Molly Casad has worked at St. Charles Bend for almost half of her life. The 54-year-old nurse knows the hospital inside and out, she said. But the job has worn her down.

She feels overworked, undervalued and unheard, she said, blaming staffing levels. That’s what drew her to join more than 200 nurses, politicians and supporters at the corner of Neff Road and NE 27th Street on Monday to demand the St. Charles Health System address staff recruitment and retention.

“It got to the point where I didn’t like being a nurse anymore. I actually loathed it,” Casad said.

Bend Mayor Melanie Kebler, city Councilors Megan Perkins and Anthony Broadman and Deschutes County Commissioner Phil Chang attended Monday’s rally. People held wood-handled picket signs that read “Respect, recruit, retain nurses.” At one point, they marched down Neff Road chanting, “Nurses on the outside means problems on the inside.”

“Nurses are the backbone of our community,” Perkins said Monday. “You take care of us. You literally take care of us.”

The 900 nurses at St. Charles Bend have been in negotiations after their contract expired Dec. 31. The health system and members of the Oregon Nurses Association bargaining team have met 10 times.

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The nurses have said that patients are at risk at St. Charles Bend because of low staffing levels. They argue that raising pay and raising safety standards will produce better care for patients. In March, the health system gave a $5 an hour wage increase to nurses and health care professionals.

But Megan Bovi, 38, a staff nurse and a member of the negotiating team, said there hasn’t been much movement from St. Charles.

“As of right now, they continue to state that they support us, they want to retain and recruit us, and the proposals that have been on the table have not been anywhere close to that at all, whatsoever,” Bovi said.

Nurses want more protections that prioritize their safety and the safety of their patients, Bovi said.

Current staffing protection laws don’t have much teeth, said Heather Bristol, a staff nurse in the neonatal intensive care unit at St. Charles Bend.

She believes there isn’t a shortage of qualified nurses. Instead, there is just a shortage of nurses who are actually willing and able to work in the field, she said.

“You want to recruit people who want to be a part of the community and want to be invested and want to make it a better place and help solve the unique issues we’re dealing with in this community. But if you can’t afford to live here, the people you’re bringing in are just here for 12 weeks and then gone,” Bristol said.

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There is a shortage of nurses nationwide, prompted by early retirements during the pandemic. A shortage of qualified nursing programs also is contributing to the shortage, according to the American Association of Colleges of Nursing.

At a bargaining session earlier this month, St. Charles Health System reported that there were 333 nurse vacancies at St. Charles Bend, said Kevin Mealy, Oregon Nurses Association spokesman. However, in a statement issued Monday, the health system said there currently are 80 open registered nurse positions at the Bend hospital.

“We agree with the (nurses union) about the importance of retaining and recruiting health care professionals and are happy to report that despite a national shortage of nurses we have been making significant progress,” said Julie Ostrom, service line administrator for trauma and surgical services and a member of the St. Charles bargaining team. “Over the past nine months, we have hired more new caregivers than we have lost to turnover in that timeframe.”

The average salary is $108,000 a year for a full-time registered nurse working 36 hours a week at St. Charles Bend, according to the health system’s statement.

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“We are very much looking forward to reaching an agreement in these contract negotiations and are working hard toward that goal,” Ostrom said. “In the meantime, our focus remains on providing high quality patient care to our Central Oregon community.”

The health system is the region’s only hospital and is its largest employer. The union said that since 2018, nearly 60% of the St. Charles Bend nurses have resigned. However, the health system said that number is not correct. The current turnover rate over the past three years is 14.5%, according to the health system’s statement.

St. Charles Health System helped put Deschutes County on the map, Chang told The Bulletin on Monday. But high housing costs, recruitment and retention challenges and scrimping on wages and benefits have placed the system in a financially strained position, he said.

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At an earlier bargaining session, an economist hired by the health system suggested that nurses should get married, get a roommate or commute from lower cost communities as a way to offset the rising housing costs. The suggestions caught the attention of a nursing TikTok influencer who used her 472,000 followers to communicate the negotiation posturing between the health system and the nurses.

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“Recruitment and retention and workforce shortages, I believe, are the number one threat to our local economy,” said Chang. “Whether it’s St. Charles, a tech company, an outdoor manufacturer or a local restaurant.”

So long as housing prices are not keeping pace with salaries and wages, employers will continue to have struggles, he said.

Chang has heard stories of nurses overrun with patients working virtually nonstop. It’s heartbreaking, he said.

“Their crime was basically that they were trying to take care of too many people at once,” he said.