This article is the first in a series that will shine light on the inner workings at our local hospital system. Administrators at Jefferson Healthcare would have us believe that all is well within their institution, particularly as they return to the taxpayers, hat in hand, to fund their next dream of upgrades to the Sheridan Street facility. With the backdrop of a looming global financial crisis, materials shortages and supply chain ruptures, how viable is this $100 million-plus gamble? What will it actually cost when all is said and done?
Jefferson Healthcare is struggling mightily to retain and recruit nurses and other patient-facing staff, and as this exposé will reveal, significant roots of that problem are internal. Through personal accounts from insiders, public records requests and investigation of current federal funding mechanisms, we will take a deep dive into the contemporary condition of Jefferson County’s hospital system.
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“We concluded years ago that we are in the trust business… Hospitals are nothing but fancy buildings with expensive technology if we don’t have a great employee base. So we are very focused on — one, recruiting and bringing in the right people for our team, and then once they are here, working really hard to provide a work environment that is satisfying both personally and professionally and allow for providers to grow and develop.”
Jefferson Healthcare CEO, Mike Glenn at the May 12, 2022 Community Presentation
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We have come to expect glowing reports of good deeds and great intentions when public agencies are selling a property tax increase. But how much truth is contained within Mike Glenn’s flowery assessment above? Is the view from the ivory tower the same as it is on the patient floors? What degree of “trust” exists within “the team” in the medical institution so many in this community count on?
Anyone who has lived here for long has personally, or has family and friends who have received stellar care at Jefferson Healthcare facilities. I have, my partner has. The nursing and support staff get rave reviews again and again, as do most providers.
However, the Free Press has been contacted on multiple occasions by hospital workers who feel an urgency to sound the alarm on what they see as chronic mismanagement that puts nursing staff and patients alike in potentially dangerous situations. The aim of this article is to give voice to those who have not been heard, despite their years-long efforts to improve the work environment through dialogue and negotiation. Management responds with platitudes like “let’s continue to work on solutions together…” as they neglect the reforms most requested by staff — regular schedules and part-time employment.
I sat down with one of those whistleblowers recently, and listened to her story. She’s asked that I use a pseudonym to protect her identity, understandably concerned about retaliation.
Suzanne is a Registered Nurse (RN) who came to work at Jefferson General Hospital over twenty years ago. She loves her work — that is to say, she loves taking care of people.
The era of healthcare facility mergers and acquisitions ushered in new and improved bean counters and fancy new nomenclature to distinguish upper management from the rest of the pack. Jefferson Healthcare birthed its own Strategic Leadership Group (SLG) approximately fifteen years ago. The current SLG is pictured below.
Strategic Leadership Group (from top left):
MIKE GLENN, MHA, Chief Executive Officer; JOSEPH MATTERN III, MD, FAAFP & HMDC, Chief Medical Officer; TINA TONER, RN, MSN, MBA, CENP, Chief Nursing Officer; BRANDIE MANUEL, MBA, CPHQ, Chief Patient Safety and Quality Officer; JENN WHARTON, PT, MHL, Chief Ambulatory and Medical Group Officer; JACOB DAVIDSON, MHA, FACHE, Chief Ancillary and Support Services Officer; TYLER FREEMAN, MSA, CPA, CHFP, Chief Financial Officer. (Not pictured, ALLISON CRISPEN, Chief Human Resources Officer)
Suzanne describes a gradual and insidious decline in staff morale that’s emerged since 2014-2015, most notably when the SLG Chief Ambulatory and Medical Group Officer began restructuring the clinics and family practice offices. Then the hospital stopped hiring part-time nurses.
Using ever sharper pencils, the SLG further streamlined by cross-training, deleting existing part-time positions (firing those who couldn’t work full time), cutting overall positions in each department and not hiring new staff — even when there were qualified applicants, Suzanne reports. Set schedules, the likes of which make life predictable for days off and family time, were eliminated. Plans to attend important rites of passage like graduations, weddings and funerals became a luxury of the past.
Scheduling and the loss of part-time positions created wide-spread disgruntlement throughout the facility. Complaints from staff were met with “you just need to figure out why you want to work here, or you can leave.”
Senior nurses pleaded with management for more staff and part-time positions, citing their own recognition that if their concerns were ignored, there would be an escalation of safety issues that could harm patients and the hospital’s bottom line and reputation.
There was also the phenomenon of what has come to be known as “compassion fatigue” in overworked and under-supported staff. Suzanne says “We’re caregivers. We don’t want to make the hospital look bad.” So the nursing staff shouldered more and more responsibility, working long days without breaks, sacrificing their own welfare for the sake of patient care and hospital optics.
