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<img src="https://run.imgix.net/84db080a-902e-4197-8a3d-2c204624cbec/fbaeafb5-48a2-4edb-950d-f0e6ba145fcf/fbaeafb5-48a2-4edb-950d-f0e6ba145fcf.jpeg?ixlib=js-3.8.0&amp;bri=-6&amp;con=0&amp;sat=0&amp;high=0&amp;shad=0&amp;usm=0&amp;rect=0%2C0%2C1770%2C2024&amp;w=1500" alt="" caption="" align="left" alignwidth="30" tiltdirection="left" variant="framed"><h3>At Home in Snohomish</h3>Kelli lives here in Snohomish with her husband, Eric, and their two cats and two dogs. Originally from St. Louis, Missouri, they came here for the beautiful mountains, valleys, and rivers that make up the great outdoors here. After arriving, they fell in love with the people and the pleasure of living in a big, small city. She wants to nurture everything that makes Snohomish County special. In her free time, Kelli loves to bake and enjoys the natural beauty of Snohomish.

<h5>Hear from the Community</h5><h2>Personal Endorsements</h2><h4>James Walsh</h4>Would you join me and our crew in endorsing Kelli Johnson for the position for District 5 Snohomish County Council.    I endorse Kelli Johnson, Snohomish County counsel, District 5.&nbsp; Kelli has a firm grasp on the challenges we are facing and what needs to be done. Kelli's experience as an Emergency Room nurse has given her a true perspective on what is important and how to solve problems.Kelli will support rational and community-based land use principles and take into account neighborhood values. &nbsp;She knows that adjusting the land use code around the needs of the people and the environment is the true path to affordable homes. &nbsp;Clear cutting plats and overbuilding on them destroys the ecosystem and only adds to the increasingly overwhelming congestion and traffic problems we all have experienced. &nbsp;Kelli will take this head on once and for all.    Kelli realizes that government cost money and citizen demand value. She will keep this in mind while striving to maintain a balanced budget.    As always, Kelli is a healthcare advocate and will aim to continue to expand access to community healthcare with the expertise that she has acquired and raise awareness where needed.    This time vote for change you can believe in.<h4>Trevor Gjendem</h4>"Kelli Johnson is a tireless advocate and a proven leader in the fight for safe nurse staffing and community well-being. For the past several years, she has been a powerful force at both the Everett City Council and Snohomish County&nbsp; Council, relentlessly pushing for policies that protect patients, healthcare workers, and the public.I’ve had the honor of working alongside Kelli for the past three years as we fought together in city and county council meetings for safe staffing. While I didn’t have the capacity to continue into the state legislative session, Kelli never stopped—she pushed forward, advocating for safe staffing at the state level and joining me on the hospital staffing committee.As chair of the hospital staffing committee, Kelli led with determination and clarity, championing meaningful improvements that directly impact patient care and working conditions. Her leadership was instrumental in securing a $500 monthly short-staffing bonus during RN contract negotiations with Providence in 2023—a bold move that held hospital executives accountable and ensured that short staffing couldn’t be exploited for profit.Kelli’s dedication is unmatched. She shows up, she speaks out, and she follows through—always guided by an unwavering commitment to ethical leadership and community care. She doesn’t back down when it’s hard or unpopular. She represents the people, not the status quo.If you want someone on the Snohomish County Council who will fight for working families, healthcare access, and a safer, more equitable future, Kelli Johnson is the candidate we need."<h4>James Harrigan</h4>I am honored to endorse Kelli Johnson for Snohomish County District 5. As someone who has spent the last 5 years serving on a city board dedicated to human services, I am confident that Kelli understands the huge challenges that ordinary people face because of unaffordable housing, rising cost of living, and inaccessible healthcare and child care. As a fellow nurse who has witnessed the care Kelli provides in her ER, I have seen first hand the profound compassion she has for every single person with whom she interacts. I believe it is this compassion for people and love of nature that makes Kelli such a fierce advocate for change. Not only does Kelli understand the power of people who come together to overcome barriers and special interests, but she also has the vision and dedication to lead and achieve real progress. Our communities literally cannot afford to spend another four years moving in the current direction. Kelli represents a valuable opportunity&nbsp;to move in a&nbsp;better direction. Kelli will be a formidable advocate for all of us here in Snohomish County. Please join me in supporting Kelli Johnson for Snohomish County Council District 5<h2>Endorsements by Organizations</h2><img src="https://run.imgix.net/84db080a-902e-4197-8a3d-2c204624cbec/67089d99-6bba-434c-b308-23356f5990a3/67089d99-6bba-434c-b308-23356f5990a3.png?ixlib=js-3.8.0&amp;bri=0&amp;con=0&amp;sat=0&amp;high=0&amp;shad=0&amp;usm=0&amp;rect=0%2C0%2C2400%2C2399&amp;w=1500" alt="" caption="Snohomish County Democratic Central Committee" align="left" alignwidth="32" variant="framed">Snohomish County Democratic Central Committee<h2></h2><h2>Snohomish County Indivisible</h2>

