Most WA nurses report getting breaks — advocates are skeptical - Anlık Haber

Most hospital health care workers reported that they received their breaks at least 90% or more of the time, according to the first quarterly reports submitted to the state under a 2023 law. Advocates for the hospital staffing law — which mandated the new reporting requirements for meal and rest periods — questioned the high compliance rate, saying employees often underreport missed breaks.

Data submitted to the Department of Labor & Industries in October showed that 38 out of 44 hospitals had a compliance rate of 90% or better — meaning that most hospital staffers missed fewer than one out of every 10 meal or rest breaks.

Trevor Gjendem, a nurse at <a href=”https://www.providence.org/locations/wa/providence-regional-medical-center-everett”>Providence Regional Medical Center</a> in Everett, told Cascade PBS the data showing his facility had a 93.5% compliance rate did not match his experience at work.

“There’s no way,” he said of the reported high rate of proper rest breaks. “If you were to go to a Walmart it wouldn’t be true.”

Gjendem argued many nurses may report they received their rest and meal breaks rather than deal with the inquiries from supervisors that come with reporting them as missed.

“You don’t want to be the one person that’s consistently saying they’re not getting their breaks,” he noted.

In the first batch of reports, just one hospital submitted a report that fell short of the break compliance standards. Four other hospitals also face potential financial penalties for failing to submit a charter for its hospital staffing committee, another requirement under the new law.

After the pandemic strained an already fragile health care system, hospital workers in the state lobbied the Legislature to strengthen a staffing law by setting minimum patient-to-staff ratios. They said that as hospitals experienced labor shortages, health care workers were being asked to take on larger patient loads that were unsafe and that forced them to forgo breaks.

Pushback from the Washington State Hospital Association — which argued that rigid ratios could force hospitals to stop accepting patients — produced <a href=”https://lawfilesext.leg.wa.gov/biennium/2023-24/Pdf/Bill%20Reports/Senate/5236-S2.E%20SBR%20FBR%2023.pdf?q=20241108095727″>a compromise bill</a> in 2023. It instructed L&I to start tracking how often hospital staff who work with patients missed their breaks.

The law also added new requirements for hospital staffing plans, which set staff-to-patient ratios by a committee of healthcare workers and administrators at each hospital, and it lowered the bar for when the state can investigate staffing complaints.

A <a href=”https://www.cascadepbs.org/investigations/2023/05/new-wa-law-may-not-cure-hospital-staff-shortages-nurses-say”>previous Cascade PBS investigation</a> found that at least 185 staffing complaints were submitted to the state Department of Health between 2020 and 2022. None of those complaints resulted in fines.

This story is part of Cascade PBS’s <a href=”https://crosscut.com/WA-Workplace-Watch” target=”_blank”>WA Workplace Watch</a>, an investigative project covering worker safety and labor in Washington state.

The new law is structured to take effect in phases. Staffing committee charters were due in July 2024, with fines starting right away. In October, hospitals were required to start reporting missed rest and meal breaks to the state every quarter. Fines for missed breaks are then set to start in mid-2026 if workers on average miss 20% or more of their rest periods. Updated staffing plans are due by Jan. 1.

Erika Hermanson, a spokesperson for Providence Everett, which reported a 93.5% compliance rate, emphasized that hospital leaders have prioritized getting staffers their required breaks.

“[Our] compliance rate demonstrates our commitment to ensuring our valued caregivers receive the eligible meal and rest breaks they have earned, while continuing to provide our patients the high-quality care they expect from Providence Swedish,” wrote Hermanson in an emailed statement.

Gjendem said staffing has been less of an issue lately — but attributes that to the new union contract that secured a wage increase rather than to the bill that passed in 2023.

“When we got our new contract we were competitive in the market, and we’ve been able to hire people,” he said.

Darcy Jaffe, a senior vice president for the Washington State Hospital Association, said the data on meal and rest breaks was what she expected, but it still helped provide hospitals with some data-driven perspective.

“I think it gives opportunities for the staff to be reassured that, you know what … actually most people are getting their breaks,” Jaffe added in an interview with Cascade PBS. “Makes you wonder how much the law was required in the first place.”

