‘Jumping ship’: State hospital employees describe distressing work environment at Friday meeting

The hospital has been under scrutiny following a federal investigation in September

By: - January 21, 2022 5:57 pm

The stairs of the capitol in Helena, Montana (Photo by Eric Seidle for the Daily Montanan).

Staffing shortages and mismanagement of the Montana State Hospital have led to dangerous working conditions and poor patient care, employees with the facility said Friday during a Children, Families, Health and Human Services Interim Committee meeting

“I’ve been there almost 22 years. I loved my job for a very long time. But I don’t like going to work there … and that’s kind of the overall attitude at the facility, you don’t want to work there,” said Larissa Holbrook, president of the hospital’s independent union. “People are jumping ship left and right.”

In December, the Montana State News Bureau reported that 40 percent of the hospital’s 524 full-time positions were vacant. On Friday, employees of the psychiatric hospital in Warm Springs said COVID-19 has exacerbated existing staffing issues to a dramatic — and at times dangerous — level.

“While staffing struggles themselves are not a particularly new issue at the state hospital, the current drastically inadequate staffing levels are placing patients and staff in life or death situations,” said Jeremy Hoscheid, executive director of the Mental Disabilities Board of Visitors, which provides oversight of the state’s publicly funded mental health programs.

Warm Springs, the state’s only public psychiatric facility, was the subject of an impromptu investigation in September by the Centers for Medicare and Medicaid Services in which an employee told investigators that “patients are dying from lack of care.”

The resulting report  detailed an incident where a staff member instructed a patient who was complaining about being short of breath to “return to your room and stop being so dramatic.” The patient was found dead in her room 45 minutes later.

The report also said staffing levels at the hospital, which currently serves about 23o patients, were inadequate to prevent patients from falling and that patients fell 113 times between June and August of 2021. After initially saying no corrective plan was necessary, CMS said on Thursday it would revisit the report and speak with the hospital to see if further steps are needed.

At Friday’s meeting, Debbie Mehring, a social worker at the hospital, recalled a recent incident where a staff member whose nose was broken by a patient. “Nobody from the hospital traveled him home. Nobody got him any sort of transportation; he actually waited for his mom to come to pick him up. That’s a shame. We don’t have the staff,” she said.

Mehring continued: “I asked you guys to come to Montana State Hospital, to speak to us individually. You’ll see that it’s not a cozy let’s go to work and enjoy ourselves [environment]. Heck, after today, who knows if I’m going to have a job after standing here speaking with all of you.”

To sort through the various issues plaguing the facility, the Department of Public Health and Human Services has requested $2.2 million for a private contractor to review operations at the hospital and other state-run health facilities.

“Part of the scope of that RFP  … is to understand the climate and culture. To understand the needs, where those needs are being met, to understand how we create a better work environment, better supports and better career ladders,” DPHHS Director Adam Meier said during Friday’s meeting.

However, some legislators said more immediate action is necessary.

“It sounds to me as if there’s a fire going on. And we’re at we’re going to have to study to see how to put out fire,” said committee chairman Rep. Ed Stafman, D-Bozeman. “But in the meanwhile, if we wait for the outcome of that to deal with this crisis … I see that as being quite dangerous.”

And while some agreed that an outside entity must come in and investigate, others said the money would be more wisely spent if it was invested in hiring more nurses and retaining the hospital’s current nursing staff.

“Instead of investing over $2 million on an evaluation and a review of the operational structure … why not choose to invest in recruitment and retention of these current staff. We need to retain the registered nurses and other workers as they are providing care for these patients every day. Invest in them,” said Robin Haux, labor program director for the Montana Nurses Association, which represents the hospital’s registered nurses.

In the wake of staffing shortages, the hospital has turned to travel and contract nurses to fill the void, which Haux and others said is more costly to the state and the hospital’s patients. Haux estimated about 70% of the nurses working at the hospital are travel nurses receiving a wage between $80 and $90 per hour, which she said is far higher than the rate for their non-traveling counterparts.

“To be blunt, a contracted worker who is on a short-term assignment does not have the same commitment to the patients and the success of the Montana State Hospital as a permanent employee,” said Jennifer Weigand, a field consultant for the Montana Federation of Public Employees, which represents the majority of the staff at the hospital.

Olivia Butori, who works at the hospital, said some of the travel nurses hired as supervisors have zero experience working at the hospital. “Lack of training is an issue. I know staffing is an issue. Sometimes there’s one registered nurse for 30 patients; patients aren’t getting the care and attention they deserve. We need to come up with a plan to where we can retain permanent staff.”

Our stories may be republished online or in print under Creative Commons license CC BY-NC-ND 4.0. We ask that you edit only for style or to shorten, provide proper attribution and link to our web site. Please see our republishing guidelines for use of photos and graphics.

Keith Schubert
Keith Schubert

Keith Schubert is a reporter for the Daily Montanan. Keith was born and raised in Wisconsin and graduated from the University of Minnesota in 2019. He has worked at the St.Paul Pioneer Press, Milwaukee Journal Sentinel and most recently, the Asbury Park Press, covering everything from local craft fairs to crime and courts to municipal government to the Minnesota state legislature. In his free time, he enjoys cheering on Wisconsin sports teams and exploring small businesses. He can be reached by text or call at 406-475-2954 .