The union representing RNs and caregivers at Palomar Medical Center Wednesday morning held an informational picket in front of the hospital alleging that patients are at risk from “chronic short staffing.”
Palomar Health told The Times Advocate the union was reacting to the recent Janus v. AFSCME decision by the U.S. Supreme Court that is seen as weakening public employee unions (see more of the Health Systems’ comments below.)
Members of Caregivers Healthcare Employees Union (CHEU) carried signs calling for “Safe Staffing Now” Wednesday and said they wanted to highlight concerns about chronic short staffing and other working conditions that contribute to high turnover and undermine the quality of patient care.
The California Nurses Association represents Palomar RNs, and Caregivers and Healthcare Employees Union (CHEU), a CNA affiliate, represents other caregivers, including certified nursing assistants, imagine technologists, food and nutrition services workers. The unions represent a total of about 3,000 employees.
One of the RNs, Sue Phillips, declared, “We demand that Palomar make patient safety its first priority, and respect its patients, and its nurses, and its caregivers.” She added, “Palomar is refusing to address the chronic short staffing throughout the hospital. The situation is very stressful, with nurses working to utter exhaustion and going without breaks or meals.”
In addition, nurses are flagging problems with management’s scheduling practices including demanding nurses work extra shifts and forcing nurses to work in units without providing the specific training necessary. “Palomar is undermining patient safety. Nurses who have years of experience working in specific units are being reassigned to other units without management providing the necessary training,” said Phillips.
Phillips said many nurses are being pushed by management to work additional shifts. “These nurses are having to go without sleep in order to work these extra hours,” she said.
Phillips told The Times Advocate of a recent personal experience in the emergency room, which she described as “chronically understaffed.” Phillips has been a member of the hospital’s “rapid response team” for 23 years. Its job it is to respond to patients whose nurses feel they are on the verge of being “code blue,” which is near death.
She said, “I responded to a pre code [pre Code Blue] on a patient who was upstairs. There was a mental health patient who was unattended and had gotten away from staff and was in the room when I got there.” She didn’t immediately recognize him until he started speaking. “He blocked me to keep me from my patient.” This problem, said Phillips, “is an indicator that short staffing put a patient at risk, I was put at risk and the patient was put at risk”
The union members claim they are “literally running” to keep up with their patients’ needs as Palomar cut the number of certified nursing assistants per unit down from three to two.
“Patients need to be cleaned, to be turned, to be helped to the bathroom, and we must make sure no one falls,” said Imelda Aldana, a certified nursing assistant with Palomar for more than ten years. “We cannot rush our patients, they are often elderly and they are all sick. They deserve our time and we want to give them the best care. We work 12 and a half hours shifts and we are running all the time, and often we go without breaks because there is no one to relieve us. It is very frustrating for us and for the patients, we just don’t have all the people we need on the floor.”
Longtime hospital cook Gil Millian, who has worked for the hospital 30 years, said, “We are disappointed in the direction Palomar Healthcare District is going as it fails to honor its promises to patients.” He continued, “When Palomar fails to staff housekeeping, or the kitchen adequately, experienced workers leave. When we are short staffed, it is hard-to do our job in a timely manner, and that makes it difficult for us to give the best care to our patients.”
Palomar Health spokesman Derryl Acosta commented, “We agree that providing quality patient care is the most important priority at Palomar Health and we are committed to ensure every patient receives safe, high-quality care at all times. The recent accusations of understaffing and poor working conditions are false and seem to be an attempt to rally nurses in light of the Janus Supreme Court decision which threatens to undermine the power of labor unions.”
Acosta added, “Our employees are simply being asked to work within the agreement that was voted on and signed by our nurses and caregivers just nine months ago; an agreement which outlines pay, benefits and working conditions. Staffing levels at Palomar Medical Centers Escondido and Poway meet or exceed federal guidelines and received five and four star ratings respectively for quality from the Centers for Medicare and Medicaid Services (CMS). Palomar Health leadership values its nurses, caregivers, physicians and support staff as its most valuable assets and together we make patient care our number one priority.”
The Times-Advocate spoke to another RN, Susan Adams. “Many things have changed in my department (the Palomar Hospital Birth Center) since our move to the new campus in December, 2016,” she said. “Those changes have not all been positive. Many other nurses would speak out but they are fearful of management retribution.”
Adams added, “We have experienced staffing changes imposed on our unit that decrease the safety of the care we can give our mothers and babies. The RN Nursery position has been eliminated. The nursery nurse was a designated , trained RN that attended every delivery and provided care for our precious little ones. Now, our break nurse or charge nurse is expected to ‘catch and go.’ ”
This plan’s success is spotty, she said, because the “break nurse” has patients of her own and can’t do other duties such as being the baby nurse and giving RN breaks.” Because the unit is understaffed, the unit is left without a break nurse. According to our source, “Our charge nurses try to meet the needs that can’t be filled by the otherwise assigned break nurse but the other charge duties limit a charge nurses ability to fill the additional needs.”
Adams claims that the hospital has lost over 20 night RNs and 6 day RNs over the past year and that the positions were not refiled.
Adams told The Times-Advocate: “We are picketing today to let our community know that we advocate for their safety. We support their birth choices. We offer excellent care, education, and compassion but we are concerned that our ability to provide quality care is eroding. RNs without breaks, care without designated Nursery RNs, and adequate RN triage care have put us in unsafe situations.”