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<h4>Your campaign donations are greatly appreciated!</h4>These funds will be used to support campaign efforts and expand public engagements with Kelli.She will be hosting multiple virtual events so that you have an opportunity to meet her and ask questions. Campaign donations will be used to spread the word about these events and how Kelli plans to keep Snohomish affordable.

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<h5>IssueS</h5>As an ER nurse in Everett, Kelli has seen firsthand community members struggling to pay for rising costs of healthcare on top of their mortgage or rent.She’s no stranger to fighting for those she represents. She’s fought for legislation at the state level for our county and state’s nurses to have the support they need to save lives. And she’s won.<h2>Public Health Advocate</h2>Kelli brings critical public health advocacy experience to the Snohomish County Council. In this role, she’ll expand her advocacy on behalf of nurses across the state and continue building relationships with state legislators to fight for what Snohomish County residents need to have healthy lives – access to quality healthcare that won’t leave them bankrupt.The Medicaid cuts passed by Congress this year will have immediate impacts on patients, healthcare workers, and hospitals in our county – keeping insurance out of reach for many, limiting access to more in our community, and driving up the cost of healthcare for everyone. People paying more for healthcare means they have less for their household needs and leisure. Kelli will advocate at the city, county, and state level for policies that protect patients and the dignity of all healthcare workers to ensure a safe and healthy Snohomish County.<h2>Making Snohomish County More Affordable</h2>Kelli hears the concerns regarding the rising costs to live in Snohomish. The county’s nurses, police officers, firefighters, military members, and local government workers are struggling to buy a home that is affordable, forcing them to move. To solve this, it’s not enough to blankly allow development in the name of affordable housing without ensuring that housing that is actually affordable to most is built. Kelli will work with the community to ensure Snohomish is building a variety of affordable homes for working families while honoring the landscape and great outdoors that makes Snohomish County so beautiful.<h2>Managing Budgets Without Additional Taxes</h2>Like most people, Kelli and her husband live on a budget. She knows firsthand that not everyone has extra money to spend. The state’s recently approved 4% property tax increase will eat into the incomes of Snohomish County residents. Everett’s attempt to pass a property tax increase in 2024 showed just where the people stand – a majority is against increasing property taxes. Kelli is not here to take more from the families of Snohomish County. She’ll keep a sharp eye on local budget management and do everything in her power at the county level to advocate for a better tax situation for residents.<h2>Fighting for Mental Health Services</h2>Kelli has over 10 years of experience as an ER nurse. She’s seen firsthand the gaps of service for community members and understands that mental health crises can lead to addiction and homelessness. She’s been on the front line with firefighters, EMS, police, and social workers. As county councilmember, she will listen and advocate for healthcare that expands access to affordable mental health services – a key part of creating a safer community.<h2>Protecting What Makes Snohomish Special</h2>Kelli loves Snohomish county: the beautiful nature at our doorstep, the charming family farms, and all the hardworking, tight-knit community members she’s connected with. These are the things that make Snohomish, Snohomish. Kelli will work hard to preserve the best of it.

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<h5>MEET KELLI</h5><h2>Kelli Leads by Listening</h2><img src="https://run.imgix.net/84db080a-902e-4197-8a3d-2c204624cbec/023d5e4f-203f-400b-b078-cf1e486c94a7/023d5e4f-203f-400b-b078-cf1e486c94a7.heic?ixlib=js-3.8.0&amp;bri=0&amp;con=0&amp;sat=0&amp;high=0&amp;shad=0&amp;usm=0&amp;rect=637%2C217%2C3395%2C2456&amp;w=1500" alt="" caption="" align="right" alignwidth="40" tiltdirection="right" variant="framed"><h3>Kelli is a nurse and patient advocate first, and a proud union member.</h3>In her own words, “being an advocate means listening to the people around you and then building connections to identify solutions for the problems at hand.” Kelli is running for Snohomish County Council to do just that for her community.As an ER nurse, Kelli hears patients struggling to access healthcare because of rising costs. As a community advocate, she hears the concerns about affording housing in our county. Meanwhile, hasty development designed to solve this challenge has changed the landscape of what makes Snohomish County Washington state’s greatest gem. As a grassroots organizer, she hears from those worried about the repeat proposals to raise taxes and the stress it would have on the working families of Snohomish already living on a budget.<h4>Kelli knows that elevating community voices to the right places can effectively address the challenges that feel impossible to solve today. She’ll work tirelessly to be your voice at the County Council.</h4>

