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California Health Department Failing to Address Unsafe Care Problems Raised by Nurses

California Progress Report, 6/17/10

By Geri Jenkins, RN, CNA Co-President
California Progress Report
June 17, 2010

It’s been six months after Registered Nurses and the California Nurses Association/National Nurses United filed a complaint with the California Department of Public Health regarding sweeping and pervasive patient care problems at the University of California Davis Medical Center in Sacramento.

Yet state officials have yet to act. On Monday, a CDPH told one of our representatives, after our latest call to see what they are doing about this urgent problem: “No one has been assigned.”

Perhaps we should not be surprised. Another California agency that is dominated by appointees of the Schwarzenegger administration, the Public Employee Relations Board, is the agency that, on behalf of the University of California hospital administration, went to state court seeking to block the democratic right of UC nurses to strike, as a last resort, to demand the UC correct the patient care problems in their system.

A Superior Court in San Francisco, which issued a temporary injunction at PERB’s request last week, is scheduled to hold another hearing this week. Nurses will rally outside the courthouse Friday, at 8:30 a.m., 400 McAllister, San Francisco, prior to the hearing.

PERB’s filing this week to the court tells you all you need to know about whose interest they are representing.

In one telling part of PERB’s filing, its attorneys wrote, “PERB must accept the University’s factual allegations as true.” So much for the myth of Schwarzenegger’s PERB being an impartial board.

UC RNs have not had much better response from CDPH, which should certainly prompt alarms about that agency’s ability to protect the public interest which is its prime responsibility.

Our complaint was filed with CDPH on November 2, 2009, following months of efforts by UC Davis RNs and CNA to prod hospital officials to correct the understaffing that is the source of most of the patient care problems.

The complaint cites case after case of substantial under staffing that has led to near misses of serious injuries: for  newborn, pediatric and adult patients, in heart, burn, neurological, post-surgical and other units. Among the many examples are dangerous delays in responding to emergencies, providing medications or antibiotics, and care for patients in substantial distress.

UCD’s own staffing documentation provided to CDPH by CNA shows that one-third of shifts at UC Davis were staffed with fewer RNs than the law required based on how sick patients were.

The inaction by our public oversight agency is unconscionable. Part of the blame lies squarely in the hands of Gov. Schwarzenegger for his irresponsible furloughs of public staff and the systematic underfunding of our regulatory agencies, though it is also the responsibility of the state to follow up on these serious problems that endanger public safety.

However, we also recognize that ultimately it is the officials of the hospital administration who have disgracefully failed to act on our repeated demands for action to protect the especially fragile and vulnerable patients who count on UC hospitals for care.

As CNA/NNU’s UC division director Beth Kean noted this week, “UC officials have refused to work with nurses to fix these alarming shortcomings for more than two years, even ignored the pleas of state legislators to act. The University has also deliberately delayed and cancelled arbitrations scheduled to resolve patient care complaints, and the University rejected proposed solutions submitted by a neutral fact finder, jointly chosen by the UC and RNs.

“Only after the repeated stonewalling and apparent indifference to their massive patient care inadequacies did the nurses feel they had no choice but to plan for a strike,” said Kean.

Davis is not the only UC medical center with serious patient problems.

UC San Francisco has experienced major staffing cuts in its general medical and post-surgical units and step-down (an intermediate care unit between intensive care and the general medical floors). In the hospital’s transplant unit, patients recovering from liver or kidney transplant surgery are regularly being cared for by an inadequate number of nurses in violation of the state’s minimum nurse-to-patient ratio law.

UC Irvine has repeatedly not passed  inspections by federal regulators due to numerous patient care problems, including staffing issues. The problems are so severe that the hospital is being threatened by the regulators with loss of its Medicare certification.

At Davis, individual patients at UC Davis were repeatedly put in jeopardy because of short staffing, according to the complaint. Some examples:

* Cardiothoracic stepdown unit (heart patients). Delays in care for patients on ventilators that led to respiratory distress and other incidents. Late medications and assessments. A patient deteriorating because nurses were unable to monitor as needed. Nurses unable to walk patients, provide wound care, or give adequate discharge instruction.

* Burn unit. New burn patients admitted without adequate staff; extremely anxious new burn patient not adequately cared for.

* Orthopedic trauma unit. IVs left beeping, numerous delays in pain pills and other medications.

* Pediatrics. Frequent delays in needed lab and other tests, long waits for medical transports; in one case delayed transport situation a developmentally delayed child bit and hit herself and others.

* Newborn intensive care: A premature baby was accidentally fed twice, with formula having to be suctioned out of the baby’s stomach before serious complications could occur. Numerous late feedings, late assessments, medication errors, and other short staffing issues.


Geri Jenkins is a UC San Diego RN and a co-president of the California Nurses Association/National Nurses United

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