DSHS Nurse Abuse

Recently the CEO of WSH has mandated multiple mandatory overtimes while stipulating that RN’s must be scheduled to only one RN2 per ward “regardless of staffing numbers” (for holidays).  This incompetent approach, supported by the Secretary and Assistant Secretary of DSHS has resulted in massive overtime use and endangerment of patients.  “Communication meetings” have been held with the Secretary and Assistant Secretary of DSHS with ZERO positive results.  The incompetent directives and procedures remain in place to devastate staffing, destroy the DSHS budget, and endanger our patients.  What we are now witnessing is disgusting as well as being an insult to our intelligence.  What we are also witnessing is patterned behavior by the current WSH CEO.   See the below headline about our CEO’s actions in Alaska:

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For weeks now, DSHS has implemented mandatory overtime at Western State Hospital.  Employees who do not know our patient treatment plans nor individual ward procedures have been assigned to provide patient care.  DSHS has through its holiday scheduling practices mandated a thirty-to-one patient to staffing ratio for RN2’s.  This level of overload prevents the meeting of standards on a daily basis and horribly endangers clinical care.


DSHS currently compensates its licensed nurses (RN’s and LPN’s) twenty percent below the private sector.  This results in continually increasing vacant position numbers.  WSH is already at the breaking point of being able to provide clinically safe care as has been demonstrated by the recent CMS (Medicare/Medicaid) surveys.  Has DSHS asked the Legislature for the additional 104 RN2, 10 LPN, and 64 nursing aide FTE’s?  Has DSHS asked the Legislature for the amount of Food Aides required to provide for full meal service beyond less than half breakfast and dinner daily meals?  The answer is NO!  WSH has only hired more administrative support personnel and on-call personnel that work only several days a week to cover up the incompetence of DSHS administrators.


Here are some interesting and true facts about DSHS.  DSHS payroll system does not record unscheduled absence in any permanent records, thus no employee productivity data can ever be produced.  DSHS has cut deals with various unions to falsify payroll information within public records.  Some overtime-eligible employees (the minority) work eight hours per day for eight hours of paid wages at the collectively bargained hourly wage rate.  The majority of overtime-eligible employees work only seven hours and forty five minutes per day (or 8 work days less per year than the other employees) for eight hours of compensation at the collective bargained hourly wage rate.  This illegal falsification process is called “transition time.”  The falsification of DSHS wages occurs through CIBS (Consolidated Institutional Business Services) by their transcription (of false data) to HRMS (Human Resource Management System) which conducts payroll duties.  


Are nurses treated differently within DSHS than with any other employer within Washington?  The answer is yes!  Only DSHS nurses are exempt from mandatory overtime exemptions that are afforded to all other nurses within Washington.  I present the following data which is provided through the Labor & Industries website:

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The above copy is abbreviated.  See complete copy here.


Of special note to DSHS nurses is the following:


  • State psychiatric hospitals.
  • Other state facilities operated by the Department of Social and Health Services.
  • Home health facilities that do not operate under the license of another health care facility.
  • Nursing homes that operate under their own license.


Yes, within Washington, only DSHS nurses can be discriminated against to work mandatory overtime regardless of the danger.  DSHS nurses work within the most dangerous environment within the State


It is time that RN’s and LPN’s worked together to lobby the Legislature for equal nurse protections under the law.  DSHS abuse of nurses must be ended and DSHS must change to meet the practice standards of the current century.  Our Federal funding is at risk for good reason.


WSH requires an immediate change in leadership to survive.  I recommend that a qualified psychiatrist be appointed by the Governor to act as the CEO and Medical Director (both) at WSH for a cost effective resolution to the clinical incompetence demonstrated by current WSH Administration. I demand compliance with:

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As is stated in my cover page…  The views presented here are my own and do not represent those of DSHS or any labor union.  I am expressing my personal opinion as a 30+ year nursing supervisor employee at WSH who has participated and co-chaired numerous WSH committees over the past decades.  I have also served many past terms as the Chair of the RN union.  What was presented is my honest opinion of the current situation at WSH.

© Paul Vilja 2017