No License to Harm
Disclosure:
I currently work as an Emergency Room Technician at Confluence Health.
This blog is not specifically about Confluence Health.
It’s about a systemic issue in healthcare.
No License to Harm
A nurse can lose their license over a charting error.
A tech can be fired for clocking in late—or for messing up a timecard.
But a hospital administrator?
They can cut staff, close beds, cancel contracts—and walk away untouched when those decisions harm people.
No license.
No oversight.
No accountability.
That’s what Washington’s HB 1567 tried to change.
It said: If you have the power to decide how care is delivered, you should be held to a standard of care.
It didn’t pass. Not this time. But we can’t let this conversation die in committee.
Because here’s what happens in the vacuum of inaction:
Emergency rooms buckle under unsafe ratios.
A Washington State report analyzing 423 hospital staffing plans found patient-to-nurse ratios in some emergency departments as high as 6.3 patients per nurse, far exceeding safe levels.
Nurses are forced into moral injury.
In 2022, 50% of nurses reported experiencing moral distress—often from unsafe staffing, being forced to ration care, or witnessing avoidable harm.
Techs, Unsupported.
ER techs, often left out of formal staffing protections, describe working with minimal support—raising the risk of burnout and medical error.
Patients wait. And wait. And sometimes die.
The CDC reports average ER wait times now top 2 hours nationally, and in severe staffing shortages, delays have turned deadly—like the 2022 case where a Washington patient died after a 7-hour wait.
Now let me tell you where I fit into this.
In 2021, I was Vice President of the Wenatchee Valley Chamber of Commerce. A bill came to our advocacy committee—HB 1868—that would’ve set nurse-to-patient staffing ratios in hospitals across Washington. I argued against it. I believed the talking points: it would be too rigid, too costly, too hard for smaller hospitals. I didn’t know enough to question what I was told. Fast forward to now. I work in the ER. I see the real cost of low staffing. I feel it in the bodies of my coworkers. I see it in the faces of patients waiting for hours. And it wrecks me to know that I once fought against the people standing up for change.
They were right.
We needed that bill.
We still do.
Let me be clear: this isn’t about villainizing administrators.
It’s about responsibility.
Healthcare is a human system.
And humans make decisions that either protect or endanger others.
When those decisions happen in boardrooms—detached from the noise and urgency of real care—the disconnect can turn deadly.
We saw it dramatized in The Pitt, the Max series that follows a single 15-hour ER shift.
The show doesn’t just depict medical emergencies; it highlights the systemic issues—like bed shortages and staffing crises—that healthcare workers face daily.
Its creators aimed to portray the emotional and logistical challenges of emergency medicine, shedding light on the often unseen struggles within our healthcare system.
Read more about the show’s themes →
Because healthcare doesn’t just need more staff.
It needs more leadership.
It needs accountability, top to bottom.
If a nurse can lose their license for a mistake,
If a tech can be fired for a timecard error,
Then, yes, a hospital administrator should be accountable when their decisions hurt patients.
Licensing administrators isn’t radical. It’s responsible.
It’s how we say: lives matter more than margins.
Safety matters more than spreadsheets.
Let’s be the first state to lead.
Let’s say: no one is above accountability.