Overtime at WSH

Take time to review the newly generated Western State Hospital overtime document.  See smaller rendition of the document below:

For the past months at Western State Hospital all education classes and competency reviews had been cancelled.  Supervisors were tasked to work out of their job classes as a “body” on the ward in lieu of retaining required overtime to provide quality care.  


As a result no correction plans met their due dates and all wards operated at less then base staffing because supervision did not essentially exist for direct patient care personnel.  RN3 supervisors never knew what duties they would be required to perform on any given day.  If an RN3 was not working as a “body” on a ward, the RN3 was often covering six or more wards on a unit.  All productivity stopped while skewed overtime statistics were generated.  Now you can view the skewed statistics that Western State Hospital Generated.


Western State Hospital has recently been on a hiring spree for intermittent personnel that only work several days per week rather than address the ACTUAL problem of having too few full time positions to meet the current patient care needs within the hospital.  We are now encountering a huge shortage of Registered Nurses, which is the reason WSH has been unable to open new wards to expand psychiatric beds…  Along with the current physician shortage.  RN’s and physicians require a market adjustment in wages to compete with the Federal Government as well as the Private Sector, the figure that is required is over 20%.


As the former Co-Chair of the Joint Nurse Staffing Committee, I am aware of the following facts:


  • WSH has a total of 756 full time funded direct patient care nursing positions.


  • Based on eight months of statistical data, 756 full time positions results in the average staffing per day of 381.37 staff (taking all components into considerations such as scheduled absence, unscheduled absence, vacancies, and training).


  • Based on eight months of statistical data, a total of 471 staff are required daily to meet minimum staffing levels.  The total daily staffing deficit is 89.63 per day.


  • Based on eight months of statistical data, taking into consideration that it takes 756 full time staff to produce 471 staff per average day, we can calculate that it will take an additional 178 full time positions to produce the additional 89.63 staff per day to null out all overtime use if ALL factors are taken into consideration.


  • Western State Hospital currently has 27 wards that operate on three different shifts.  Thus an additional 2.19 full time positions per ward per shift would be required to null out overtime taking all factors into consideration.


  • Based on high risk medication policy, three licensed staff are required for each ward and each shift to be able to provide medications throughout a shift taking breaks and lunch into consideration.  Under the current staffing configuration WSH will require an additional 90 RN2’s (81 RN2’s to bring one additional RN2 to each ward and each shift and an additional nine RN2’s to provide three full time RN2’s per ward per shift).


  • The additional staff above the 90 additional full time RN2 positions will be 9 LPN2’s and 79 mental health technicians.


  • Staffing models indicate that current WSH staffing levels can only support five staff per ward on day and evening shift and four staff per night shift for seven days per week (average staffing).  Current base staffing levels average six per ward for day and evening shift (some as high as eight), base levels of staffing for nights averages five.


You are free to check out the numbers in the staffing model that was created for Western State Hospital using the most current data.   


For any Legislators that are viewing this data please ask the following:


  • Did DSHS ever ask for an additional 178 FTE’s to null out overtime in order to meet current clinical requirements of care?  (Or 2.19 additional FTE’s per ward per shift)


  • Did DSHS every convey the need for a market wage increase for RN’s and physicians of over 20% to be able to recruit and retain from the Federal Government and the Private Sector?


  • Did DSHS use “collective bargaining” to group Physicians and RN’s into categories of just being another DSHS employee in importance?


I would ask any Legislator to seek the actual number of RN’s and Physicians that are employed within DSHS.  I would ask that Legislators seek the current recruitment and retention number of RN’s and Physicians.  You will note that RN’s and Physicians constitute a very small minority of all employees within DSHS.  But RN and Physician coverage is critical to maintain accreditation and Federal funding.  


I must state for the record, if the above factor was taken into consideration and addressed by the Senate…  Collective Bargaining and its shortcomings would be appropriately addressed by rejecting the wages proposed within the labor contracts that were negotiated.  


Please look at the facts and crunch the numbers.  


© Paul Vilja 2017