<a href=”https://www.wsha.org/articles/washington-state-hospital-association-files-suit-against-department-of-labor-and-industries-to-stop-unauthorized-penalties/”>The hospital association</a> filed a lawsuit over the new law earlier this year, claiming the “new policy exceeds the scope of penalties allowed by state law.”

Gjendem said the union at Providence Everett tried to get staff ratios written into their latest contract but that it was a nonstarter for the hospital. Instead, Gjendem added, Providence agreed to a bonus when floors were understaffed and to hire several break nurses, though he said that had yet to happen.

So now when Gjendem goes on break, another nurse — a “break buddy” — takes on his patients, essentially doubling their load.

“They’re just shuffling out the patient load to another nurse,” Gjendem said.

Providence Everett did not respond to questions about the hospital’s use of “break buddies.”

Pamela Chandran, a director at the Washington State Nurses Association, agreed with Gjendem that employees underreport missed breaks, and that the “break buddy” system can undermine patient care and contradicts staffing plans.

“It also has the effect of causing nurses to either forgo breaks or take shorter breaks, because they don’t want to unduly burden their coworkers,” Chandran wrote in an email.

Find tools and resources in Cascade PBS’s <a href=”https://crosscut.com/WA-Workplace-Watch/Check-Your-Work
” target=”_blank”>Check Your Work guide</a> to search workplace safety records and complaints for businesses in your community.

There are two other deadlines in the law WSNA is tracking: Jan. 1, 2025, when new staffing plans are due, and July 1, 2025, when those plans must go into effect.

In December, the Department of Health issued the first penalty notices under the new law to four hospitals after they failed to submit a staffing committee charter in July — a requirement under the new law, which also strengthened requirements around staffing committees.

A notice of intent to issue a civil fine went to four MultiCare Health System hospitals in Spokane, Yakima and Thurston County. Fines ranged from $1,000 to $8,000.

Scott Thompson, a spokesperson for the hospital system, said the last two staffing charters are currently being finalized.

“We recognize this timeline is longer than planned but completing this work thoughtfully and thoroughly required more time than anticipated,” Thompson wrote in an email to Cascade PBS.

L&I established a new division — health care labor standards — as the agency implements the new law overseeing the tracking of compliance rates. The manager of the new division, Carl Backen, said it’s too soon to say how well the new law is working.

“I’m waiting to see how future quarters look,” Backen told Cascade PBS in an interview. “I’m waiting to see what reactions are like from those who are closer to the ground. I think they might have a better sense of determining whether those numbers feel right to them, or if there might be reporting gaps at this point.”

Starting in July 2026, if a hospital’s staff misses 20% or more of their meal or rest breaks, then <a href=”https://lawfilesext.leg.wa.gov/biennium/2023-24/Pdf/Bill%20Reports/Senate/5236-S2.E%20SBR%20FBR%2023.pdf?q=20241108095727″>L&I must issue a fine</a>, which ranges from $5,000 for smaller hospitals to $20,000 for the largest facilities. Under the new law, hospitals also must pay staffers for missed breaks.

In the first quarter of tracking, Kaiser Permanente Central Hospital was the lone hospital that exceeded the 20% threshold. That facility reported a 64.9% compliance rate, meaning the staffers who work directly with patients missed, on average, one out of three of their rest breaks.

Linnae Riesen, a spokesperson for Kaiser Permanente Washington, wrote in an email that the hospital used “a stricter view of what is considered a ‘missed’ meal or rest period than required by L&I.”

“Upcoming reporting will more closely track L&I Guidance with an expected higher reported compliance rate going forward,” Riesen wrote. “Kaiser Permanente is committed to compliance with the law and ensuring fair treatment of its employees.”

Riesen declined to answer how Kaiser defined a missed meal or rest break.

Kenia Escobar, a spokesperson for SEIU Healthcare 1199NW, the union that represents Kaiser employees, said the workers address staffing issues through the staffing committee. Escobar declined to comment further.

The law stipulates that until fines go into effect, L&I will offer “technical assistance” to those hospitals that are below the 80% compliance rate. L&I indicated this could include more education on what the law requires and connecting noncompliant hospitals with compliant ones on best practices for tracking meals and rest breaks.

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