Oregon nurses scored a major victory in Salem Thursday as lawmakers approved a new minimum staffing mandate for hospitals.
House Bill 2697, approved by the House last week and the Senate late Thursday, could give nurses a powerful new tool to fight back against what they claim is chronic understaffing by Oregon hospitals. Nurses’ slow burn over staffing heated to the boiling point during the pandemic, when many felt they were being asked to work too many hours in dangerous conditions.
The bill could also change the dialogue between striking Oregon nurses and their employer, Providence Health & Services. Staffing is a major point of contention.
HB 2697 will for the first time codify minimum nurse-patient staffing ratios for some units within Oregon hospitals. It also will institute a system allowing nurses to file complaints against hospitals they feel violated the rules. The bill would enact similar regulations for certified nursing assistants – believed to be the first such rules in the country.
The Oregon Health Authority will be in charge of investigating complaints and administering the program. The OHA has for years been running its own nurse staffing regulatory program. Hospital and union officials alike criticized the program as burdensome bureaucracy.
“With unclear standards and no strong enforcement measures, nurses are facing a staffing crisis unlike anything they have ever experienced before,” said Anne Tan Piazza, executive director of the Oregon Nurses Association in testimony before the House Behavioral Health and Health Care Committee in February.
The bill’s fate seemed uncertain at that point. Hospitals came out strongly against the thought of mandatory staff ratios.
Providence officials argued that HB 2697 would worsen the capacity gap, which has emerged as one of the most difficult issues facing hospitals in the post-pandemic era. Hospitals and their nurses are dealing with sicker patients and a serious lack of discharge alternatives for patients who are ready to leave.
“Today Providence Oregon hospitals have more than 75 patients who are unable to discharge while they wait for a place in the community,” said Jennifer Gentry, Providence chief nursing officer in testimony before the committee. “The minimum staffing required by the bill will further constrict hospitals that are already experiencing a capacity crisis.”
But the hospitals later changed their tune. After intense negotiation, the hospitals and the nurses’ union announced an unusual pact on a number of healthcare bills, including the minimum staffing measure.
The two sides touted their new alliance, issuing their first-ever joint press release in April. Regarding the minimum staffing bill, the two sides said it “establishes enforceable statutory nurse-to-patient ratios that we hope will prevent staff burnout and return nurses to the bedside.”
The alliance has held since then, despite the Providence strike. The hospital trade association has continued to support the bill even as the largest hospital system in the state went to war with its nurses over, among other things, staffing levels.
Rep. Rob Nosse, D-Portland, a nurse and former head of the Oregon Nurses Association, credited the hospitals for finding common ground with the nurses.
“A work group of all key hospitals and unions worked for a long time,” he said. “Providence was one of them. They were a good actor.”
For its part, Providence credited the new bill as preferable to the current system of state regulation.
“It repeals outdated and burdensome regulations,” Providence said in a written statement. The legislation “will meet the needs of our nurses while allowing us to continue serving our communities.”
— Jeff Manning; jmanning@oregonian.com
