RNs Blast Six Months of Inaction by California Health Dept. on Unsafe Care at University of California Davis Medical Center, UC Officials Also Ignore Dangers

OAKLAND, Calif., June 15 /PRNewswire/ -- Six months after registered nurses filed a complaint with the California Department of Public Health regarding sweeping and pervasive patient care problems at the University of California Davis Medical Center in Sacramento, state officials have yet to act, the California Nurses Association/National Nurses United said today.

The complaint cites case after case of substantial understaffing that has led to near misses of serious injuries: for newborn, pediatric and adult patients, in heart, burn, neurological, post-surgical and other units. Among the many examples are dangerous delays in responding to emergencies, providing medications or antibiotics, and care for patients in substantial distress.

UCD's own staffing documentation provided to CDPH by CNA shows that one-third of shifts at the medical center were staffed with fewer RNs than the law required based on how sick patients were.

At the request of the UC hospitals and another Schwarzenegger-dominated agency, the Public Employment Relations Board, a state Superior Court last week issued a temporary order to block a planned one day UC strike on June 10.

A follow up hearing is scheduled this Friday in San Francisco. Nurses will rally outside the courthouse, at 8:30 a.m., 400 McAllister, San Francisco, prior to the hearing.

'No one assigned' to investigate patient care problems

An extensive complaint was filed with CDPH on November 2, 2009, following months of efforts by UC Davis RNs and CNA to prod hospital officials to correct the understaffing that is the source of most of the patient care problems. Yet despite several follow-up calls over the past few months, the state has still not investigated. "No one has been assigned," a CDPH representative told CNA's UC Division Director Beth Kean on Monday.

"The inaction by our public oversight agency is unconscionable and should sound an alarm across California," said CNA/NNU co-president and UC San Diego RN Geri Jenkins. "Part of the blame lies squarely in the hands of Gov. Schwarzenegger for the irresponsible furloughs of public staff and the systematic underfunding of our regulatory agencies, but it is also the responsibility of the state to follow up on these serious problems that endanger public safety."

"Ultimately, the disgraceful failure is the responsibility of the University hospital administration for failing to act on our repeated demands for action to protect the especially fragile and vulnerable patients who count on UC hospitals for care," Jenkins said.

"UC officials have refused to work with nurses to fix these alarming shortcomings for more than two years, and even ignored the pleas of state legislators to act," said Kean. The University has also deliberately delayed and cancelled arbitrations scheduled to resolve patient care complaints, and the University rejected proposed solutions submitted by a neutral fact finder, jointly chosen by the UC and RNs, Kean said.

"Only after the repeated stonewalling and apparent indifference to massive patient care inadequacies did the nurses feel they had no choice but to plan for a strike," said Kean.

Serious problems throughout the UC hospital system

Davis is not the only UC medical center with serious patient problems, notes CNA.

UC San Francisco has experienced major staffing cuts in its general medical and post-surgical units and step-down (an intermediate care unit between intensive care and the general medical floors). In the hospital's transplant unit, patients recovering from liver or kidney transplant surgery are regularly being cared for by an inadequate number of nurses in violation of the state's minimum nurse-to-patient ratio law.

UC Irvine has repeatedly not passed inspections by federal regulators due to numerous patient care problems, including staffing issues. The problems are so severe that the hospital is being threatened by the regulators with loss of its Medicare certification.

At Davis, one-third of shifts were staffed with fewer RNs than the law required based on how sick patients were, as revealed by the hospital's own documents.

As a result, individual patients at UC Davis were repeatedly put in jeopardy because of short staffing, according to the complaint. Some examples:

• Cardiothoracic stepdown unit (heart patients). Delays in care for patients on ventilators that led to respiratory distress and other incidents. Late medications and assessments. A patient deteriorating because nurses were unable to monitor as needed. Nurses unable to walk patients, provide wound care, or give adequate discharge instruction.
• Burn unit. New burn patients admitted without adequate staff; extremely anxious new burn patient not adequately cared for.  
• Orthopedic trauma unit. IVs left beeping, numerous delays in pain pills and other medications.
• Pediatrics. Frequent delays in needed lab and other tests, long waits for medical transports; in one case, delayed transport situation a developmentally delayed child bit and hit herself and others.
• Newborn intensive care: A premature baby was accidentally fed twice, with formula having to be suctioned out of the baby's stomach before serious complications could occur. Numerous late feedings, late assessments, medication errors, and other short staffing issues.

SOURCE California Nurses Association/National Nurses United