UC hospital workers allege patient neglect, harm

By SCOTT MARTINDALE / ORANGE COUNTY REGISTER

ORANGE – A labor union representing about 15,000 UC hospital workers has issued a report accusing UCI Medical Center and four other hospitals of inadequate and uneven staffing levels that have led to patient neglect and harm.

In the 40-page report released Thursday, union leaders alleged that bedridden patients at UCI Medical Center in Orange were developing pressure sores and urinary tract infections because of understaffing, and that workers tasked with monitoring sick and critical patients were skipping their breaks to avoid jeopardizing patient safety.

UCI Medical Center denied the allegations, saying the report was based on selected, anecdotal findings.

The report, titled “A Question of Priorities: Profits, Short Staffing and the Shortchanging of Patient Care at UC Medical Centers,” was commissioned by the University of California chapter of the American Federation of State, County and Municipal Employees.

The union, which represents UC hospital workers other than nurses and physicians, said the report was its first comprehensive effort to publicly chronicle UC patient care problems statewide.

“What we’ve been seeing for a while now … is an under-resourcing of patient care that puts the patient and us, the provider, at risk,” Kathryn Lybarger, president of AFSCME 3299, said during a conference call with reporters. “This paper is really a call for help.”

AFSCME 3299 is in a stalemate with UC officials over labor-contract negotiations for patient-care technical workers that began in summer 2012; an independent mediator is being brought in to try to resolve the differences.

Thursday’s report argued that too many “essential” services were being contracted out to inadequately trained temporary workers. One patient at UCI Medical Center lay in his own feces overnight, until it dried, because a subcontracted nurse “hadn’t gotten to the patient,” a custodian testified in the report.

UCI Medical Center spokesman John Murray said the Orange hospital is appropriately staffed and that the union’s report relied on “selective information and anecdotal evidence” to draw its conclusions.

“It’s just not true – there is not a staffing problem at the hospital at any level,” Murray said. “The training we require of the temporary registry workers is the same standards we expect of our regular staff. If we see a registry worker not doing a proper job, then we put them on a do-not-call list.”

California requires hospitals to maintain minimum staffing ratios for nurses, but not for other patient care workers such as nursing assistants.

Murray said UCI Medical Center bases its hospital assistant staffing ratios on its nurse ratios, and uses a variety of metrics to develop and refine those ratios. There is no single external standard because every hospital is made up of different departments with different populations, Murray noted.

Thursday’s UC union report said that not only must permanent staff train temporary workers, impeding efficiency, but that permanent employees also sometimes end up doing the work assigned to the temporary employees.

“We have to take time to show them how to do charting of vital signs on the computer, and it’s a waste of time,” Esther Flores, a UCI Medical Center senior hospital assistant, stated in the report. “A lot of the time, they are given a temporary password, but if they don’t have it, they have to wait for the office to give it to them, which can sometimes take one to five hours. And then the nurses need vitals, so you end up doing the vitals for the whole unit.”

Flores also said in the report that she skips her breaks “often” when monitoring her patients because staffing is so thin that there’s not always someone to cover for her. “It’s not safe,” she stated in the report.

When she confronted a manager with her concerns, Flores testified, the response was: “Well, do your best.”

Murray said UCI Medical Center has been working aggressively in recent years to lower the number of its temporary workers, especially among registered nurses and nursing assistants. But he emphasized that temporary workers would always be part of the hospital environment and that they did not compromise quality of care.

“There’s a team of care approach here,” Murray said. “If someone has to step off the floor or take a break, then there are others to cover.”

UC runs five medical centers – Davis, Irvine, Los Angeles, San Diego and San Francisco – that make up California’s fourth-largest health care delivery system, according to UC.

UCLA’s medical center is ranked the fifth best hospital in the nation by U.S. News & World Report, while UCSF’s is ranked No. 13. UCI Medical Center is ranked 11th best in California in the magazine’s 2012-13 rankings.

Union leaders said patient-care problems at UC’s medical centers stemmed from “chronic understaffing, administrative bloat and record levels of debt being taken on” to finance construction and renovation projects.

UC spokeswoman Dianne Klein said in an email the allegations were “wildly misleading” and declined to respond to them directly.

“It’s not unusual for such allegations from AFCSME to arise during the bargaining process,” Klein said. “UC medical centers are world renown for their patient care.”

In Thursday’s report, union officials also alleged that UC donors, celebrities and friends and relatives of UC administrators received “VIP” treatment at the expense of other patients.

“They receive immediate attention, and they get everything they need,” Leonor Orozco, a UCI Medical Center custodian, stated in the report. “They tell us to come clean their rooms very quickly because they’re a VIP. They get preference on care. If they need something, everyone comes running.”

Murray denied the allegation, stating UCI was “committed to providing the same level of care for every patient in the hospital.”

[Source]: The OC Register