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<h3>A Councilmember that Fights for You</h3>Snohomish county needs a leader who hears the concerns of those around her, can find a way to take action by working with others, and always puts what is best for the people as her number one priority. As your county councilmember, Kelli Johnson will be exactly that kind of leader.<img src="https://run.imgix.net/84db080a-902e-4197-8a3d-2c204624cbec/1ee53074-681f-4d70-b5bd-ff647ccba7fc/1ee53074-681f-4d70-b5bd-ff647ccba7fc.heic?ixlib=js-3.8.0&amp;bri=-3&amp;con=0&amp;sat=0&amp;high=0&amp;shad=0&amp;usm=0&amp;rect=0%2C0%2C2316%2C3088&amp;w=1500" alt="" caption="" align="center" alignwidth="30" tiltdirection="left" variant="framed">

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<img src="https://run.imgix.net/84db080a-902e-4197-8a3d-2c204624cbec/45994424-b845-41fd-b0b5-594d7b8095f3/45994424-b845-41fd-b0b5-594d7b8095f3.heic?ixlib=js-3.8.0&amp;bri=-9&amp;con=-4&amp;sat=0&amp;high=0&amp;shad=0&amp;usm=0&amp;rect=0%2C0%2C4032%2C3024&amp;w=1500" alt="" caption="" align="left" alignwidth="37" tiltdirection="left" variant="framed"><h3>Kelli has a record of fighting for her nurses. And winning.</h3>Kelli’s path into political advocacy began during the pandemic. After witnessing the alarming safety risks facing patients at her local hospital because of nurse staffing shortages, she knew it was time to speak up and take action. Kelli worked to bring nurses together to voice their concerns to the Everett City Council and Snohomish County Council. Together, with multiple nurses across hospitals, they researched the nurse staffing issue, and took to social media to involve more nurses in the legislative process. These efforts led to the passage of SB 5236 – which improved nurses' work standards and increased staffing to better care for patients.<h4>Kelli knows that elevating community voices to the right places can effectively address the challenges that feel impossible to solve today. She’ll work tirelessly to be your voice at the County Council.</h4>

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Kelli is running to build a more affordable Snohomish County for working families. We need a leader who can bring community voices together to solve our county’s most pressing challenges.

