State Sen. Walsh says mandatory breaks for nurses can’t work everywhere
Washington state Sen. Maureen Walsh says her remark during an evening floor debate about nurses playing cards on the job was not meant to be malicious.
“I was tired,” she said. “I said something I wish I hadn’t.”
On Friday the Washington State Nurses Association posted a blog about her comments during a Tuesday floor debate on the bill, and by the end of the day Walsh’s remarks had gone viral on social media. The next day CNN covered the controversy.
Walsh was arguing Tuesday for an amendment that would exclude small, rural hospitals, like Dayton General Hospital, from the bill’s requirements.
The requirements for rest breaks would make it more difficult for small, rural hospitals “that literally serve a handful of individuals” to stay open, she said.
“I would submit to you that those (small hospital) nurses probably do get breaks,” she said. “They probably play cards for a considerable amount of the day.”
Nurses outraged across the nation
The comment drew the wrath of not only nurses in Washington state, but also those across the nation.
“The cards are not in your favor,” said one message to Walsh, signed Proud Kentucky Nurse.
A change.org petition demanding that she follow a nurse for a 12-hour shift had 5,000 signatures by noon Saturday.
“I dare you to even try to keep the pace,” said a registered nurse commenting on the Tri-City Herald’s website.
Walsh said her office received thousands of emails.
But accusations that she hates nurses are wrong, she said.
“My mother was an RN for many years, and I have the greatest respect for nurses,” she said.
Her card-playing comment was referring to only small, rural hospitals that are open around the clock to provide emergency care, she said.
Hospitals like the one in Dayton — population about 2,500 in Eastern Washington — have few patients, she said. There is no other hospital within 20 miles and it is classified as a “critical access hospital” under a program to keep essential services in rural communities.
Nurses say patient safety at stake
Mandated lunch hours and breaks are not an issue for small, rural hospitals and are not needed to meet the needs of patients, Walsh said.
Increased staffing that could be needed to meet the bill’s requirements would hurt already struggling hospitals, said supporters of the amendment.
Some 61 percent of the state’s critical access hospitals, which have 25 beds or fewer, are operating in the red, according to Walsh and other Republican lawmakers who argued to exempt such hospitals from the requirements in the bill.
The Washington State Nurses Association disagreed.
Most Washington critical access hospitals are operating with a surplus and can afford to bring on an extra nurse or technician to provide patients with safe care, it said, citing Department of Health data.
Lourdes Medical Center in Pasco is one example of a hospital with a “critical access” designation that shows a solid net income for 2014-17, the nurses’ association said.
No more than 30 percent of the critical access hospitals in the state have negative margins in any given year, and that is usually due to short-term factors such as capital expansions, it said.
The association called Walsh’s comment about nurses playing cards “incredibly disrespectful and patronizing.”
It has called mandatory, uninterrupted breaks a safeguard needed to address dangerous fatigue and prevent medical errors as registered nurses, licensed nurses, certified nursing assistants and hospital technicians work long hours.
The nurses’ union has pressed for years for the Legislature to adopt such staffing protections for nurses.
“When we’re rested, we’re alert, focused and ready to make life and death decisions,” said Martha Galvez, a labor and delivery nurse at Kadlec Regional Medical Center in Richland, in a statement distributed by the nurses’ union and other unions representing workers covered by the bill.
“When our breaks are interrupted, it isn’t just bad for me, it’s bad for my patients,” Galvez said.
Walsh says bill not needed
Many other states, including Oregon and California, have laws that require hospitals to provide uninterrupted breaks and prohibit mandatory overtime to protect patient safety, the nurses’ union said.
Walsh supported the amendment as passed to exempt small hospitals from the bill’s requirements. But she still doesn’t like the bill.
She accused the nurses’ union of fabricating a problem, when most nurses get their breaks and lunches using their own professional judgment and flexibility on when to take them, she said.
The Legislature addressed the issue in 2017 with strengthened processes for when nurses’ schedules are an issue, she said.
It added new requirements for nurse staffing committees that hospitals have been required to have since 2008.
As of the first of this year, the committees must develop a process to examine and respond to complaints, and the Department of Health can take enforcement action if there is a chronic pattern of violations of staffing plans.
The new law needs to be given a chance to work, Walsh said.
After the amendment to exclude small hospitals from the bill’s requirements passed Tuesday evening, Walsh proposed another amendment to prohibit nurses from working more than eight hours in a 24-hour period.
Shift-limit amendment passes
“Well, if we have an issue with nurses getting tired, let’s quit letting them do 12-hour shifts,” she said. Nurses want the longer shifts “but then they come back and start talking out both sides of their mouth and telling us how tired they are.”
It was meant to be a “statement amendment” by the minority Republican party in the Senate to make a point on the floor about the bill, she said.
“We as citizen legislators should not be micromanaging how industries in our state conduct their businesses, and I am especially uncomfortable telling hospitals how to administrate and staff their facilities, when they are caring for . . . patients,” Walsh said.
To her surprise, the amendment was approved on a voice vote. She placed the blame on Democrats, who are in the majority.
The House has already passed the bill, without the amendments added by the Senate. The two versions must now be reconciled.
The Washington State Nurses Association opposed both amendments.
All nurses should get their breaks, whether they work at large or small hospitals, it said in a statement.
“As for the eight-hour language, we believe this is unworkable for most hospitals and unfair to nurses,” it said.
Walsh speculates that one outcome of the process to reconcile the House and Senate versions of both bills may be a push to remove the unpopular eight-hour amendment in exchange for removing the amendment that excludes small hospitals.
“The bill will either change in the final days of session or it will die,” she said. “It is certainly up to the majority party if they want the legislation or not.”