She reports that managers began to look for excuses to ship patients out for care. Surgeons were being pressured to hurry it up. Staff witnessed nurse managers asking, mid-surgery, “how much longer do you think this will take” and providers being told “you’re taking too long to do surgeries.” Adding to the pressure, in recent years the number of surgeons has increased as the number of support staff has been eliminated.
The lack of respect and increasing demands have resulted in “running off 20 nursing assistants” in the last few years, according to Suzanne. They were being asked to care for too many patients. Changes that could be implemented to maintain staff and improve morale — set schedules, retention bonuses, compensation for extra shifts — have not been forthcoming.
“Human resources,” a risible term for working people, is at a crisis point in healthcare. Efforts by institutions to run lean has led to many nurses abandoning the security of steady work in a familiar place close to home in favor of hitting the road and hitting it big with travel nursing.
According to this 2016 article on the trade website TravelNursing.org, nursing shortages began with the 2008 financial crash. The CEO/president of the American Association of Colleges of Nursing (AACN) was quoted back then, saying:
“At AACN, we are most troubled by the shortage of nurses prepared at the baccalaureate and graduate levels since research shows that having enough of these nurses is important to lower patient mortality rates, reducing medication errors and realizing other positive care outcomes.”
At the time, nursing schools were turning away qualified applicants because the schools lacked “faculty, clinical sites, classroom space, preceptors and [had] budget constraints.”
Fast forward six years and the unnatural disaster surrounding Covid, and those highly trained, veteran nurses — the shortage of which so troubled the AACN — now often find themselves working alongside novices with decades less experience who are being paid three to four times as much.
Raises for Me, But Not for Thee
The battle for pay increases at Jefferson Healthcare has been epic, with mediators arguing on behalf of nursing staff for the most niggling little bump. Management maintained that “it’s not sustainable to pay more.” Retention became a major issue, with experienced staff leaving to work elsewhere for single digit increases and the perennial issue of scheduling. During labor negotiations in November 2021, the contract was delayed because the SLG was
“philosophically opposed to raises
for nurses in the top five steps.”
Philosophically opposed. Well, at least they had a philosophy.
There is a seniority tier system in nursing, with the tiers varying from hospital to hospital. Each year of experience is called a “step.” There are 32 steps to reach the apex of the nursing world at Jefferson Healthcare. Random steps are called “ghost steps,” a pause year that precludes pay increases.
After another grueling round of mediated negotiations, the latest contract was finally ratified three weeks ago, on June 22nd, 2022. Despite management’s philosophical opposition, all of the nurses got at least a 4% raise. Ghost step years now pay modest increases instead of none.
Suzanne reports, “The time spent to get there was very disappointing and disheartening. The nurses were made to feel unworthy and expendable.”
In stark contrast, CEO Mike Glenn’s 6% raise three months earlier sailed through the board with only one commissioner, Matt Ready, opposing. [Ready maintains a creative blog of his experience as a Jefferson Healthcare Commissioner.]
Glenn’s pay package is now around $380,000. The rest of the SLG incomes range from a quarter to a third of a million dollars, most of them paid as much or more than Washington’s Governor.
In addition to public record request responses from Jefferson Healthcare, the Free Press has received news tips from stressed nursing staff, current and former, all of them requesting anonymity for obvious reasons. The following are excerpts from a variety of these sources:
“The ACU Staffing Crisis is management created. The Restructure and the stress of Covid-19 are not the root causes of the mass exodus…”
“I understand staffing ICU, especially at night, has been a challenge, however untrained and unqualified staff are being used to staff ICU in unsafe ways that risks liability and patient safety especially when taking into account ICU patient census and telemetry monitoring obligations. It seems the expected standards for ICU care have become adulterated recently with untrained staff for the amount and the acuity of patients we have been having. As I mentioned above, I am all for cross training willing and able nurses to ICU, it just needs to be done correctly with consideration to ICU census, patient acuity, telemetry patients, and number of qualified staff. I’m more than happy to discuss this further and assist in any way. My apologies for the long winded email, I’ve been stewing on this for a couple days now. I can only imagine the amount of similar emails you have been receiving. I’m just rather concerned for the reasons listed above; and my co-nurses, I am sure, share the same sentiments as well.”