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Nurses will help decide plans for staffing, meals and rest breaks. Hospitals could face hefty fines if they don’t comply.OLYMPIA — Hospital executives and nurse union leaders achieved detente late last month in their years-long battle on staffing levels.They only had a handshake, not a deal.Agreement required several more days of negotiations between the two groups and a handful of state senators, drafting every word in a bill prescribing procedures for drafting, deploying and enforcing of staffing plans.On Monday, the product of those labors, Senate Bill 5236, cleared the Senate on a 35-13 vote. It now heads to the House."I think there is a clear incentive for every hospital in the state to step up for their workers,” Sen. Mark Mullet, D-Issaquah, told colleagues before the vote.Sen. June Robinson, D-Everett, the bill’s prime sponsor, teamed with Mullet to get it passed.“Our health care workforce has been asking us to address this situation for a long time, and it has gotten worse throughout the pandemic as health care in general has become more stressful, with more people coming in need of care,” she said ahead of passage.“When our hospitals do not play by these rules and provide the protections this bill lays out, they will face corrective actions — they will face consequences,” she said. “ It’s a really good bill that will provide a balance and strong workplace protections for our health care workers.”Opposition from Republicans has centered on concerns hospitals would be forced into either hiring staff they couldn’t afford or reducing services to avoid hiring. Smaller hospitals and those in rural areas could be hurt the most with strict standards, they argued.As now written, the bill exempts hospitals with fewer than 25 acute care licensed beds and certified as critical access hospitals.“I still have concerns. It felt like we were going after the hospitals,” Sen. Curtis King, R-Yakima, said before voting for the bill. “I hope, I pray that we don’t have to go through this again. I feel like this bill will really help nurses and maybe the next time we can come back with a bill to help the hospitals.”Front-line nurses and health care workers, many physically and emotionally wiped out by the pandemic, view ratios as crucial to improve job safety by addressing staffing shortages they said create dangerous conditions for themselves and patients.Hospital executives contend that to comply with ratios would require hiring thousands of nurses, an improbability in the midst of an industry-wide staffing crisis. Hospitals would wind up leaving beds unfilled, they said.Under SB 5236, a committee of administrators and nurses of a hospital will agree on how many nursing staff will be assigned in each patient care unit, and how workers will be assured of getting proper rest and meal breaks.Those plans are due to the state by January 2025 and deployed six months later. Over time, hospitals must file regular reports to the state Department of Health, as well as Labor &amp; Industries. Those found to be out of compliance too much of the time could be fined thousands of dollars, according to the bill.The Washington State Hospital Association was glad to get a deal done.“We all want to support hospital staff and also ensure access to health care for our communities,” said Chelene Whiteaker, the association’s senior vice president of government affairs in a statement. “We are pleased to be able to reach an agreement that recognizes the importance of the voice of staff at the local level, who are best positioned to develop staffing plans that appropriately match the needs of patients with the experience of staff.”The bill does not mandate minimum staffing levels, often called ratios, which nurses have long sought. It will give nurses a stronger voice in establishing working conditions.“This bill isn’t quite everything we’ve been calling for,” acknowledged Jack Sorenson, spokesman for a coalition of health care worker unions backing the bill. “This compromise we got passed in the Senate is a real and meaningful step forward for safe staffing.”Kelli Johnson, a nurse at Providence Regional Medical Center Everett, said it’s progress even if it’s not as much as hoped.A key piece is it will require hospitals do a lot more reporting to the state on when they are not sufficiently staffed, she said.”Nurses and health care workers have been carrying the burden for a long time. We needed something passed. This bill is that something a step in the right direction,” she said.Katy Roth, a veteran nurse who also works at Providence in Everett, expressed apprehension Tuesday. She has kept watch on the bill but had not yet read the fine print of the version passed by the Senate.“If this current bill doesn’t have ratio language in it, I am concerned how successful it will be,” she said. “It needs to have ratio language in it to protect patients’ safety.”The bill now heads to the House.Last session, majority Democrats <a href="https://app.leg.wa.gov/billsummary?BillNumber=1868&amp;Year=2021&amp;Initiative=false" target="_blank" rel="noopener noreferrer">approved legislation</a> containing specific ratios of patients per nurse. Mullet blocked it in the Senate Ways and Means Committee, then committed working on a potential this year.“This is a very different approach. This one targets bad actors,” Mullet said in an interview. Hospitals will face “regulatory misery” if they fail to abide by the terms of the staffing plans, he said.Rep. Marcus Riccelli, D-Spokane, carried the 2022 version. While what’s coming from the Senate lacks ratios, he sounded confident it will advance without a major massaging by his colleagues because it is still focused on ensuring adequate work force in hospitals.“We see that these staffing plans have existed for years without much teeth in them,” he said. With the bill, he said, “we’ll be making sure these plans are enforceable and have teeth in them.”

Kelli Johnson, a nurse at Providence Regional Medical Center Everett, said it’s progress even if it’s not as much as hoped.A key piece is it will require hospitals do a lot more reporting to the state on when they are not sufficiently staffed, she said.”Nurses and health care workers have been carrying the burden for a long time. We needed something passed. This bill is that something a step in the right direction,” she said.

A handshake, a deal then hospital staffing bill emerges from Senate

Housing solutions for our county can’t just rely on blind development, which is resulting in production of more luxury homes. Kelli will be the community’s connection to resolve the bureaucratic standoffs that keep Snohomish from being affordable for hardworking residents.

