News

Nurses Overwhelmed and Understaffed

Surveys of nurses in Oregon and across the country show understaffing is one of the primary causes for an ongoing crisis in health care

By Jack Harvel

Photo courtesy of Alberto Giuliani

Nurses are spending less time on more patients as the workforce shrinks.

Oregon nurses are understaffed, overworked and burned out, according to a new poll conducted by the Oregon Nurses Association. Less than 1% of polled nurses said their unit is always fully staffed, half say they’re caring for too many patients and 42% say they skip meals and breaks on most of their shifts.

The ONA called on the state to more rigorously enforce the Oregon Health Authority’s standards of care that sets a baseline of 1:3 nurse-to-patient ratio, though that ratio can change for different health care units, such as orthopedics or general medical units. ONA said 85% of surveyed nurses report their units aren’t staffed to the standards of Oregon law and 84% said OHA was ineffective in enforcing those laws.

“We are in a crisis. That crisis has been decades in the making, and unsafe staffing is at the very heart. If we do not act, Oregon will continue to experience the devastating impacts of a failing health care system,” said ONA President Tamie Cline in a press release. “Patients will continue to suffer, sick people will continue to face hours and hours of wait times in the ER, surgeries will continue to be canceled or delayed, and nurses will continue to leave the bedside.” A national survey by the American Federation of Teachers’ Health Care Division found similar trends across the country. The total number of registered nurses fell by over 55,000, the first decrease in registered nurse employment in five years, driven by retirements and an exodus from the industry by younger employees. The average age of a registered nurse jumped from 42.1 to 42.6 years old in that survey, too.

The trend is likely to continue with nearly a quarter of surveyed nurses saying they’re likely to leave the profession within the next year. The pandemic has also been a challenging hurdle for many RNs. Some 61% said the pandemic negatively impacted their mental health, half of whom report needing mental health services. Over 70% of health care workers reported symptoms of anxiety and depression, 38% have symptoms of post-traumatic stress disorder and 15% had recent thoughts of suicide. The pandemic also created a more hostile clientele, with an 144% increase in reported at-work assaults in an industry that already accounts for 76% of all reported violent workplace injuries.

“Health care professionals knew long before COVID-19 that working conditions had been deteriorating for years. Then came the pandemic. For nearly three years, they’ve worked under unprecedented challenges—while for-profit institutions made record profits,” said Randi Weingarten, president of the ATF. “Understaffing is the core problem, which leads to other horrible conditions like crushing workloads, mandatory overtime, extended shifts lasting 12 to 16 hours, constant fatigue, worker injuries and skyrocketing rates of violence against health care workers, making hospitals one of the most dangerous places in America to work.”

The Rent is Too Damn High and Getting Higher

Bend rents are rising at some of the fastest rates in the nation, despite rent control caps

By Jack Harvel

Bend’s fair market rent rose by 37.4% from 2019 to 2023, making it the ninth-largest increase in rent among small metros in the United States. The Consumer Price Index shows rents across the country have risen by 24.1% since 2019, the fastest pace since the 1980s. A study from Construction Coverage lays the blame on an increased demand for housing while supply remains constrained, and that rental prices are still increasing as housing prices stabilize.

The price of smaller rental units is increasing at a greater rate than larger ones, with the cost of studios rising by more than 30% and one bedrooms by about 25%. In Bend the average studio apartment runs around $1,000 a month and a one-bedroom $1,184, according to Construction Coverage’s analysis.

The Center for American Progress estimated that the United States was short 7 million affordable homes for low-income renters in 2019, resulting in

The study range from 2019 coincides with Oregon enacting the first-in-thenation rent control law that prohibits landlords from raising rent more than 7% plus inflation per year — for 2023 rents could rise as high as 14.6%. The law isn’t universal though; it only applies to multifamily housing that’s been certified for occupancy less than 15 years, meaning rent at newly built complexes and single-family homes of any age can be changed at will.

Supporters of rent control argue it protects against predatory hikes that can put people on the street while opponents argue it leads to less tenant mobility, lower housing quality and discourages the creation of new units. Though Bend rents are rising at much higher rates than the national average, Oregon is just slightly ahead of the national average at 28.6%. The states with the highest increases are Arizona at 53.9%, Nevada at 48.4% and Idaho at 40.5%.

Photo courtesy of Construction Coverage

Rents are rising fast as tenants have to compete over a limited supply of units.

