LAKEWOOD, Wash. -- Nurses and doctors inside Western State Hospital are breaking their silence about what they call a "toxic" environment where employees fear being in physical peril and stretched to the limit.
Nurse Candice Noble counts herself those who battle the darkness of mental illness with as much positivity as possible.
But it's hard.
"Overwhelmed," she said. "Overwhelmed. We're overworked, we're tired. We're burned out."
Noble is just one of 1,800 employees working inside Western State Hospital simply trying to stay afloat. She and fellow nurses took their struggles to Olympia earlier this month showing lawmakers the realities of life behind the gates.
They're asking for more money, additional nurses, and better conditions.
"It is a little hard to stand up and say I'm proud to work there right now," said intake specialist Barbara Shelman.
"We can keep asking until someone will finally speak with us," said Steffanie Hibbard.
The nurses say mandatory overtime is common practice. Their workloads have spiked and there's a backlog of mentally ill people waiting to be admitted. This comes at a time when both patients and staff are under attack.
"I was fortunate with my assault that it was just a punch in the face and nothing more," Noble said.
Multiple nurses said attacks like this are so commonplace, reporting them is pointless.
"It's not worth going through the paperwork and the time off. It's just better to go on," Noble said.
The good news is that Washington state records show assault rates against Western State staff are slowly declining.
But among California, Oregon and Nevada, Western State ranks highest when it comes to patient-to-patient assaults.
Noble said help is needed soon.
"We need better training. We need better ways to be able to deal with patients that are having a psychiatric crisis," she said.
The numbers appear to back up the nurses complaints about being short-staffed.
Western ranks third in staff-to-patient ratios, ahead of only California.
The KOMO Investigators obtained internal emails between leadership and medical staff that expose troubles that go far beyond staffing numbers.
In one exchange several doctors asked for the chance to meet in person with federal inspectors to "give our perspectives, positive and negative."
Sources say that never happened and doctors were actually barred from doing so.
As a result, Western's Chief of Medical Staff Joe Wainer resigned a week and a half ago, citing a "loss of trust" in leadership.
In an email to KOMO, Wainer elaborated on that, saying anything other than positive talk about Western "would be interpreted as a violation of our code of conduct and we would face disciplinary action."
Another source described a "toxic" culture of fear that is pervasive at Western.
Yet nurses like Noble keep pushing for improvements rather than abandon a hospital on the brink. It's worth it to make a difference, they say.
"It's like a marathon. From the time I get there to the time I leave, I run a marathon," she said.