— ICU RN, Feb. 2022
“I came onto shift this morning as Charge RN and am receiving no report on the patients. I have never come on and gotten no report in 7 years. Last night one set of patients had 3 nurses covering in succession. When I came on shift Monday the same thing happened and the set of patients I received had 3 different nurses in a 12 hour period. I had to round to the patient and family members who were upset because the care plan was not followed and a comfort care patient inadvertently had oxygen placed on her, which they did not want. I had to explain it was because of the staffing that information did not get across as it should have. This patchwork planning is having impacts on our patients and our staff. It is unsafe. We also have a new nurse for ICU who was put on the floor with no orientation. He spent hours running back and forth to ICU getting supplies because he did not know where they were on ACU [Acute Care Unit]. The standard of nursing care here is actively deteriorating and it makes me uncomfortable.”
— Charge Nurse, Feb. 2022
“The staffing on night shift is unsafe. From the time of the restructure, travelers not fully oriented to our hospital have had to work independently monitoring tele [telemetry] , managing FBC [Family Birth Center] or ACU RNs in the ICU. During many of those times, Telemetry was not documented per policy…
The restructure and the administrations refusal to set templates, or allow self-scheduling, forcing part time employees to take full time positions have left us relying on per diem RNs and travelers. In the ICU, we now only have 3 full time RNs and 1 part time. The rest are employees who have switched to per diem in order to control work-life balance. We are woefully understaffed because of their hubris and arrogance.”
— ICU RN, Feb 2022
“I am not sure if you are aware of this, but the current ACU and ICU staffing situation is very bad. Dayshifts and nightshifts.
It is difficult to see that there is any management involvement in providing real solutions. We just hear about increasing ratios. That will NOT be safe. Over night we had a very busy floor with lots of cognitively impaired impulsive fall risk patients, and only one CNA [Certified Nursing Assistant] available as the other one is stuck as a sitter with our 1:1 resident. The ICU was slammed all night last night and needed assistance that I could not always provide while also assisting the floor. There was an FBC nurse sitter there silencing Teles because the ICU Nurses were so busy.
This feels very dangerous. What is going to happen next week when surgery goes up to full speed and you lose another full-time nurse? We’re drowning here.”
— RN, Feb. 2022
“From 2017 onward, as management initiatives evolved and pressures increased, morale began to decline and the scheduling method changed. As time went on, I watched as we hemorrhaged CNAs (30 in less than a year at one point) and the nurses continuously expressed their discontent and began to leave too…
The lowest hanging fruit to improve morale and to retain staff is to give the nurses a REGULAR SCHEDULE… Please know that the [employment] contracts are attached to PEOPLE. People with lives and families. Well-educated and hard-working people who care about taking care of patients. People who actually WANT to work at Jefferson Healthcare (and would come back) except they just can’t take the mismanagement anymore. They are exhausted by the irregular schedules… and the disregard shown for their work-life balance… nurses that are left are disheartened and do not believe that there is any hope for change. Some of them biding their time prior to retiring, others are actively looking around at other hospitals. I am watching as warm bodies are leaving, first year nurses be pushed into the Charge Nurse Role, being robbed of developing their clinical foundation. Doesn’t this seem dangerous to you?
The ACU Staffing Crisis is management created. The Restructure and the stress of Covid-19 are not the root causes of the mass exodus…
I understand that this is just part of a very complicated issue with this hospital system and there are many pressures from all sides, but it is tough to run and grow and maintain a basic safety level if your staff is gone.”
— RN, Nov. 2021
“I left as I didn’t want the Jab, nor did I want to put a religious exemption in as I fully believe that my right to choose not to have the Jab was exemption enough… employee health is struggling as they don’t have enough staff… I wish more nurses would come forward.”
— former Care Team Specialist, JH Home Health & Hospice, Oct. 2021
Management Response
SLG Chief Nursing Officer Tina Toner offered this response to emails she’d received from nursing staff, including some of the above:
“I want to acknowledge the real challenges we continue to be faced with in terms of staffing. Please know, it is ever apparent that you and everyone of our team is doing all they can to help support their department and care for our patients. I hope that you know that as nursing leaders we are also doing all we can to support staffing, recruitment and retention. When we do have days with less-than-optimal staff our staffing coordinator, the House Supervisor Team and department leaders are all aware. Each morning at 0815 our team comes together to discuss staffing for the next 24 hours so we can collectively work on solutions. This is in addition to time spent looking ahead over the several days and weeks into the future and evaluating the need for additional staff. I know that this is hard, everyone is working hard, and we are all tired. Please, let’s continue to work on solutions, together, I know we will find them. Thank you for all you are doing!”
