While Washington’s lawmakers and governor celebrated their efforts to fix the state’s ailing mental health system, workers at the state’s largest psychiatric hospital struggled with a new assault, sewage flooding, excessive overtime and the spread of chickenpox that sent dozens of workers home without pay.
On Sunday, a mental health therapist at Western State Hospital was hospitalized after a patient bit off part of her left thumb. Over the weekend, patients flushed non-disposable items down toilets, causing sewage flooding in several offices on two wards.
On Tuesday, hospital officials quarantined patients after two showed signs of chickenpox. They tested about 300 others and said “susceptible staff will not be allowed to work between May 7 and May 23,” according to a note sent to staff on May 6 by Karen Pitman, director of nursing support services.
Nurses at the Lakewood facility have worked an average of 154 hours of overtime each day in 2019 to operate at base staffing levels, according to an overtime report that covers up to the end of April and was acquired by The Associated Press. That’s an increase from the daily average of 149 hours for 2018.
Gov. Jay Inslee signed a package of bills on Thursday that are designed to expand the care for mentally ill people by opening more treatment facilities and by opening a new teaching hospital in Seattle.
“We want the best for our patients,” Inslee said in a statement. “That means shorter wait times, the best care possible from leading experts, and appropriate facilities close to home so they can still access their own support system.”
But many of the changes could take months or years to implement.
“Western State Hospital is drastically short-staffed of direct patient care personnel, while massively over-staffed with administrative positions and administrative support personnel,” said Paul Vilja, a nursing supervisor.
Kelly Stowe, a spokeswoman for the Department of Social and Health Services, said they were saddened by the recent attack on a worker, but said they continue to improve and increase training “regarding crisis prevention and intervention for staff and to give team members the tools needed to de-escalate patients showing signs of aggression so assaults can be stopped prior to occurring.”
The lack of direct-patient-care staff makes responding to assaults more difficult, workers say.
Stowe also praised officials at Western State for their quick response to the discovery of chickenpox at the facility.
After confirming two cases, the staff asked the state and Pierce County health departments for support to get vaccinations for patients and staff within 72 hours. They also screened for immunity and offered vaccines to those in need.
Adolfo Capestany, an agency spokesman, said the staff were on unpaid leave because their collective bargaining agreement only allows paid administrative leave “to seek testing and treatment.”
“Employees ineligible to work due to possible exposure and no immunity are required to use their personal leave, either paid (sick, vacation, etc.) or unpaid for anyone who is waiting out the incubation period,” he said.
He also confirmed that this impacted workers and 20 patients, “who are still considered potentially susceptible and are being monitored.” Twelve staff on Ward E8 were restricted until Friday and 13 staff on Ward F3 will be restricted until May 23, he said.
But the nurses said the agency’s response was “haphazard.”
The first chickenpox patient was on Ward E8, Vilja said. They moved that patient to Ward E5, causing exposure there, and then moved the patient back to E8 and then to St. Clare Hospital. During that process, a pregnant worker was exposed and several others were sent home on administrative leave during their incubation periods, he said.
The next case occurred on the forensic services ward, and then another in South Hall, he said.
“I sent a memo to administration after a leadership meeting stating that they had incorrectly interpreted the situation,” Vilja said.