California Hospital Closes Due to Ratio Law

[Gomer]

From the L.A. Times:

By Stephanie Chavez, Times Staff Writer

"Santa Teresita Hospital in Duarte is shutting down its emergency room and acute-care facility today, closures that officials blame in part on the state's nursing shortage.

The hospital's 177-bed skilled nursing facility, outpatient surgery center and fertility clinic will remain open, said Sister Michelle Clines, chairwoman of the hospital's board of directors.

The hospital had slowly cut back on its acute-care beds, from a high of 150 in 1987 to fewer than 40 last year. Santa Teresita's emergency room saw about 12,000 patients a year who were not brought in by paramedics in ambulances and approximately 1,700 brought in by paramedics.

The closing of Santa Teresita's emergency room further strains the county's emergency medical services system. More than a year ago, St. Luke Medical Center in northeast Pasadena closed its doors.

"Every ER that closes in L.A. County puts greater pressure on our system, which is already overwhelmed," said Carol Gunter, acting director of the Los Angeles County Emergency Medical Services Agency.

At Methodist Hospital in Arcadia, about five miles south and the closest hospital to Santa Teresita, officials are preparing for a 25% increase in emergency room patients. "It will mean about one more person an hour, about 24 more patients a day," said Lynn Ingram, a spokeswoman for Methodist Hospital.

She said the hospital had been talking to members of the nursing staff at Santa Teresita in the hopes of hiring them.

Santa Teresita was founded in 1930 as a tuberculosis sanatorium by the Carmelite Sisters of the Most Sacred Heart. It became a fully accredited hospital in 1956, and its campus covered 14 acres in Duarte.

Many of its nurses have worked at Santa Teresita for 10 to 30 years because they are committed to working for a Catholic hospital, said the nursing supervisor, Mark Cline.

Although Sister Clines did not have figures on layoffs, she said many of the hospital's 475 employees would stay on because most of its operations are linked with its skilled nursing facility and other clinics. "

This may only be the beginning. The CEO was just on the news stating the new ration law is to blame.

[tlynsmith]

I agree with everyones view. What is sad is people like my sister the CNA, mental healthworker, etc loosing their jobs. My sister was told today pink slips will be issued in 21 days. It will be based on your attendance, work performance, etc if they keep you. If the hospital decides to bring them back they have a year to return Lets face it, it is not enough nurses for this transition. I do not understand why they will not create flexible nursing programs instead they encourage nurses from other countries to come work. I am sorry these nurses were and are a huge problem in the hospitals. No bedside manner! I am not speaking of one occurance I have witness. I am speaking of several issues I have noted. I guess CA feels they have to do what they have to do......... I hope for the best because the best is what the patients deserve!

Teresa

[caroladybelle, BSN, RN]

Gomer,

I am one of those travelers of whom you speak.

And I do not want to work with a ratio of 1:9 or greater.

I have dealt with more than enough employers that lie/misstate patient and staffing numbers and acuity. The levels of up to 13 patients, including a so-called stable C1 Halo braced Quad Vent patient, and multiple ones on chemo/blood - at a facility that consistly ranks in the top 50 nationwide. That with 1 shared PCA.

I never said that the care in facilities with higher ratios are poor. But they can be the greatest nurses in the World and they are still going to have more potential for deathes/injury to the patients and themselves at a poorer ratio. And if you are the one that is injured, when studies have clearly demonstrated the dangers of poor staffing, what will you do?

I also have heard the crap about how they will eliminate support staff. Well, at my current facility, there is little to no support staff and what is there is highly unsupportive. And I still have 9 patients on and evening shift with blood and chemo to hang.

If travelers are phased, trust me, as a traveler that has excellent references and hospitals fighting over me, I have plenty of places to go.

[mayberry]

If John Q Public really had ANY idea of what goes on and were educated as to why ratios were a good thing for thier own health and livlihood - perhaps everyone (including nursing) would benefit:idea:

[WyomingRN]

Your right Mayberry. Education is the key. And here is a great chance to educate the public. For the next two - three weeks California nurses should be sending in a stream of letters to the editors of all the newspapers and radio stations. Send them the information out of the "play book". Send them directly to individual reporters. Send them directly to disk jockeys. If these people got 3 or 4 thousand letters over the next two weeks, the facilities move just might backfire. But the nurses in California have to take the time to write the letter and then send it to several people. With all the nurses in California, why isn't the public being educated? Aparently, the nurses in Califrornia don't want to educate the public and the California Nurse Association is as worthless as Wyoming's is. Now I remember why I don't waste my money on it.

[Agnus]

l understand what you mean by monopolies. However, lets assume the majority of hospitals close. There will still be just as many sick people. People receive nursing care in places other than hospitals. Right now that is where the majority of nurses are employed but it does not have to be that way.

Contrary to what you say I assume the patients received the best care the that was humanly possible under the circumstance.

I say let the hospitals close. Once this happens there will be a public outcry. Demands and pressure will be placed by the public to reopen hospitals. What a wonderful oportunity to educate the public for the need to have sufficient RNs to care for them. What a wonderful oportunity to educate the public as to the reason nurses leave the profession and others do not enter. This is poor treatment of nurses and working conditions provided by hospitals. It is high time the public knew this is critical to the self interest of every person with health concerns.

The public will not pay a bit of attention until this hits them where they live and they can see the direct effect on their own health care. Once they do they will not stand for closures or (if you educate them) poor staffing.

I disagree once more that the hospital is dependent on the nurse not the other way around. Just because the majority are employed by hospitals does not suggest that the majority can only function in a hospital. If every hospital in the world closed today there would still be nursing care provided to the sick and injured. Actually that would probably create more jobs for nurses as we would be providing more individulized care instead of mass care in confined institutions. No I am not worried about my hospital job. and neither should you be.

[Sheri257]

After watching the report, I definitely got the sense that this hospital had other problems besides ratios. For one thing, they had absolutely no cash reserves whatsoever.

Plus, there could be more to the story here. Their website still says they're hiring, yet they only gave 24 hours notice to the staff about closing. Something else could have been going on here.

I would worry about this more if other hospitals closing but, for now, this could be an isolated incident.

[imenid37]

I f hospitals had treated their nurses well, paid them well, and not tried to replace them w/ "cheap help" at every turn, there would not be mandated ratios. Nursing ratios weren't introduced because the hopsitals were playing fair. I hope to see them spread. They are not perfect solutions, but at least they are something. A person can only keep a limited # of pt's straight at one time. The conditions at my facility on the med-surg floors are apalling. I am glad I work OB, but am furious when I get pulled to med-surg because they are tx'd like crap and have an impossible job. We had a bonus sytem for extra shifts but they took it away. Now there's no help. Gee....I wonder why???