WATSONVILLE -- Scores of nurses demonstrated in front of Watsonville Community Hospital on Thursday, protesting what they say is the hospital's practice of employing so few nurses and medical assistants that patients are receiving substandard care.

The 275 or so nurses have been negotiating a new contract since February and without a contract since October, said Lisa Harlow, a negotiator with the California Nurses Association.

The sticking point is not about salary or benefits; it is the nurses' request for more help, she said.

They have no coverage for breaks, too few nurses per patient in some cases, and often no assistants to help with meals, bathing, admitting and other patient care, Harlow said. Many are working 12-hour shifts without breaks, she said.

"It's a real problem; we need adequate staffing," Harlow said. "We know inadequate staffing raises mortality rates."

But a hospital spokeswoman disputed any dearth in care or staffing.

In a prepared statement, hospital spokeswoman Cindy Weigelt said the hospital is committed to providing high-quality, safe and compassionate care for patients, and that they appreciate all employees who contribute to those efforts.

"WCH maintains appropriate nursing levels in compliance with state-mandated ratios and increases staffing levels, as necessary, in response to the number of patients and the acuity of those in our care," Weigelt said. "As always, the hospital's top priority is the care and safety of our patients, employees and visitors."

Thursday's two-hour "informational picket" included about 30 nurses at a time, many of whom came out during their 15-minute breaks. Nurses lined Airport Boulevard holding signs such as "Patient Care is our Bottom Line" and passed out fliers to people as they entered the hospital parking area.

The hospital is owned by Tennessee-based Community Health Systems Inc., one of the leading operators of general acute care hospitals, according to Community Health's website. The organization's affiliates own, operate or lease 126 hospitals in 29 states, the site states. Community Health bought the hospital in 1998, and paid off the hospital's $35 million debt.

Nurse Mariza Rivas said she has worked at the hospital for 20 years, and that conditions began to deteriorate when Community Health Systems purchased the hospital.

"It has gotten worse and worse," she said.

Rivas works in the pediatric medical and surgical unit, she said. "Once in a while we get one CNA on the floor; it's ridiculous," she said. "A lot of patients suffer, and we suffer."

A few people interviewed in front of the hospital had different opinions of care received there. One woman said she had surgery the day before, and that sometimes it took a long time for a nurse to respond when she requested help; two other people said they had no complaints about care they had received.

The picketing comes after nurses went on strike in late October, planning for a one-day event and then being barred by the hospital from returning to work for the following two days.

Nurses then also claimed there was a staffing shortage and said the hospital was stalling in resolving that problem.

Weigelt has declined to discuss specific labor negotiations, but has said nurses were offered a raise.

The company recently announced third-quarter earnings results, showing that net operating revenues totaled $3.3 billion, up 5.4 percent over the same period in 2009, and that net income increased 17.9 percent to $70.4 million, or 76 cents per share.

By Cathy Kelly