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Nurses and their families plan to picket the Evertt hospital’s two campuses from Tuesday to Sunday.EVERETT — As of 6 a.m. Tuesday, nurses at Providence Regional Medical Center Everett are set to walk out. It’s the first strike at the hospital since 1999.The work stoppage comes after more than six months of talks. About 1,300 nurses and their supporters plan to picket both Everett campuses, 1700 13th St. and 900 Pacific Ave. They plan to picket for 24 hours each day, with rotating shifts. Nurses are also planning a candlelight vigil for 6 p.m. Thursday at Drew Nielson Neighborhood Park, across the street from the hospital at 13th Street and Colby Avenue.Many supporters are expected to join the picket line, nurse Kelli Johnson said.“I imagine it will be a very active strike,” she said Monday.In anticipation of the strike, nurses used a light to project a countdown onto the side of the hospital building after dark. Both sides of the dispute have paid for full-page ads in Tuesday’s print edition of the Herald, with nurses touting their public support and Providence accusing nurses of putting “pickets before patients.”Nurses plan to strike until Sunday unless Providence agrees to negotiate further over staffing issues. After the strike, nurses will return to work and contract negotiations will continue, Johnson said.How will the strike affect patient care?Providence has partnered with a staffing agency to employ replacement nurses during the strike. The hospital will have enough nurses to provide “uninterrupted care” to patients, spokesperson Erika Hermanson said last week. Management and staff from other Providence locations are also expected to help with daily operations“I feel confident with the staffing plan that we have,” Chief Nursing Officer Michelle Lundstrom said Monday. “It will be a seamless transition.”Leadership has prepared for a strike for months, regional Chief Executive Officer Kristy Carrington said . She declined to say how many replacement nurses the hospital will have during the strike or how much they will be paid.Carrington said she can’t provide specifics since workload at the hospital fluctuates, but leadership will assess patient needs daily.“There’s not a hard and fast number at this point in time,” she said Monday. “Where we stand right now, we have no need to scale back on any services.”<a href="https://www.heraldnet.com/travel/" target="_blank" rel="noopener noreferrer">Travel</a> nurses with Aya Healthcare who have current work contracts with Providence are being offered a base rate of $61.53 an hour to work during the strike, according to an email obtained by the Herald.Why are nurses striking?Union nurses say they are striking because Providence won’t consider “safe staffing” terms in a new contract. The hospital lost over 600 nurses since 2019, and while Providence has rehired some nurses, most units <a href="https://www.heraldnet.com/news/providence-nurses-conditions-at-everett-hospital-still-dire-or-worse/" target="_blank" rel="noopener noreferrer">remain understaffed</a>.For more than a year, nurses have described a hospital in trouble with <a href="https://www.heraldnet.com/news/providence-nurses-tearful-plea-shines-light-on-short-staffed-er/" target="_blank" rel="noopener noreferrer">overworked employees</a> and fears for patient safety. Initially, nurses asked Providence to limit how many patients each nurse could take on. Providence rejected set nurse-to-patient ratios in favor of a more flexible staffing model that shifts more work to nurse aides, Lundstrom said last month.Nurses have also asked for extra pay during understaffed shifts to encourage Providence to hire more nurses.Providence has rejected that ask, but increased its offer for overall wage increases to 21.5% by the last meeting with the nurses’ union on Nov. 3. Nurses gave their <a href="https://www.heraldnet.com/news/providence-everett-nurses-give-10-day-strike-notice/" target="_blank" rel="noopener noreferrer">10-day strike notice</a> after the meeting.Nurse Trevor Gjendem said the strike will be a “cathartic emotional release” for nurses who feel Providence has dismissed their concerns. Nurses don’t expect the hospital to budge on staffing language in the contract, he said, but hope visibility from the strike will encourage the public to get involved.What is Providence’s response?Providence is “disappointed” nurses have decided to strike, Carrington said, in part because it will delay contract negotiations.“People are burned out, there’s no doubt about that,” she said.Leadership has bargained with nurses in good faith, said Chief Nursing Officer Michelle Lundstrom . Providence is offering market competitive wage increases and more flexible work schedules, among other incentives.“The longer we drag this out, the longer the amount of time without them getting an appropriate raise,” Lundstrom said.Leadership and nurses want the same thing, Lundstrom said, but they don’t agree on the path forward.“On the other side of the strike, we will welcome them back,” she said. “We won’t love them any less.”

The work stoppage comes after more than six months of talks. About 1,300 nurses and their supporters plan to picket both Everett campuses, 1700 13th St. and 900 Pacific Ave. They plan to picket for 24 hours each day, with rotating shifts. Nurses are also planning a candlelight vigil for 6 p.m. Thursday at Drew Nielson Neighborhood Park, across the street from the hospital at 13th Street and Colby Avenue.Many supporters are expected to join the picket line, nurse Kelli Johnson said.

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About 1,300 Providence nurses are walking out. Here’s what to know.

