Call on County to Make Community Health Top Priority

With contract talks stalled, nurses who work for Contra Costa County voted nearly unanimously late last week to authorize a strike, if necessary, to protest the County’s continued refusal to address unsafe staffing and high nurse attrition/turnover and its failure to properly invest in its healthcare system. No strike date has been set as yet.

“Contra Costa County nurses have been coming together, for over a year, trying to get management to address chronic unsafe staffing levels and deteriorating patient care conditions,” says Isioma Mbanugo, ICU RN. “What this vote shows is that County nurses will continue to move forward, united in our advocacy for our patients. We are willing to speak up, collectively, until these serious issues are resolved.”

The California Nurses Association/National Nurses United represents nearly 1,000 RNs in Contra Costa County who have been trying to negotiate an agreement with the County since July 2014.

“This strike vote should send a loud and clear message to County Administration that their lack of investment in our community hospital and clinics is unacceptable. We will not stand by while management cuts corners on the mothers and babies in our Labor and Delivery unit—which is constantly under staffed—and on the patients who visit our Emergency Department and can experience a wait of two to three day waits if they are found to be ‘stable’,” says Jeanne Coffey, Labor and Delivery RN. “Our patients and the residents of Contra Costa County deserve better.”

In June, a delegation of RNs brought the issue of unsafe scheduling practices in the County hospital's perinatal units to the Contra Costa County Board of Supervisors. RNs testified that the unit regularly lacks core staff and does not meet the mix of staff needed for appropriate care. The County health system's short staffing has also delayed expansion of the Contra Costa County Health Plan to many county residents after the Affordable Care Act expanded Medi-Cal eligibility in 2014, say nurses.

Last week, RNs joined community and faith leaders at another Board of Supervisors’ meeting, appealing to the County Supervisors to invest in health and healing, not incarceration, as Contra Costa Sherriff David Livingston seeks millions to expand Richmond’s West County Detention Facility—in the same community that recently lost Doctors Medical Center. (The proposal will move on to the state level, despite opposition.)

“Our nurses are committed to asking those in positions of authority, both County administration and our elected officials, ‘What are your priorities?’” says Rosalie Cabading, Medical Unit RN. “We’re seeing jail expansion while a public hospital that provided critical services to some of the most vulnerable in our community has closed. Our remaining community hospital and clinics are experiencing issues that put patients and nurses at risk. Nurses are standing up and saying, on behalf of our patients, our community’s health must come first.”

The County's unwillingness to seriously invest in its nursing staff, say Contra Costa RNs, has resulted in an inability to recruit and retain experienced RNs and high turnover rates. Since June 2014:

• In the ER, 22 nurses left, an overall turnover rate of 28 percent including 41 percent of the day shift nurses
• In Labor and Deliver, 24 nurses left, an overall turnover rate of 39 percent including 65 percent of the night shift nurses
• In Neonatal Intensive Care, the turnover rate is 25 percent, including 50 percent of the night shift nurses

Nurses are concerned that under current management practices, the County is providing training for new nurses who leave after a couple years for better employment conditions in other area hospitals. The County currently has at least 124 vacant RN positions.

Registered nurses working in the Contra Costa County Health system serve patients at numerous locations, including the Contra Costa County Regional Medical Center, 8 Ambulatory Care Clinics in Brentwood, Antioch, Pittsburg, Bay Point, Concord, Concord Public Health, Martinez, and the West County Health Center, 3 Adult Mental Health Clinics in East County, Central County, and West County.