As registered nurses who have worked at Doctor's Medical Center in San Pablo, for 48 years we feel a deep commitment to the health and well-being of our patients and community.

That's why DMC registered nurses have joined with other medical professionals and West County residents to insist that DMC remain open as a full-service acute care hospital. Nothing less than the health and safety of tens of thousands of our neighbors is at stake.

Unfortunately, the alternative, favored by this newspaper's editorial board and by those who seek to close the hospital or replace it with a limited, "stand-alone" emergency room, falls short of what is needed.

A stand-alone ER offers little more protection than a highway sign promising a hospital that doesn't exist -- an "emergency room" that fails to protect patients in the event of an emergency.

Under California law, stand alone" ERs are illegal unless they are directly connected to, and supported by, at least, an operating room and intensive care services.

That's why county officials are scrambling to come up with the pretense of a solution to the threatened closure that will not solve the crisis.

This proposal is not "realistic," as its backers claim. It is dishonest and promotes incomplete, fragmented care for patients who would still have to be sent miles away on congested highways for needed hospital services.

Community members have rightly wondered if the same solution would be proposed for the threatened closure of the main hospital that served more wealthy residents in East County.

DMC has served 40,000 patients a year and provided 60 percent of the emergency care in the region. The need for the hospital has been vividly illustrated by Chevron refinery accidents, including a 2012 inferno that sent 15,000 community residents to DMC.

The importance of DMC remaining a full-service hospital was demonstrated following the reduction of services Aug. 12. Ambulance transports to other hospitals exploded, with Kaiser Richmond seeing a 73 percent increase, Contra Costa Regional Medical Center a 43 percent increase and Sutter Alta Bates, a staggering 164 percent increase.

West Contra Costa residents suffer from chronic, life-threatening health conditions, including heart disease, diabetes, cancer, adult and childhood asthma. Many patients come to us after years of receiving inadequate or no preventive care. We are proud of the work we do in stabilizing them and working with them to improve their health through proper care and health education.

The only "realistic" way to support the best health outcomes is to integrate DMC, as a full-service hospital, into the Contra Costa Health System.

Resources to save DMC include a share of the $19 million property tax windfall the county expects this year and the increase in Medicare reimbursements when DMC becomes a county facility. They should also include contributions from private hospitals that have depended on DMC's safety net for years, including Kaiser, John Muir and Sutter, as well as Chevron, one of the wealthiest companies in the U.S.

We reject the idea that our patients should have to pay with their health and in some cases, their lives, for the county's abrogation of its responsibility to all the residents of Contra Costa County. That includes those who are medically underserved and deserve more than rationed, second-class care.

Adrian Boyance-Reid and Carol De Young are registered nurses at Doctor's Medical Center in San Pablo.

The original posting: www.contracostatimes.com/opinion/ci_26470343/guest-commentary-west-county-residents-deserve-full-service