Hospital administrators and nurses will craft staffing plans together. The state will be able to make sure plans are followed.OLYMPIA — Nurses secured a greater role in deciding minimum staffing levels in hospitals across the state under a law signed Thursday by Gov. Jay Inslee.The legislation requires hospital administrators and nurses to agree on the number of staff assigned in each patient care unit, and how workers will be assured of receiving proper rest and meal breaks.Those details will be written into staffing plans. Hospitals that fail to comply with those plans could face fines and other penalties from the state Department of Health, as well as Labor &amp; Industries. Hospitals with fewer than 25 acute care licensed beds and certified as critical access hospitals are exempt from some of the bill’s provisions.Senate Bill 5236, sponsored by Sen. June Robinson, D-Everett, represents a compromise between nurses and hospital leaders. The two sides battled to a draw in the 2022 session.“I’m just thrilled that we got it to the finish line,” Robinson said. “It will make conditions better for nurses and patients.”Nurses pressed hard for specific patient-to-nurse ratios to be written into the bill. Though it didn’t happen, they expressed confidence the new law will get them there eventually while boosting morale immediately.“We needed something this year. This is very strong,” said Kelli Johnson, an emergency room nurse at Providence Regional Medical Center in Everett who attended the bill signing. “I think it’s going to turn things around in the staffing crisis.”Dana Robison, who works in the labor and delivery area of the same hospital, called it important “scaffolding” on which to build toward getting ratios into staffing plans.“This is an important beginning to get somewhere better than we are now,” she said.In signing, Inslee said the legislation will improve safety of nurses and health care workers, and increase hospital accountability.“This is a step toward addressing the nursing shortage in our state by giving nurses a stronger voice on hospital staffing committees, with the intent to create a safer work environment, less burnout, and higher retention rates,” he said.Senate Bill 5236 cleared the House on a 92-6 vote. The Senate passed the measure 35-13.

Nurses pressed hard for specific patient-to-nurse ratios to be written into the bill. Though it didn’t happen, they expressed confidence the new law will get them there eventually while boosting morale immediately.“We needed something this year. This is very strong,” said Kelli Johnson, an emergency room nurse at Providence Regional Medical Center in Everett who attended the bill signing. “I think it’s going to turn things around in the staffing crisis.”

