The applause at the commissioners’ meeting was so loud, I wonder if all the commissioners really heard what Mike Glenn was saying?

Noting “staffing challenges” in the clinics during the fourth quarter of 2016, Jefferson Healthcare CEO Glenn praised clinic managers for “filling in the staffing gaps” at the commissioners’ meeting on February 15th.

“In addition to their regular duties, Krystal Brock-Farrington, Colleen Rodrigues and Alicia Syverson filled in the staffing gaps to keep the daily operations of primary care open and running. And what that means--filling in the staffing gaps--means that in addition to providing leadership and management, and going to meetings with important people like me and Jenn [Wharton, Medical Group Executive Director], they also are in the clinics dealing with provider issues, RN issues, patient issues, answering the phone and truly doing anything and everything necessary to keep the clinics running during an extraordinarily busy time. The operations of the clinic would not have been possible without the three of them working as a cohesive team. It was not unusual to see Alicia in scrubs and working as a tactical nurse, Krystal at the front desk at Family Medicine or Colleen answering the phones.”

These hardworking women deserved the applause and recognition they received. After all, who doesn’t love a manager who can roll up her sleeves, pitch in and do the work that needs to be done? Without devaluing their accomplishment, however, I would like to better understand why their extraordinary efforts were required.

The staff shortage was presented in the context of unprecedented patient load due to an unusually severe flu season, but staffing is a perennial concern. Is having managers cover for other employees the best way to cope with the demands of flu season? Why is adequate staffing a problem in the first place? Or, to put it from a patient perspective: “Why is it so hard to get an appointment with my doctor? Why do I get a recording when I call the clinic? How come refill requests take so long?” Staffing is not an abstract issue. It has a direct effect upon patient care.

In the best-case scenario, managers performing staff duties can obscure the real staffing levels needed to do a good job for patients and distract managers from their own work--managing. In many workplaces, unfortunately, having managers fill-in for other workers is a sneaky way to systematically under-staff. And as hard as the managers praised by Glenn worked, you can be sure they weren’t the only employees having to work harder to compensate for “staffing challenges.” There are many workers who know what it is like to perform the duties of two jobs but to only be paid for one.

Having non-union managers at Jefferson Healthcare consistently do the work of union employees seems unlikely to foster good relations with UFCW 21, the union to which most hospital employees are members. Contracts are due for renegotiation in 2018. From this perspective, managers “filling in the staffing gaps” seems an odd thing for Glenn to highlight during a public meeting.

Jefferson county needs hospital commissioners who can look beyond the executive lovefest and ask the tough questions about working conditions that impact patient care. Have managers requested, but been denied, additional staff? Are per diem staff being utilized to cover staffing gaps? Have employees complained of burn-out or stress-related illness? Are they being denied paid time off due to staff shortages? When managers and other employees are praised for never objecting to additional duties (a common theme in Jefferson Healthcare’s employee recognition program), how can employees feel safe saying they are being asked to do too much?

Unfortunately, not all the current hospital commissioners have a track record of being willing to ask these kinds of questions or take an active role in listening to employee’s concerns about working conditions. Last year, for example, commissioner Tony DeLeo urged the more recently elected commissioner Kees Kolff to take a 20,000 foot view of operations and avoid interactions with hospital employees. Kolff said he would be governed by applicable laws, but maintained his willingness to hear from employees about their concerns.

DeLeo, along with commissioners Marie Dressler and Jill Buhler, urged our elected officials to vote against legislation supported by the Washington State Nursing Association that would have established statewide minimum staffing standards, provided uninterrupted breaks for nurses and staff delivering direct patient care, and closed a loophole in the overtime law used by some healthcare organizations to fill chronic staffing shortages.