Gov. Martin O'Malley has included 93 additional jobs in his budget proposal, but workers and hospital leaders worry that that number might get pared down by nearly 30 as the state faces fiscal pressure.
The workers, members of the American Federation of State and County Municipal Employees, rallied in front of the hospital waving green signs that said "Budget for Safety." They were joined by Perkins CEO David Helsel, who was brought on three months ago to help stabilize the facility. Helsel wore a green AFSCME scarf to show solidarity with workers.
"We are asking our legislators to simply give us the tools we need to improve conditions at Perkins Hospital," said Lamont Baker, a security attendant at Perkins and president of AFSCME Local 57. "Please fully fund Governor O'Malley's budget."
Helsel and workers said the increased staff is needed to help cut the amount of overtime employees are working. Many staff members are working 16-hour days, they said. Two consultants hired by the state have also recommended that the hospital hire more workers.
Helsel has made it a priority to improve staff morale and has had regular meetings with employees. Staffers said they believe they have the ear of management more than they did in the past.
Baker and other employees said there have been some improvements at the hospital in recent months. More workers have been hired, they said, and there is a worker in charge of each shift so there is more accountability. A lounge area has been added so workers can rest after long shifts. Patients have been psychologically reassessed, and some have been moved to other facilities.
Baker said having more workers makes the patients feel safer and prevents problems that may arise when patients are anxious.
But Baker and Helsel said they need more resources to make more significant changes.
"We simply cannot continue to keep Perkins safe by relying on the use of overtime and have staff continue to work as much as they have been in recent months," Helsel said.
In a report after one of the killings, state regulators said some staff members had been sleeping on the job, among other problems.
Most of the patients at Perkins have been ordered there by a court for evaluation or treatment. The bulk of them have violent histories, including killings, which clinicians say make them the most difficult psychiatric cases to treat.
Hajeezah Majeed, a psychiatric technician who has worked at Perkins for six years, is among the staffers who have been asked to work 16-hour shifts since the deaths at the hospital. And while she said she believes the extra workers on each shift are contributing to a safer environment, she's ready for relief.
"We've implemented some precautionary procedures, including checking on patients every 15 minutes instead of every 30," she said. "But that means more work and mandatory overtime. It's physically been almost unbearable. My biggest concern is the quality of my work, because you're not the same person at 8 a.m. as you are at 7 p.m."
She said the staff believes safety depends on changes that the two consultants recommended, including more resources for rehabilitation for patients, who sometimes seem little more than "housed" at Perkins, she said.
Majeed, however, said that she does believe that the increased checks and better coordination with security staff, as well as the attention from management, are making a difference in morale and safety.
"The problems aren't solved," she said. "But Dr. Helsel has taken steps, so I feel encouraged."
Baltimore Sun reporter Meredith Cohn contributed to this article.