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By Miriam Raftery

Photo via CHEU:  Palomar Healthcare nurses at a protest earlier this month

December 29, 2020 (Escondido) – Registered nurses and caregivers will hold a car caravan from Palomar Medical Center to Palomar Health’s administration building today to protest a blanket waiver of nurse-to-patient ratios approved by the state Department of Health Tuesday. Nurses contend that the change is dangerous for patient safety.

The action comes as the California Office of Emergency Service announced plans to activate a vacant floor of Palomar Medical Center to handle COVID-19 patients. National Guard members arrived Wednesday to complete a buildout of the surge unit begun earlier this year. Hospital ICU units across Southern California are completely full, with zero capacity, currently due to COVID cases that have increased ten-fold locally since early November. CNN reported yesterday that one of every 1,000 Americans have now died of COVID-19.

San Diego County reported 1,751 cases countywide, bringing the county’s total COVID-19 cases to 147,530. Of those, 3.9% have been hospitalized.  Of patients hospitalized locally, 20.9% have been admitted to an ICU unit.  Another 22 deaths have been reported from Dec. 18 through Dec. 27, including patients ranging in age from their 30s to 90s.  Around 9% of tests last week came back positive as community outbreaks reached 59 in the past week.

“We must put patient safety first,” says Pacita Balcom, CAN and representative of the Caregiver and Healthcare Employees Union.  “The hospital must think outside the box and invest in patient care instead of taking the easy way out.

“We are already exhausted. A waiver does not help anyone,” says Sue Phillips, RN.  Caregivers call the hospital’s decision to seek the waiver premature and claim more should be done to protect patients from short staffing.

State law requires one nurse for every two patients in an intensive care unit. The waive would allow three patients – two mid-level and one ICU patient, per nurse.

In Northern California, Sutter Health Calfornia Pacific Medical Center and the UCSF Medical Center rescinded their applications for state waivers of nurse-to-patient ratios after protests by the California Healthcare Employees Union.

Nurses also contend that Palomar has been mixing COVID-19 and non-COVID patients, exacerbating unsafe conditions, and that there is not enough personal protective equipment (PPE).

Diane Hansen, president and CEO of Palomar Health, denied that claim as “false” in an interview with CBS 8. But she acknowledged, The nurses do have a right to be concerned…we’re concerned about the safety of our nurses, the safety of all of our staff, the safety of our physicians as well as the safety of our community.”

Palomar Health spokesman Daniel Acosta said more bluntly, “Palomar Health rejects the nurse’s union contention of unsafe patient conditions and inadequate PPE.”

She also denied arguments that the decision to apply for the waiver was premature. 

Chris Van Gorder, chief executive officer at Scripps Health, speaking at a county health briefing Wednesday, read a letter from an emergency room physician voicing dismay at people flocking to malls and restaurants in defiance of stay-home orders.  “Soon we could be in a situation like Italy or New York City, when all we will be able to offer a critically ill patient will be nasal cannula oxygen, causing numerous individuals who could be saved to needlessly die.”

Miriam Raftery, editor and founder of East County Magazine, has over 35 years of journalism experience. She has won more than 350 journalism awards from the Society of Professional Journalists, San Diego Press Club, and the American Society of Journalists & Authors. Her honors include the Sol Price Award for responsible journalism and three James Julian awards for public interest reporting from SPJ’s San Diego chapter. She has received top honors for investigative journalism, multicultural reporting, coverage of immigrant and refugee issues, politics, breaking news and more. Thousands of her articles have appeared in national and regional publications.

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Welcome to the rest of the US

Only 14 states have laws in place for nurse ratios. Does it make it safer for the patients/nurses, sure, but it obviously is not the end all as its not widely adapted. Face it, it sucks, there are WAY too many people getting sick for our hospitals to even attempt to stay afloat. We are holding ICU's in the ER by the dozen, RNs all the sudden becoming ICU nurses with no official ICU training. You can't expect nursing ratios to stay in place, its absolutely impossible to maintain the ratio. We haven't even seen anything yet, mid January is going to be an absolute nightmare. I also highly doubt these hospitals can just "fix" the issue buy hiring nurses. #1 there just is not enough nurses, #2 the chances of the nurses being inexperienced (new grads or people returning to the field) would be more dangerous than removing the ratio. To all those "anti maskers" saying COVID death rate was nothing, THIS is the issue we were trying to prevent. Overloading our hospitals will cause deaths because we can't give the care we could otherwise. Not just COIVD patients either, this is going to effect every aspect of healthcare and the ability to give life saving care.