The Current Progress of WSH

WSH is currently dealing with massive staffing shortages of psychiatrists and registered nurses.   Current WSH administration remains essentially unchanged as the previous CEO’s supervisor and appointments continue to influence all aspects of WSH that require immediate correction.


There are currently 15 psychiatrist vacancies (approximately 30%) with an additional psychiatrist leaving tomorrow and no plan as to how psychiatrist coverage can be accomplished.  Psychiatrist supervisors have been recently resigning that duty as the burden has been too great to continue with those duties.  Psychiatrists are being required to cover additional patients on a daily basis without additional compensation diluting the quality of care they can provide.  Psychiatrist patient loads are now unmanageable.  Recently the new Medical Director implemented even greater workloads upon the psychiatrists  by dismantling the patient transfer committee and implementing the doctor to doctor transfer process.  Additionally, doctors are required to fill out their own timekeeping documents as there is no form of modern timekeeping system within DSHS.  Doctors that have been reassigned for investigation, remain reassigned to Olympia even though the issue under investigation does not pertain to patient clinical care. In this system when the investigation is the crime there is no recourse, and tax dollars are wasted on an individual investigation at a rate as high as $900,000 yearly- money that should be spent on patient care that might help save this sinking ship.  Many doctors have resigned.  Administration has attempted to have agency doctors fill the void to no avail.  Agency doctors often only stay for a couple months at a time and cost the state twice as much as staff doctors- $457,000 yearly for each contract doctor. One agency, Correct Care, walked away stating that they did not wish to affiliate with WSH.  Some psychiatrists that applied to return to WSH were discouraged by administration due to their stances on the previous CEO despite being well known to staff as excellent clinicians and leaders.  The problem being, the appointments by the previous CEO remain employed by WSH and the supervisor of the previous CEO remains in power.  Wages for psychiatrists is far behind that of the private sector.  Numerous doctors have expressed no confidence in the previous CEO appointed Medical Director.


Recently 51 registered nurse positions were funded for WSH…  One was hired, and then quickly resigned.  RN wages are approximatly 25% less than in the private sector as is also the case in the Federal sector.   WSH administration this past year eliminated the ability to earn comprehensive leave time on half of the holidays, further WSH administration implemented directives to only allow one RN to work per ward on any given holiday… Thus eliminating holiday overtime earning potential while creating overtime situations if an RN called in sick on a holiday.  Average patient loads for an RN at WSH are 30 patients to a single RN on most days.  Due to CMS correction plans, paper workloads have grown exponentially as has clinical liability.  WSH is losing four LPN’s by the end of this month and there have been no additional LPN hires.  This trend will essentially result in RN’s passing medications along with 30 patients to 1 RN charge nurse duties, when this occurs patient safety will be compromised.  Mandatory overtime is now rampant, as State RN’s at WSH are not considered by law to be working within a “hospital.”  Therefore RN’s at WSH are NOT protected under the law which protects all other RN’s within the State. 


The previous CEO eliminated all competency training in early 2015 at the same time DSHS had receive additional funding for training via the Ad Hoc Safety Committee recommendations.   This was due to the fact that WSH did not have enough full time positions (FTE’s) to provide even base safe staffing levels for seven days per week without massive use of overtime, let alone provide staffing for ANY additional training that was required to keep CMS funding and hospital accreditation.  DSHS provided false information to the Legislature regarding staffing on a consistent basis, resulting in the current crisis and eventual collapse of staffing which I believe can no longer be reversed before losing 64 million dollars a year in federal funding.    I was part of a WSH Training Workgroup, a few days ago I received an email stating that the WSH Training Workgroup was suspended.  The reason for this is that there is insufficient staffing to provide ANY ongoing training at WSH, therefore dooming any reasonable chance to rehabilitate the massive damage that was created by DSHS administration.  


This bleak picture at WSH was caused by the past two years of administrative incompetence within DSHS at all levels, and DSHS administration providing consistent false information regarding staffing needs of WSH to the Legislature.   The numbers of additional full time positions required at WSH are staggering and will be a sudden shock to the Legislature when reality based numbers are provided.  As has been stated in previous blogs, DSHS chain of command knew two years ago that an additional 170+ full time employees were required for WSH to operate at bare minimal levels of safe staffing…  The CEO asked for ZERO from the Legislature that questioned how this projection was possible when the overtime statistics were reviewed.  

Radical change in DSHS administration is required.  The Legislature must be provided with accurate information at all times.  DSHS should be held accountable for providing knowingly FALSE information to the Legislature.  

© Paul Vilja 2017