In the past, nursing and other staff could reach out to board members to share issues and concerns that weren’t being dealt with by their supervisors. Apparently, as the complaints increased, management’s tolerance for that approach trended in the opposite direction. Late last year the board passed a new bylaw that requires all staff complaints and concerns to be copied to the board chair and/or the CEO, thus making the complainant a potential target for retaliation from the very people who aren’t fixing the problems being complained about. No wonder staff dummies up, or leaves to work elsewhere.
A public records request I submitted recently disclosed that Jefferson Healthcare conducted a survey entitled “Employee Engagement 2020,” covering the time period of October 20, 2019 to October 20, 2020. The resulting 46-page document revealed gratitude for co-workers, a modicum of satisfaction and appreciation for the facility, and a substantial amount of frustration and mistrust towards management.
Granted, that was a singularly difficult year for everyone, particularly those in healthcare fields. However, the vast majority of complaints were not Covid-time specific, rather referenced embedded institutional norms of disparity and upper echelon cliques that have resulted in a disabling rift between the worker bees and the bosses.
I’ll share that document with our readers and highlight key aspects in the next installment of this series shortly, along with an overview of the Jefferson Healthcare’s proposed “Campus Modernization & Expansion Project.” On July 20th, the SLG gives one more update to the board before they vote on Wednesday, July 27th, whether or not to take this project to the voters in the form of a bond measure in November.
One can only imagine how beleaguered staff choked on the CEO’s words at the top of this article. A demand for transparency is in order. Should the administration be required to get their house in order before they build another house?
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Updated July 16, 2022
Top photo by Sebastian Eggert
Annette Huenke studied International Relations at the University of Pennsylvania. Prior to heading west, she was a manager for an Auckland-based international publisher of peer-reviewed drug information journals. In 1992 she moved to Port Townsend, opening Ancestral Spirits Gallery in 1993. She is past vice president of the Jeff Co EDC and board member of The Boiler Room. She researches, writes and wanders the forests around PT.
I agree with the author and her sources. I have been an in-patient and found the nursing care to be excellent.
I do question the mgmnt based on the article. Why should we allow this overpaid CEO to promote expansion when he is unable to manage the existing facility?!? Sounds like the current POTUS’ administration- throw money at the problem and it will go away – irrational and incompetent thinking as we all now know all too well.
Solutions:
1. Reduce the CEO salary and use the savings to hire more patient care staff. Make the CEO salary accomplishments driven so if no measurable improvement – his pay is reduced not raised. After all his job is to solve not create problems and 300k in salary is ridiculous for such a small facility.
2. Fire whoever implemented a policy of inflexibility in staffing schedules as they are insensitive and obviously incompetent.
3. Have a Patient/Staffing Ombuds man/woman who has the power to effectively represent patients and staff and is accountable to the taxpayers NOT the hospital leadership.
4. Create a community board of oversight that is tasked with identifying problems and the power to force the CEO to do his job, which he apparently is not doing and publish the minutes of their activity so the taxpayer can be assured tax dollars are not wasted on dysfunctional management.
5. Hold the hospital commissioners’ feet to a hot fire so they properly represent the community instead of kowtowing to upper mgmnt and their excuses for their failures. IT’S OUR MONEY NOT THEIRS.
6. Hold these elected commissioners accountable since it appears they have abandoned their oversight responsibility and are just sycophants.
7. DO NOT APPROVE ANY FURTHER LEVIES for expansion until metrics show the issues are fixed, otherwise we just throw good money at the problems that won’t be resolved.
Finally, this CEO should probably be sent packing since he is ultimately responsible and then reduce the salary to the new CEO with incremental increase contingent on performance and results.
Thank you for your thoughtful consideration of the article’s content, and some excellent suggestions, Past Patient. I agree wholeheartedly that admin salaries should be based on outcomes that include employee involvement, retention and satisfaction, rather than some cooked up data points from a trade group like the hospital association (which thrives off memberships).
Former JHC employee here, clinical and not hospital nurse. My experience was pleasant with the other nurses and desk staff, but the MD and ARNP were not. The political environment was so toxic I felt I had to keep my head down and mouth shut. But when I didn’t laugh at their endless disparaging jokes and comments about “Orange man bad,” they soon figured out where my sentiments lay and did everything they could to interfere with my workflow and contentment. I was happy to leave the place behind, but would have liked the opportunity to grow in my career and skills instead.