New law gives nurses stronger voice in setting hospital staffing levels

Short-staffing is prompting an exodus of nurses. Health care workers in Everett are demanding solutions in Olympia.EVERETT — Nurse Katy Roth is supposed to have three to four patients. But she always has five or more, sometimes up to eight on day shift, when patient needs are higher.In 22 years of nursing, she told The Daily Herald, “I’ve never experienced the patient loads that I experience now, this last year.”On Thursday, she told state senators it can lead to tragic results.“Last week I had a patient who died on my shift, and he should not have,” she said.Roth testified in favor of Senate Bill 5236, which would reinforce hospital staffing committees, as well as meal and rest breaks. It also would direct the Department of Labor and Industries to create minimum hospital nurse staffing levels by 2027.Frontline workers and their administrators are largely divided on minimum staffing levels — often called ratios — as an effective approach to solving the staffing crisis. On Thursday, 13 frontline nurses <a href="https://tvw.org/video/senate-ways-means-2023021332/?eventID=2023021332" target="_blank" rel="noopener noreferrer">testified</a> in support, including several from Providence Regional Medical Center Everett. The bill had 5,700 signatures in support, with 1,000 opposed.Michelle Lundstrom, chief nursing officer at Providence in Everett, said Friday she worries about the lack of available nurses and the loss of flexibility.“In Snohomish County, we are severely under-bedded for both acute care and <a href="https://www.heraldnet.com/post/" target="_blank" rel="noopener noreferrer">post</a>-acute care,” Lundstrom said. “And if we were to implement this bill tomorrow, with the workforce that we have today, we would have to close even more beds. What that does for our patients — it reduces access to care.”Providence Everett is the largest hospital in Snohomish County, accounting for nearly 75% of non-psychiatric discharges in 2021, according to state Department of Health <a href="https://doh.wa.gov/data-statistical-reports/healthcare-washington/hospital-and-patient-data/hospital-discharge-data-chars/chars-reports" target="_blank" rel="noopener noreferrer">data</a>. For the Snohomish County residents who needed hospital care in 2021, just under half received care at Providence.Roth chose to be a nurse after being inspired by the way nurses took care of her grandmother at the end of life. She has worked at Providence hospitals in Washington state for 18 years, most recently nine years in the float pool in Everett. She loves the variety of work as she covers shifts across many units.But this last year has pushed her to consider leaving. Many <a href="https://www.heraldnet.com/news/few-core-staff-left-droves-of-nurses-take-high-paying-travel-jobs/" target="_blank" rel="noopener noreferrer">others already have</a>. Roth said since the pandemic, <a href="https://www.heraldnet.com/news/nurses-face-burnout-as-hospital-staffing-shortage-continues/" target="_blank" rel="noopener noreferrer">nurses have left</a> due to compassion fatigue, ethical and emotional burnout, and overall mental health strain.“We have a staffing matrix or staffing plan that had been submitted to the Department of Health. We’re not following it ever anymore, no matter what unit I go to,” Roth said.Lundstrom doesn’t dispute the <a href="https://www.heraldnet.com/news/with-influx-of-patients-everett-hospitals-er-is-overwhelmed/" target="_blank" rel="noopener noreferrer">short-staffing</a> that multiple <a href="https://www.heraldnet.com/news/providence-nurses-seek-hazard-pay-from-everett-amid-staffing-woes/" target="_blank" rel="noopener noreferrer">nurses have described recently to The Herald</a>. She said even with four years to add to the workforce and meet minimum ratios, hospitals need more solutions to address the workforce shortage, such as more nursing faculty, an easier path for out-of-state nurses to get licensed, student loan repayment and tuition assistance. State lawmakers are considering some bills this session that could help.‘These challenging staffing conditions’Statewide, about half of surveyed health care workers said they are likely to leave health care in the next few years. Of those under age 50, about 44% said they’d likely leave. Three unions representing the sampled workers commissioned the <a href="https://static1.squarespace.com/static/619c009fb3e63b1bb3d3684f/t/63ea7cc907b00f4489e0424e/1676311753980/Healthcare+Workers+Memo+021323.pdf" target="_blank" rel="noopener noreferrer">survey</a> of 1,200 workers, 60% of them nurses.Short-staffing is the major driver of this possible exodus — with 68% of all the respondents saying it is a primary reason. Even more — 80% — of those under 50 say short-staffing is a primary reason they might leave, according to an analysis provided by the WA Safe + Healthy campaign.Nearly 80% of health care workers feel burned out, while 45% say they feel unsafe.Everyone could be affected by short staffing, Roth said, if they or their loved ones cannot receive attention they need. To protect privacy, health care professionals must use caution sharing specific patient stories.Roth shared a hypothetical scenario from an acute cardiac unit:“I’m supposed to have three patients and maybe I have five patients,” she said. “And one of my patients belongs in the ICU, but there’s no beds and she’s in respiratory distress and needs frequent monitoring, advocacy, oxygen titration. She’s on high-flow oxygen — in respiratory distress. I also then have four other patients with cardiac issues and I can’t get out of the room, for example, because she needs that much attention.”Roth is also on the hospital’s safety committee, which means reviewing the patient safety plan and any safety issues. She chose her words carefully about “<a href="https://www.jointcommission.org/resources/sentinel-event/sentinel-event-policy-and-procedures/" target="_blank" rel="noopener noreferrer">sentinel</a>” events — a type of “adverse” or avoidable event that results in death or serious physical or psychological harm.“I am aware of sentinel events that have happened under these challenging staffing conditions,” she said. “Several of them that I’m aware of, and have witnessed even.”Lundstrom, from Providence, said the hospital investigates every incident “that didn’t go the way that we wanted.” Without knowing specifics of cases mentioned by nurses at the hospital, she said, “I can tell you that we’ve not had any findings of anything that was related to staffing.”