RNs and caregivers at Palomar Health say cuts in services to the community, patient safety are top concerns

Nurses and caregivers at Palomar Health in Escondido, Calif. will hold an informational picket on Thursday, Oct. 10 to demand management improve staffing levels, commit to the needs of the community, and address the dire need for the recruitment and retention of experienced nurses and caregivers, announced California Nurses Association/National Nurses United (CNA/NNU) and California Healthcare Employees Union (CHEU).

Nurses and caregivers- who include technicians, certified nursing assistants, nursing unit secretaries, and others- are deeply concerned about chronic short staffing that deteriorates patient care, the constant turnover of staff, and cuts to service lines and unit closures, including the closure of a 12-bed behavioral health unit in June.

"As patient advocates, we want to make sure the public knows how management's decisions are negatively affecting patient care in our community," said CNA chief nurse representative Susan Adams, a registered nurse in the labor and delivery unit. "We are seeing charge nurses, the nurses who oversee the flow of patients and nurse assignments, being asked to cover more than one unit at a time, which is completely unacceptable and jeopardizes patient care. Other times, due to short staffing, management calls on charge nurses to take on their own patient load. If a charge nurse has their own patient load, they are not able to jump in to help a floor nurse, assist when problems arise, or devote proper attention to their own duties. These practices are detrimental to our patients' safety and must be stopped."

Who:    RNs and Caregivers members of CNA and CHEU

What:   Picket for patient safety and more community services

When:  Thursday, Oct. 10 6:00 a.m. - 8:00 a.m.

Where: Palomar Health Escondido 2185 Citracado Pkwy, Escondido, Calif. 92029 (picket will take place at hospital main entrance.)

Nurses say there are numerous ways the lack of staffing is deteriorating patient care. In the emergency room, the hospital eliminated much of the phlebotomy staff. Nurses are expected to do the work of the phlebotomists, in addition to caring for their patients. These additional duties for nurses creates delays in care for patients. Also, management has replaced sitters, caregivers who observe patients in their rooms, with so-called "virtual sitters," which is nothing more than a camera focused on their beds. A monitor tech remotely watches these cameras, but that tech may be "monitoring" up to 12 patients.

"When a patient is in a state of delusion or confusion, whether from a mental health crisis or a reaction to a procedure, they are dependent on the staff to keep them safe," said Constanza Nider,a member of CHEU and anemergency room nursing unit secretary and translator. "We know that a camera on a stick cannot calm an agitated patient, hold a crying patient's hand, or help reorient an elderly patient who may be confused about where they are. These are fundamental human needs of our most vulnerable patients. Our patients need and deserve holistic care, and they are not getting that at the other end of a camera. We need to be at our patients' side when they need us the most."

Registered nurses and caregivers are also calling on management to address the administration's failure to provide adequate meal and rest breaks for nurses, many of whom work 12-hour shifts. Studies show that nurses who are fatigued are more apt to make mistakes or miss the subtle changes in a patient's condition that can mean significant changes in their health.

Nurses and caregivers say these poor working conditions have led to a revolving door of staff because they don't feel they can provide their patients with the care they deserve. More than half of the registered nurses and the caregivers at Palomar Health have less than two years with the district.

"We need to have safe workplaces, for patients and staff, so we can retain the current nurses and caregivers and recruit experienced health care talent," said Michelle Jones, a registered nurse at Palomar Medical Center in Poway. "It is heartbreaking to see unit closures shrink the services in the community. We have lost a behavioral health unit and women's services at our campus. This is not in the spirit of our role as a public health district with a mission to heal. We need to build up our public health services so we can better serve our community."

CNA and CHEU represent close to 2,800 registered nurses and caregivers at Palomar Healthcare District. The registered nurses (represented by CNA) and caregivers (represented by CHEU) are bargaining their contracts jointly. Palomar Health registered nurses and caregivers work at facilities in Escondido, Poway, and surrounding clinics.

California Nurses Association/National Nurses United is the largest and fastest-growing union and professional association of registered nurses in the nation with more than 100,000 members in more than 200 facilities throughout California and nearly 225,000 RNs nationwide. Caregivers and Healthcare Employees Union (CHEU) is an affiliate of California Nurses Association.