Maggie Simpkins begins her work week at 6:30 a.m. on Sundays at Oregon State Hospital, where the registered nurse administers medications to patients, reviews their treatment plans and sets the daily schedule, including appointments, meals and care.

Her shift was supposed to end at 5 p.m., but on most Sundays, Simpkins has to work overtime, which can last until about 10 p.m.

For Simpkins and her colleagues, the mandatory overtime triggered a wave of fear and concern that exhaustion could endanger the safety of staff and the more than 500 patients at the state psychiatric hospital in Salem. Oregon American Association of State, County and Municipal EmployeesThe association, which represents about 300 registered nurses at the hospital, has filed 225 complaints on their behalf in the past four weeks, alleging that the mandatory overtime violates their collective bargaining agreement and state law governing nurse staffing.

“Towards the end of the shift, I’m more exhausted, and I’m afraid that the more tired I am, the greater the risk of making a mistake,” Simpkins said. “It’s very scary when you’re dealing with mentally ill people and you make bad decisions or mistakes with medication. Thankfully, that hasn’t happened yet, but that’s partly because I have a great crew looking out for me.”

Nurses and registered nurses worked more than 2,500 hours of overtime between June 3 and Aug. 4, hospital data shows. Complaints have increased as nurses worked overtime. In most months, the union typically only files two to four complaints on one issue.

Amber Shoebridge, a spokeswoman for Oregon State Hospital, said a combination of factors led to the mandatory overtime. They included staff turnover, the statewide nursing shortage and increased patient needs, Shoebridge said. In addition, the hospital needed more nursing staff to implement changes after federal inspectors found violations.

The hospital is looking for ways to hire more nurses.

Nevertheless, nurses and their union are dissatisfied and fears persist.

“Scared to death”

David Lynch, president of Oregon AFSCME Local 3295, which represents about 300 nurses at the state hospital, said the increase in complaints and mandatory overtime was a “shattering change” for nurses.

“People call me and cry,” said Lynch, also a nurse at the state hospital. “They are scared to death that they or their colleagues or their patients are going to be killed.”

The union says the hospital is violating state law governing the hiring of nurses and contract provisions that limit the amount of mandatory overtime. Under the contract, the state hospital cannot require a registered nurse to work more than 48 hours per week or more than 12 hours in any 24-hour period.

Lynch said the hospital needs to be held more accountable.

“Once people find out what happened, they just won’t believe it,” he said. “I think whoever made this decision needs to apologize to all the staff, all the patients and their families, and then provide us with a detailed plan on how this can never happen again.”

Waiting for a solution

The hospital’s Shoebridge declined to comment on whether the hospital’s actions violate the contract and state law.

In response to 35 complaints filed in July, Angie Johnson, the hospital’s nursing and human resources director, wrote to the union, “We acknowledge a violation.” However, the hospital dismissed the complaints and demanded an additional hour of paid leave for each mandated hour.

Johnson said the hospital is making changes but may not be able to prevent future violations to “ensure the safety of patients and staff.”

Shoebridge said the hospital’s goal was to provide relief to overworked nurses.

“You can’t expect them to continue at this pace,” she said.

About one-fifth of the hospital’s nearly 500 budgeted positions for registered nurses and nursing assistants are unfilled, hospital data show. Recruitment efforts include job fairs, outreach to nursing schools and a mentoring program, Shoebridge said.

Twelve nurses from the temporary employment agency are currently undergoing a training phase, and another 19 will start work next week, Shoebridge said.

However, the hospital has not complied with the union’s demand to eliminate excessive mandatory overtime and to provide each nurse with an additional hour of paid vacation for each hour of mandatory overtime.

Exhausting but rewarding

Simpkins, on the other hand, is tired for much of the rest of the work week because of the long Sundays, making it difficult for her to keep going.

On Saturday night – before her work week begins – her anxiety level is high because she has a long day ahead of her.

“I know I’m being forced to work on Sunday, and my anxiety levels before bedtime are through the roof,” she said. “But when I get up on Sunday morning to get ready for work, I know I’m going to be frustrated and anxious, and it’s ruining my whole week.”

But the job also has its advantages.

Simpkins, 53, began her nursing career at the state hospital in 2016 after transitioning from the banking industry. And nursing is fulfilling work that allows her to help people learn skills, return to their communities and lead productive lives, she said.

“That really excited me,” she said. “After I started working at the hospital, I continued to enjoy the work. That’s why I’m staying here.”