‘I’m really hopeful’The Washington State Hospital Association and hospital leaders have testified against Senate Bill 5236 at two hearings in 2023, as well as a similar bill in 2022. Hospital leaders who oppose the bill question if mandated minimum staffing levels will bring nurses back to the field and improve patient safety.Are enough out there?Or will hospitals remain short-staffed, resulting in turning away patients?Four years away from a possible staffing standard, the Washington State Hospital Association has analyzed <a href="https://nursing.wa.gov/about-us/research-data-and-reports" target="_blank" rel="noopener noreferrer">data</a> to suggest that just under 3,000 licensed nurses are interested and ready to work. The Washington State Nurses Association analyzed different data from the state, with different assumptions, concluding that up to 16,000 licensed nurses could be available to work.None of those numbers account for projected new nursing grads and retirements, which could be significant, according to the <a href="https://www.wcnursing.org/wp-content/uploads/documents/reports/2022-May_WCN-WA-2021-Nursing-Workforce-Supply-Data-Report-Characteristics-of-LPNs-RNs-and-ARNPs_FINAL.pdf" target="_blank" rel="noopener noreferrer">Washington Center for Nursing</a>.To meet the demand for nurses in hospitals, the state would need a total of 6,100 nurses, according to a 2021 <a href="https://www.wsha.org/articles/staffing-legislations-one-size-fits-all-approach-will-increase-health-care-costs-and-make-care-delays-permanent/" target="_blank" rel="noopener noreferrer">survey</a>. Nurses say that poor staffing leads to a reinforcing cycle of people quitting, higher patient loads and more people quitting. So, they argue, better staffing should work in the opposite direction.But Lundstrom asked: “The challenge and the concern that we have from health care professionals is if we implement these strict ratios, what happens when they don’t come back?”Hospital leaders at Providence also oppose the bill because it would stifle the flexibility to continue developing an innovative, team-based approach to nursing, as the hospital system is experimenting with elsewhere. In this model, the certified nursing assistants, licensed practical nurses and registered nurses work together, taking on the most responsibility they are capable of and licensed to do, while caring for each unique patient. Lundstrom said both patients and staff report positively on the team model.“I’m really hopeful that through partnership and collaboration with our frontline caregivers, our hospital teams will get back to a place where we feel that again,” she said, meaning feeling like a team that loved coming to work. In Everett, the hospital is training nursing assistants on the job, as they have also been in short supply.Lundstrom also worked in California hospital emergency departments, with staffing ratios, and saw ambulances backed up and hospitals “on divert,” unable to meet the ratios to staff all the beds. While <a href="https://www.heraldnet.com/research/" target="_blank" rel="noopener noreferrer">research</a> has supported improved patient outcomes with nursing ratios, she cites comparative research suggesting California does not currently have better outcomes than Washington.The Senate bill directs the <a href="https://www.wsipp.wa.gov/" target="_blank" rel="noopener noreferrer">Washington State Institute for Public Policy</a>, a nonpartisan public research group, to study minimum staffing standards in other jurisdictions.‘The care my patients deserve’Sara Gering quit her job at Providence Everett, but she didn’t quit nursing. She could no longer manage what she said was an unsafe patient load in the ICU and other units where management sent her.She said each nurse is supposed to have a maximum of two patients in the ICU, but routinely had three in the past six months or so. In other units, she had five to seven patients. On Thursday, she told state senators she had watched “patients suffer needlessly and even die avoidable deaths due to the unsafe staffing conditions, which hospitals refuse to address and seek to normalize.”Gering heard from nurse friends about better staffing in another ICU, so she just started work there in early February.“When safe staffing ratios are maintained, I know I can come to work and give the care that my patients deserve. I’m able to spend time with them, getting to know them as individuals,” Gering said. “That is the nursing care that every person deserves, and nurses want to be able to give.”Kelli Johnson has worked as a nurse for 10 years, the past three in the emergency department at Providence Everett. She has been talking to public officials for her patients and herself <a href="https://www.heraldnet.com/news/providence-nurses-seek-hazard-pay-from-everett-amid-staffing-woes/" target="_blank" rel="noopener noreferrer">wherever possible this past year</a>: the state, Snohomish County and the city of Everett.“If we can’t get legislators to heed the concerns that nurses are trying to share with them about what’s happening at the bedside,” Johnson said, “it doesn’t bode well for the future of health care.”She feels excited about the minimum staffing levels in Senate Bill 5236, and that it would continue hospital staffing committees, remove a hospital CEO’s ability to reject the staffing plan, and provide some teeth. As things stand, she said her staffing committee recommended changes for the emergency department. But hospital administrators did not adopt it, leaving nurses with the prior year’s plan and a pile of frustration.Johnson had spent at least four hours of her day off this week, and countless hours over the past few years, advocating and organizing for safe staffing standards. She said of the bill: “If we get it passed, it will all be worth it.”Sen. June Robinson, D-Everett, sponsored Senate Bill 5236. She told The Herald: “We have to come out of here with legislation that protects the work environment for nurses. How far we are going to get is still a question.”

Kelli Johnson has worked as a nurse for 10 years, the past three in the emergency department at Providence Everett. She has been talking to public officials for her patients and herself wherever possible this past year: the state, Snohomish County and the city of Everett.“If we can’t get legislators to heed the concerns that nurses are trying to share with them about what’s happening at the bedside,” Johnson said, “it doesn’t bode well for the future of health care.”

‘I’ve never experienced the patient loads that I experience now’

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