Empowering Nurses in Oregon

Since the passing of Oregon’s staffing legislation in July 2023, we’ve been working to ensure its successful implementation.* The nurse-to-patient ratios take effect June 1, the new non-RN staffing committees must be formed by December 2024, and then June 2025 will bring civil monetary penalties for hospitals that violate the law. While passing this legislation was not easy, the real work lies in seeing it implemented and ensuring our members are empowered to report staffing violations.

Administrators at some smaller hospitals are already complying with the ratios set under the new legislation. But many larger hospitals aren’t. Our state regulatory agency is already receiving complaints about employers that are understaffing (such that nurses are still missing their meal and rest breaks), assigning nurses to areas they’re not properly trained for, and canceling staffing committee meetings. In one hospital that had better staffing ratios than what’s mandated in the new law, administration used the law as an excuse to increase nurses’ workload—even though the law specifically forbids it.

This new legislation won’t work if our members don’t know about it and don’t fight to enforce it. Administrators will continue trying to skirt the law or exploit loopholes. So we are educating members about their rights under the law and about the role of staffing committees. It can be challenging to get the word out to our many members, so we’re using several channels to communicate. We are holding membership forums and will be offering on-demand courses on our website through OCEAN (Oregon Continuing Education Activities for Nurses; visit oregonrn.org/page/onlinece). We’re hosting monthly conference calls with the staffing committee chairs and reaching out to them individually to ensure they are engaged and have the resources they need. And once a month, I’ll be including a personal message in our weekly member newsletter to ensure we keep spreading the word.

We are also focusing on where our power lies in this law: drafting comprehensive staffing plans that ensure a good working environment for staff and high-quality care for patients. We have a team of nurse practice consultants who are meeting regularly with staffing committee co-chairs and advising on what staffing plan changes to consider—and how to prevent changes to existing plans. They’re telling our members to stand strong and to not accept ratios that are outside the intent of the law. The law says that if they cannot come to an agreement with the employer, they go to mediation. And a mediator will uphold the law.

We also want to empower members to file complaints when employers violate the law. Many nurses are not filing complaints because they’re so used to complaints going nowhere and because the complaint process is very cumbersome. Nurses are too overworked to write out complaints during their shift, and the last thing they want to do is spend 20 minutes doing it when it’s time to clock out. To address this, we are also involved in the regulatory agency’s rulemaking process, helping interpret the law, closing loopholes so employers cannot manipulate staffing plans, and refining the complaint process. And we’re encouraging members not to wait until the law goes into effect to write complaints. Filing complaints when violations occur now can help ensure that hospitals’ violations will automatically bring a monetary fine beginning next year.

Pushing back on hospitals and refusing to be overworked goes against nursing culture. We are conditioned to believe that we must step up and take on extra work. We believe we must put our own health and safety in danger to fix problems created by administrators—who are making greater profits each year by cutting costs on the backs of the workforce. So as we’re educating our members, we are also retraining our way of thinking. I think we’re going to see a huge difference as hospitals learn they can no longer bully and manipulate our nurses because we’re fighting to protect ourselves as well as our communities.

Tamie Cline, RN, is the president of the Oregon Nurses Association (ONA) and a bargaining unit leader at Good Shepherd Medical Center in Hermiston, Oregon. She has served on the ONA Professional Nursing Care Committee since 2020 and has been a delegate to the AFT’s convention since 2018. She is currently an IV therapy and wound care nurse in the Good Shepherd Treatment Center.

*For an introduction to Oregon’s Code Red campaign and new staffing legislation, see “Historic Staffing Win for Oregon Health Professionals” in the Fall 2023 issue of AFT Health Care. (return to article)

[Photo: Courtesy of Oregon Nurses Association]