The Shroomdocks

The Deschutes County Planning Commission drafted rules for psilocybin use in rural Deschutes County, but residents are torn over their use at destination resorts

By Jack Harvel

Photo courtesy of Mädi via Wikimedia

Magic mushrooms are a Schedule 1 drug for the Drug Enforcement Agency, but clinical studies show they have positive impacts for mental health disorders.

Oregon became the first state in the country to legalize psilocybin therapy in 2020, and starting next year psilocybin manufacturers, processors and service centers will be able to apply for licenses to operate. The ballot measure passed with 56% of the voters, largely from urban areas, though since then 25 of Oregon’s 36 counties voted to opt out of the measure. Deschutes and Jackson are the only two counties that voted against a county-wide opt out of the program — and now, the Deschutes County Commissioners are deciding time, place and manner restrictions for psilocybin facilities in the unincorporated parts of Deschutes County.

Incorporated communities can regulate psilocybin on a municipal basis. Redmond voters approved a twoyear moratorium on any psilocybin services during this past election, while La Pine banned all magic mushroom visits. Bend didn’t have an opt-out measure on the ballot. Deschutes County voters rejected the optout for the unincorporated parts of the county with about 57% of the vote; in unincorporated Deschutes County where these time, place and manner restrictions apply, 53% of people rejected the prospect of an opt out. Some counties aren’t drafting any time place and manner restrictions, relying on their own land use rules to approve or disapprove psilocybin facilities on an individual basis.

“There's a lot more variables when there's not rules in place,” said Tanya Saltzman, a senior planner with Deschutes County. “In Deschutes County they would have to come in under what's called a similar use ruling or decision. The onus is on the applicant. They'd have to say, ‘This is my business, and I believe that it's going to operate or have the same impacts as other uses that's already listed in the code.”

In late September the Deschutes County Planning Commission finalized recommendations allowing psilocybin manufacturing and processing in land zoned as forest use and exclusive farm use. Manufacturing and processing of psilocybin mushrooms have a pretty small footprint, Ben Unger, a consultant for Measure 109, told the Source in July. It's likely just a few small workspaces the size of a garage will likely be able to supply all of Deschutes County. Most of the public testimony at the commission’s public hearing and written comments beforehand related to the placement of service centers and where state-licensed facilitators will administer the psilocybin. “Service centers is where it's been a real challenge to figure out what is allowed by law and what's not, because this is a whole new ballgame for basically everybody in the state,” Saltzman said. “Unincorporated counties are super restrictive for what you can and cannot do.”

Salzman said after working with the state’s Department of Land Conservation and Development, there are two mechanisms to allow service centers on farmland: home occupation and commercial activity in conjunction with farm use. Though possible, siting a service center on farmland comes with a lot of hurdles.

“[The Planning Commission] recommended keeping those doors open for now; we know it's still going to be really difficult to go through those processes. For instance, commercial activity in conjunction with farm use has a ton of restrictions built in, in terms of income proportion it has to be a certain percentage of the income generated by the farm use,” Saltzman said.

Under the current recommendations service centers in rural commercial areas, Sunriver Commercial zones, Sunriver’s Town Center, Terrebonne Commercial zones, Tumalo Commercial zones and in destination resorts. Public testimony to the Board of County Commissioners has mostly been about destination resorts. Saltzman estimated about 90% of testimony submitted to County Commissioners focused on resort destinations and was split pretty evenly between those in favor of psilocybin at destination resorts and those against. A spokesperson for Juniper Preserve, formerly Pronghorn Resort, directly asked commissioners to allow service centers in destination resorts.

“The Planning Commission recommended to allow service centers in destination resort zones, based largely on a number of factors, one being how critical a nature-based quiet setting is with no distractions, how critical a multi-day stay is to be able to have that administration session and then be able to reintegrate back into life after the session and therapeutically go over the experience you just had,” said Corinne Celko, a land-use attorney working with Juniper Preserve.

On the other side, critics of psilocybin at resorts say they’re expensive and would prioritize wealthy tourists, that resorts are far from emergency services, that any psilocybin use in an outdoor setting would be disruptive and that it’d change the character of resort neighborhoods.

Deschutes County Commissioners will consider the planning commission’s TPM restrictions on Dec. 14. The commissioners are going to attempt to make it an emergency declaration so they can implement the policy before people can apply for permits, rather than the statutory 90 days for non-emergency declarations. Emergency declarations must be unanimous, and if commissioners can’t agree it’s possible it’d open a brief window where applicants can apply to be a service center without the county’s rules in place.