Christine Himmelsbach, MSN, RN, Assistant Executive Director of Labor Relations for WSNA.

In addition to the impact on rest breaks, lack of adequate staffing leads to many unsafe patient care situations. Currently, many nurses are forced to work mandatory overtime after the end of a shift because the hospital has not scheduled enough nurses to cover patient care needs. Even during foreseeable and avoidable staffing shortages, the administration is using mandatory overtime or on-call nurses to fill staffing gaps. Management is also proposing a new rule that would force nurses to be on call without any notice on their days off. These types of policies hurt retention, lead to nurse fatigue, and cause burnout which isn't safe for nurses or patients. They also cause significant disruptions to nurses' lives making it difficult to get adequate rest before work, find childcare options, or schedule time for personal responsibilities and needs.

Nurses are also concerned about the impact of the administration's proposed changes to retirement benefits. Currently, nurses pay into a pension and receive a defined, guaranteed benefit when they retire. The administration wants to switch to a system where they contribute a set amount to nurses' retirement funds, shifting the investment risk to the nurses and subjecting their retirement funds to stock market fluctuation. The result is a less secure retirement benefit for nurses at Sacred Heart.