For Immediate Release:  Friday, June 26, 2020

CONTACT: Terry Carter, (805) 312-0024 Shamezo Lumukanda, (818) 652-3260 Hal Weiss, (213) 247-4585

Nurses’ frustration levels skyrocket as hospital’s lack of safety before & during pandemic continues. They strike over cuts to staffing and other changes implemented unilaterally by the hospital.

Riverside, CA–Registered Nurses at Riverside Community Hospital (RCH) gathered, marched, and spoke out today on their first day of a 10-day strike. Nurses made the difficult decision to strike following a breakdown in discussions over patient and Nurse safety issues directly related to dangerously low staffing levels in the hospital. Last year, even before the COVID-19 pandemic struck, Nurses successfully urged the hospital to increase staffing and end many of its unsafe practices, which resulted in an improved staffing agreement. Recently, the hospital ended that agreement.

“The need to re-use PPE combined with low staffing has left me unable to even take a sip of water at times for up to eight hours,” said Erin McIntosh, a Rapid Response Nurse. “But when we pled with the hospital to provide breaks so we can remove our mask, drink water, get some nutrition, use the restroom—they were unmoved.”

“Those of us responding to coding patients are often forced to stay at bedsides for five, six, seven hours because the hospital doesn’t plan for emergencies or schedule enough ICU Nurses,” said Erik Andrews, RN. “That means there's no one left to respond to codes or critical patients except the Charge Nurse, forcing them to leave their 30-bed ICUs unattended.”

“Scores of my colleagues have COVID-19 due to lack of safety measures in the hospital—more ill RNs than any other hospital in my Union,” said Monique Hernandez, a Charge Nurse. “Two staff members have died. So, when the hospital walked away from our safe staffing proposals, it was really the straw that broke the camel’s back. Enough is enough.”

“The hospital should be taking extra precautions during this pandemic,” said Kathy Montanino, another Rapid Response RN at the hospital. “The hospital continues to cut corners and take risks with Nurses’ and patients’ lives. By ending the agreement, hospital administrators have basically sent a message that regardless of the number of patients, they don’t have to ensure that there are enough Nurses to care for them.”

Although a dangerous lack of PPE has been a problem at all 121RN hospitals, HCA hospitals were particularly unprepared for the pandemic, even when the Union asked them for their staffing, health and safety, infection control and preparedness plans regarding the disease on February 6—well before COVID-19 evolved into a pandemic. In a union-wide member survey, it was the wealthy HCA hospitals that had among the lowest marks for PPE (survey results here).

At the same time, the hospital’s parent company, Healthcare Corporation of America, just received $5 billion in federal bailout money, meant to be used to keep patients and frontline caregivers alive (not to wage war with them). On top of that, the hospital chain was so profitable last year that they took $2 billion to buy back their own stock and pay shareholder dividends.

Nurses will continue their strike through July 6. Contract negotiations begin on July 7, where the Union will focus on staffing, health and safety, including hospital preparedness during states of emergency.

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SEIU Local 121RN represents registered nurses and other healthcare professionals in California. This member-led organization is committed to supporting optimum working conditions that allow nurses to provide quality patient care and safety.

— FACT SHEET —

Riverside Community Hospital 10-Day Safe Staffing Strike

Last year, even before the COVID-19 pandemic struck, Union Nurses’ Staffing Issues Committee successfully urged the hospital to increase staffing and end many of its unsafe practices, which resulted in an improved staffing agreement. Recently, the hospital ended that agreement. They then rejected Nurses’ proposals to extend that agreement or continue discussions on safe staffing.

To Nurses, that refusal means:

• Fewer RNs are expected to take care of more patients, even with an increased risk of COVID-19 infection during this pandemic due to insufficient PPE, recycling of single-use PPE, lack of support staff, and inadequate safety measures.
  • Immediately after the safe staffing agreement expired, the hospital increased Nurses’ patient loads in the COVID-19 unit. Nurses say that the nurse-to-patient ratio should be 2- or at the most 3-to-1 for these patients, due to the amount of care required, the absence of support staff, and the donning/doffing of PPE. The hospital has now increased that ratio to 4-to-1. Nurses say this means that isolated COVID-19 patients now go hours without seeing a Nurse or being attended to in any way, in a closed room without family or friends. Days later, the hospital also began violating the state’s nurse-to-patient ratio regulations in its Telemetry and Cardiovascular ICU units.
• Legally-mandated rest breaks and meal periods will continue to be treated as optional.
  • Administrators continue their failure to provide break and lunch relief to exhausted nurses wearing masks, shields and other PPE for 12+ hours. The hospital would rather have Nurses pursue penalties than provide them with time to get water and nourishment.
  • Nurses report going 8 hours straight or longer without ever being able to remove their mask for even one sip of water.
• RCH can require meal/break relief RNs to take on non-meal/break relief duties.
• The hospital will continue to cram in more patients than Nurses can safely care for—including transfers from other hospitals—even if it has exceeded the hospital’s licensed bed capacity on a particular unit, or doesn’t have adequate staff for a particular licensed bed type per Title 22.
  • Last year, the hospital agreed to stop taking non-Trauma transfer patients when it reached capacity, but now they can continue taking more patients than it has the staffing resources to care for.
  • Earlier last year, CDPH temporarily closed the E.R. to all transfers after an investigation after Nurses’ reports of dangerous short-staffing.
  • While the hospital boasts of its short wait times in the E.R., Nurses report that in fact patients can wait for hours virtually unattended, with only one RN checking vitals for as many as 40 waiting patients.
• Although they have been cited by CDPH and CMS, hospital administrators feel they can resume their unsafe practice of assigning patients to its Mobile Intensive Care Nurses (MICNs), when MICNs must be available to answer the Emergency ambulance calls and to determine the level of care needed by persons brought to the Emergency Dept. by ambulance or helicopter.
  • Per title 22 and Trauma/REMSA guidelines, an MICN cannot be involved in direct patient care because it would delay Emergency care. It's also required as a trauma certified hospital.
• By stepping away from the mediated settlement, RCH administrators send a message that they believe they can resume asking new RN candidates interviewing for positions at the hospital if they will accept assignments that force them to be out of state-mandated nurse-to-patient ratios.
• Charge Nurses can be forced to split their attention between patient care and responsibility for their entire unit—sometimes more than one unit or area.
• Per Diems will not be placed back on the schedules as they were prior to the hospital’s decision to remove them all from the schedules and essentially put them “on-call.”  Many times, Per Diems have found out that there was a lack of coverage for the units they might have worked.
• During this pandemic, the hospital stopped staffing COVID-19 patients at the recommended ratios. They do not have a waiver from the state allowing this dangerous practice. Also, a supervisor’s request to put an RN out of ratio no longer needs to be made in writing.

As if Nurses didn’t have enough challenges with the short-staffing issues, the hospital refuses to take extra precautions during this pandemic, instead cutting corners and taking risks with their lives and the lives of their patients:

• Staff are dying. Scores of RNs at RCH have fallen ill with COVID-19 (more than at any other hospital where SEIU Local 121RN represents members). Two recent deaths of RCH support personnel—an environmental services worker and a lab technician—have not caused RCH to improve staffing or increase PPE. The hospital appears to view these valued staff as dispensable casualties.
• There’s a dangerous lack of personal protective equipment, which staff need to safely care for patients. Although it’s been a problem at other hospitals, HCA hospitals were particularly unprepared for the shortage and didn’t handle it well. In a Union-wide 121RN member survey, it was the wealthy HCA hospitals that had some of the lowest marks for available PPE (survey results here).
• The hospital continues to aggressively ration items for “future needs.” Nurses say that the hospital is conserving the wrong resources—save staff, not masks.
• There was and continues to be poor adherence to the OSHA mandated directive to ensure all staff are notified of all possible COVID-19 exposure.
• Nurses know that there’s no such thing as a unit that can be considered "clean" of the disease.
• Many Nurses are afraid that they’re likely spreading the disease to otherwise uninfected patients.

At the same time, RCH Nurses work for the largest, wealthiest for-profit healthcare corporation in the nation:

• HCA is in an amazingly good financial position. The had so much in profits last year that they took $2 billion of their profits to buy back their own stock and pay shareholder dividends. They had planned to do an additional $2.8 billion buyback of their own stock—in other words, they have nearly $3 billion in play money to get them through the pandemic without a scratch.
• On top of that, they got another $5 billion in federal bailout money—$1 billion of it that they never have to pay back—our taxpayer dollars.
• Here’s another way to look at this corporation:
• Between 2015 and last year, HCA’s annual income went from $39.7 Billion to $51.3 Billion—so in 5 years they increased their annual income by 29%.
• At the same time, though, they went from $2.1 billion in profits in 2015 to $3.5 Billion in 2019. That was an increase of 65% in annual profits.
• So how did they do that? How did 29% more in income turn into 65% more in pure gravy profits? By cutting corners, that's how. By understaffing. By refusing to provide break relief. By not having enough PPE on hand.
• While the coronavirus pandemic is devastating many of the smaller hospitals across the country, this is just a very survivable quick station stop on the HCA gravy train that keeps churning out money for its CEO and shareholders.