Thank you for this in-depth look at our local hospital politics. It is depressing and dangerous that they are so short-staffed, which is administration’s fault for firing unvaxed staff, who are no danger to anyone, in fact it’s proven to be the opposite. Of course, with CEO’s earning bloated salaries, adhering to handed-down protocol from corrupt agencies is to be expected, in order to keep their jobs. I wondered, do you know if the hospital is demanding patients be covid-vaxed or tested with the failed PCR test in order to be treated? I know that a person in this area needing a kidney was denied a transplant because she won’t take the covid vax, though her brother died from the vax. Bring on the PMA’s…
Tests and jabs are not required for out-patient emergency care. In-patient treatment required the test but not jabs, last I heard.
Oddly enough I just watched an episode of Fox’s “The Resident” today which dealt with a patient being denied a transplant because he said he was unvaccinated. After reading your article and the comments about prospective transplant recipient requirements, I did some further research and discovered most transplant centers require both the recipient and donor to be fully vaccinated per CDC recommendations due to the enhanced complications that can occur after the surgery.
We don’t perform organ transplants at Jefferson Healthcare and we take care of our patients whether vaccinated or not.
Great reporting, nice job! Another example of Profits over People. When will we ever learn?
From the Free Press Facebook page, two readers (one a hospital patient, the other a former JHC nurse) who did not post here also confirm their experience with mismanagement at Jefferson Healthcare:
Doug Morton
I could tell how it goes for this patient for the last solid year… It’s been hell getting care because of insurance and lack of organization
Gina Masson
Nice to hear some truths!
Because of all the discord you described that is happening the nursing staff (I put in 6 years working on the ACU – ICU and 11 years in another department) I am living my best life in Florida 🌞 Freedom and sunshine. Some would say I abandoned my fellow warriors but I felt and feel it was a losing battle. Reading this article shows me it still is. Bless the RN’s & CNA’s still there, they are the best, loving people❣️
Excellent work Annette. So important to get this important information out there. Look forward to the next one. Thank you.
“Every modern hospital is a form of corporation doing business as a hospital.” I saw that statement somewhere, and sadly, profit does seem to come first.
Thanks Annette & PTFP for another fine local gumshoe expose.
What we’ve been witnessing regionally is a microcosm of a global scale institutionalized & mega-corporate usurpation, theft & mismanagement. Skilled personnel across the spectrum are tossed under the bus, new hires under-trained, decent infrastructures dismantled, existing moneys parasited & siphoned elsewhere, while top-heavy bureaucrats and absurd capital projects are rewarded.
All in service of “the great reset”.
Some timely articles —
US Is Paying $1.7 Billion To Health Care Workers… In Ukraine
https://www.activistpost.com/2022/07/us-is-paying-1-7-billion-to-health-care-workers-in-ukraine.html
What Is The “Council For Inclusive Capitalism?” It’s The New World Order
https://alt-market.us/what-is-the-council-for-inclusive-capitalism-its-the-new-world-order/
If everyone boycotted JHC for a while, it might get their attention that we’re not happy.
One nitpick, SLG is not as new as the article says. It dates back at least 15 years under that same name, even before Mike Glenn rode into town to build his personal fiefdom.
Thanks for the clarification, Former employee. I’ve updated the article to reflect that correction.
After being admitted to the ICU I must say that the nurses in my case were very good at hiding all this from me as a patient and maintaining a good interaction with me. I’ve been admitted to the ER a number of times and also treated with a caring feeling from them. Saying that, all this doesn’t surprise me as it’s just an extension of what the city does. It shows that the rot is spreading to areas where the powers to be all have main agendas of making more money for the top layers of management and throwing away money for things that have little or no benefit for the common residents of Port Townsend. If this situation contines at the hospital they will just have comfort care for anyone who has a major health problem saving them more money for upper management..
As long as we’re talking about heathcare issues, there is one other thing that bothers me. I live in Chimacum about two miles to the Fire Hall. When I’ve been taken to JHC, I will get a bill sent from Silverdale for a fee for the amublance ride. I’m billed about $200 for the service and it has been $300 at least once. Again the EMTs are very good to me everytime I’ve been transported. I’ve been down on the floor a number of times, sometimes bleeding leaving a trail. A couple of tmes I’ve been down for about eight hours to be able to get to my phone and call 911, My health care people want me to carry an alarm if I am prone. I really don’t feel that it will help much as I’ll refuse to be transported, unless this “service” stops charging me as I just don’t have the money for it. There’s no charge if they don’t have to just get you up and stable.
WELL SAID!
Thank you for this article, Annette, as it was informative and very well-written. Also, I have heard numerous reasons why many folks in Jefferson County travel outside the county for medical care. The reasons why this is so might be an interesting topic for a follow-on story.
Thank you for the suggestion, Saltherring. I’d be interested to hear from our readers in that regard.