Registered nurses that work for Contra Costa County will hold an informational picket on Monday July 20, to call attention to the County's failure to properly invest in its health care system and address unsafe patient care conditions.

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 with little progress on key issues of patient safety, including chronic short staffing and high rates of attrition and turnover due to deteriorating conditions.

"It is impossible to provide appropriate, acceptable and safe care to the patient's that we serve, without appropriate staffing," said Kathy Avila, RN, ICU. "We see delays in care regularly, due to inadequate staffing levels. Management addresses this by asking RNs to work double shifts. This isn't the solution as it can lead to exhaustion, medical errors, burn-out, and injuries to staff," said Avila, who has worked at the County for 16 years.   

What:   Nurses Call on County to Invest in Vital Health Care for Residents, Hold Picket to Protest Serious Patient Care Concerns
When:  Monday, July 20, 4:00 p.m.
Where: Contra Costa Regional Medical Center, 2500 Alhambra Avenue, Martinez, Ca.

Last month, 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 skill mix needed for appropriate care.

The Labor and Delivery unit is also regularly short staffed, nurses say. Two to three day waits in the Emergency Department are common (if a patient is diagnosed as “stable”)  especially for patients who arrive on weekends. Both the Inpatient Psych and Emergency Psychiatric departments are so regularly short staffed that nurses often work double shifts.

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. Thousands of these residents have yet to be screened due to inadequate clinic hours. In order to make an appointment, patients must call beginning at 6 a.m. and all open appointments are usually filled by 7 a.m. Many patients give up seeking treatment because of the difficulty of getting an appointment and the fact that there are very limited clinic hours especially after 5 p.m. or on weekends. 

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 basically 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 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.