Persistent staffing shortages at Washington’s two state psychiatric hospitals continue to raise safety concerns for patients and staff, spurring calls for action from workers in recent weeks and threatening accreditation at Eastern State Hospital in Spokane County.
Mental health staff at both of the state’s hospitals — Eastern, which serves an estimated 240 patients and Western State Hospital in Lakewood, which serves around 670 patients — submitted 400 signatures to management in April calling 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, at Eastern, the dangerously low staffing levels have placed the hospital on the radar of The Joint Commission, a national nonprofit organization that accredits health institutions.
In late April, after an unannounced visit, Eastern State received notice from the commission, stating in a report that, “There was not adequate staff to support safe, 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 injuries and ultimately death of that patient.” The commission didn’t specify the patients involved, but The Spokesman-Review reported in March that Martay Ellis, 24, was charged with second-degree murder for attacking another patient, Daniel Zellmer, in a common area of their ward. Zellmer died of his injuries.
The hospital has until June 17 to submit evidence of compliance. As of Friday, officials said they had not yet submitted a plan of correction to The Joint Commission.
According to data from the Department of Social and Health Services, which oversees the state’s psychiatric hospitals, Eastern has a staff vacancy rate of 27%. The hospital needs more mental health technicians and registered and practical nurses, among other employees.
Interim CEO Tony Bowie said nurses are in especially high demand.
“It’s a competitive market. We’re losing some of our nurses, a lot of them have become travel nurses and a lot of the hospitals are offering bonuses.”
The hourly salary for a licensed practical nurse at Eastern is $32.36, according to state job postings. At a staffing agency, the same job starts at $40.
Bowie took over temporarily in September 2021, after Eastern’s former CEO resigned amid an investigation into how the hospital handled domestic violence allegations against a former nurse. A new CEO, Eric Carpenter, is expected to start June 1.
Wages are rising by 3.5% starting on July 1 for members of the Washington Federation of State Employees, which includes hospital staffers.
Bowie also added the hospital is looking to sign short- and long-term contracts with staffing agencies to provide more workers, but said Eastern can’t compete with higher pay offered elsewhere without more funding from the legislature.
Nancy Cruse, a recreational specialist at Eastern and president of WFSE Local 782, said she’s witnessed administrative staff helping on the wards when things are particularly dire: “They can help open the doors for laundry or give people towels or pass [meal] trays.”
Cruse said patients need routine and after being in varying stages of lockdown for the past few months, some are frustrated. It’s led to a number of patient-on-patient assaults and patient-on-staff assaults, she said.
Cruse says that while staffing has increased over the last few weeks, some of the new agency nurses coming in have limited experience with psychiatric patients.
“They have rushed these nurses through new hire orientation so fast that they do not know how to react if there is a problem with a patient,” said Cruse.
Eastern’s twin, Western State Hospital in Lakewood, Pierce County, withdrew from the Joint Commission’s accreditation program a couple of years before it lost its certification with the Centers for Medicare and Medicaid Services in 2018 — and with it, $53 million in federal funding. It’s now building a new hospital in an effort to get that funding back.
So far, CMS has not visited Eastern State Hospital this year.
Both hospitals suffered from low staffing levels even before the pandemic.
In September 2018, Bernia Garner was the only registered nurse on staff during her shift on ward S7 at Western State. That’s when Christopher Adams Jones, a patient who had a history of harassing and attacking female hospital employees, bit part of her earlobe off.
The following month, four nurses who cared for Jones filed a discrimination suit with the Pierce County Superior Court against Western and the Department of Social and Health Services, citing harassment based on their gender, retaliation and management’s failure to provide reasonable accommodations.
On Friday, after a six-week-long trial, a jury ruled in favor of the four nurses; three have since left the hospital, and one still works at Western State.
The nurses’ attorney, James Beck, says the case is about 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 occurring with respect to investigations and mitigation of assaultive issues, is in complete contradiction to each other,” said Beck.
A spokesperson for Western State and DSHS stated the agency is reviewing the matter and considering an appeal of the verdict, but did not provide further comment.
On a brisk spring morning in April, staff came together for a workers memorial day on the hospital grounds in Lakewood. Over 300 white signs dotted the grass, each an instance of an employee injured on the job over the past year.
Hospital managers were there as workers shared their worries.
“At the end of the day, this is still really about again serving our patients, serving really the most vulnerable citizens of our state,” said Mike Yestramski, a social worker at Western and the union president.
“We’re all raising the alarms around this, because it matters, because we care. When we are provided with the resources that we need to do our jobs… we’ve had some amazing outcomes.”