Nurses at Mary Bridge Children's Hospital's neonatal intensive care unit say they're caring for up to four times the number of babies they should be assigned, and the union representing them wants MultiCare to act faster.

The Washington State Nurses Association, which represents more than 1,100 registered nurses at Tacoma General and Mary Bridge, issued a warning Tuesday, June 23, that the 70-bed NICU is running below contractually agreed staffing minimums even as patient volume has climbed 50% since January.

The unit is the only Level IV NICU in southwest Washington, treating the region's most premature and medically fragile newborns.

Nurses who should be assigned one or two babies are regularly caring for four, according to WSNA. When covering for a colleague on break, that number doubles. On one shift, two nurses had to cover 11 patients, the union said.

An overflow area that previously saw intermittent use is now full every day, WSNA reported.

The staffing language is new. Nurses picketed outside Tacoma General on Friday, January 23, over wages and NICU ratios, then ratified a contract on Friday, February 6, that included average wage increases of 15.46% over three years.

That deal also required NICU staffing to align with guidelines from the Association of Women's Health, Obstetric, and Neonatal Nurses, the National Association of Neonatal Nurses, and the American Academy of Pediatrics.

Less than five months later, WSNA says those standards aren't being met.

MultiCare acknowledged the strain in a statement to The News Tribune, saying staffing remains a challenge amid the census increase that began earlier this year. The hospital said it has contracted travel nurses while recruiting and orienting permanent hires.

The NICU remains housed at Tacoma General, not at the new $480 million Mary Bridge campus that opened Saturday, May 16.

The hospital told The News Tribune the unit was excluded from the new campus blueprint because it did not fall under Mary Bridge's license at the time, and moving it would reduce proximity to Tacoma General's labor and delivery unit.

WSNA is calling on MultiCare to hire additional travel nurses immediately and raise hourly incentive pay for nurses covering open shifts, which the union says is currently capped below time-and-a-half. No timeline for resolution has been announced by either side.