Keeping nurses on staff at Oregon State Hospital has been a challenge over the last few months. The psychiatric facility is currently full and has stopped accepting admissions because it hasn’t been able to release enough patients. Public health advocates say they are worried for the nurses on staff that have been forced to work around-the-clock until more providers arrive. Closing off the facility also means that some mentally ill inmates will have to stay in jail without state-provided treatment.
The crisis prompted the facility to call in the National Guard as a way of keeping the lights on.
Taking Time Off
The hospital employs around 1,800 staff members while caring for around 600 patients. Administrators say the staffing crisis has persisted on and off throughout the pandemic. They add that the number of providers taking COVID-19 leave has increased dramatically since February.
Hospital Superintendent Dolly Matteucci told lawmakers on May 3rd that nearly 700 employees had taken some form of COVID leave. From February to March, there was a 45% increase in direct-care staff taking leave.
The hospital has asked managers to work weekend shifts until July 4th to keep the facility running. “Still, we struggle to maintain minimal staffing levels,” Matteucci wrote to staff. “Just last week, we had approximately 33% of our Nursing staff out on COVID-related leave.”
Without proper staffing levels, the hospital is currently not accepting any new admissions, which could put the health of the community at stake.
To keep the facility running, administrators are calling on the National Guard for help. They are currently asking for 30 additional nurses. “We need your help,” Oregon Health Authority Director Patrick Allen wrote on Tuesday. “OHA has exhausted all other staffing options for the hospital’s Salem Campus, and our circumstances are dire.”
However, the governor has yet to respond to their call for help. According to Oregon Military Department spokesman Stephen Bomar, “The Guard is also usually called in after all other civilian and state assets have been exhausted.”
Pleading for Reinforcements
State officials say they want the hospital to fill these openings with civilian talent, so the National Guard doesn’t have to pick up shifts. They are currently asking members of the public to volunteer at the facility – even if they don’t have any nursing experience.
“Anyone who has good people skills is encouraged to volunteer for an emergency assignment,” Allen said. “The need is great, and any assistance you can provide will better enable (state hospital) staff to do their most critical work – patient care.”
The hospital says that volunteers would get six days of orientation, nine days of basic training in nursing tasks, and 40 hours of orientation on a unit working with a mentor.
“As you know, the pandemic has been taking its toll on our coworkers, those who have been sick, those caring for sick loved ones, and those who’ve lost childcare due to the pandemic,” Allen wrote in a message to staff. “For many state agencies, this means important work may be put on hold — but the hospital doesn’t have that option. We have people to take care of 24 hours a day, seven days a week.”
Unlike traditional hospitals that send patients home when they’ve recovered, Oregon State cares for some of the state’s most vulnerable, including those found to be criminally insane. Many of those living behind bars also suffer from a mental illness. Some of them are too ill to go to trial, so the hospital has to stabilize them before the case can continue.
“They don’t leave when they’re cured,” said Tom Stenson, deputy legal director for Disability Rights Oregon. “They leave when they know what a lawyer is and they know what a judge is.”
Administrators say retaining staff has become a challenge, considering how the hospital has changed over the years. “The current staffing problem is an outgrowth of how the state is choosing to use the state hospital,” Stetson added. “More and more, the hospital has become a way to warehouse people who are ill rather than treat them. I think that’s burned the staff out.”
A lack of funding and investment in public health services may be to blame, as well.
“Oregon’s behavioral health system has failed to keep up with demand for services for years,” said Jesse Merrithew, who represents defense attorneys with clients at the hospital. “The only response has been to increase capacity at the state hospital, all the while we have been telling them that is not a long-term solution.”
So far, just two nurses have volunteered to work at Oregon State.