“It doesn’t matter where you live. If you’re driving down the 105 or 605 and you’re in an accident, this is your hospital. This is where you will be coming,” said Scott Byington, RN, president of the UNAC/UHCP affiliate at St. Francis. “Sometimes our whole ER has to function with only five nurses. And our ER is always packed with patients waiting to be triaged.” Byington is a mobile critical care nurse at St. Francis, which means he’s part of a crew that responds to trauma emergencies throughout the hospital. 

Prime Healthcare bought St. Francis Medical Center through bankruptcy in 2020, terminated 20% of the experienced RNs, cut RN pay by 12%, and instituted a three-year wage freeze—during the pandemic, even as RNs risked their lives every day with inadequate personal protective equipment. Now the hospital is dangerously understaffed nearly every day on every shift. RN turnover since Prime took control has been more than 50%.

The RNs at St. Francis have filed more than 6,000 staffing objection forms with California’s Department of Public Health (CDPH) just since June of this year. Each of those objections represents an instance when a unit and shift were short staffed in violation of California’s Title XXII safe nurse-to-patient ratio regulations.

“They make short staffing a standard of care here, and it’s just really sad for the community,” said Byington. “Many times, California Department of Public Health has been here. They acknowledge our complaint, they say yes, you’re right, and they haven’t done anything. 

“Why would any hospital want to violate the law? It’s not about the contract language; it’s about me dealing with people’s lives every single day,” Byington said.

The St. Francis RNs represented by UNAC/UHCP and the ancillary and technical staff represented by SEIU-UHW are in separate negotiations with Prime right now for new contracts at St. Francis. The RNs’ contract prior to the bankruptcy set standards for patient care and wages among nurse union contracts in the region and the country. In 2020, bankruptcy forced a substandard contract on the RNs, which Prime in negotiations seems determined to maintain.

“The short staffing is severe and it’s only getting worse,” said Mayra Castaneda, an ultrasound tech at St. Francis, and leader within SEIU-UHW. “The patients are hurting, the nurses, the techs, the entire hospital. Just recently we had to divert patients and ambulances to other hospitals because we didn’t have the staffing in the emergency room, we didn’t have the staffing in ICU.”

Prime has rejected every proposal nurses have made for safer patient care, including:

• commitments to following Title XXII’s nurse-to-patient ratios
• training for new nurses before they’re assigned to critical care units like ICU and ER, rather than after they’ve been thrown into these challenging assignments—Prime’s current practice
• rules for nurses to float (take a temporary assignment) only to units for which they have been trained

RN turnover at St. Francis was 24.01% in 2017-2019—before Prime took over in 2020. From 2020 to 2022, RN turnover more than doubled to 50.42%. That’s also more than double the national average for RN turnover in 2022 of 22.5%.

On August 29, hundreds of St. Francis registered nurses and support staff joined an informational picket in front of the hospital to protest the chronically unsafe staffing and other unsafe patient care practices.

Prime has acknowledged at the bargaining table that their pay for nurses is among the lowest in the surrounding area.

In addition, Prime management has committed unfair labor practices (ULP) during contract negotiations with both unions, leading to charges filed by the unions with the National Labor Relations Board. This means the strikes by the two unions will be ULP strikes, which lends extra legal protection to the striking workers.

“We are not going to back down,” said Charmaine S. Morales, RN, UNAC/UHCP President, who addressed the crowd during the informational picket. “We said enough is enough and we mean it. Enough is enough. For the sake of patients and the community, we need safe staffing. We are depended on. It is unacceptable what is happening in this hospital. Shame on Prime.”

United Nurses Associations of California/Union of Health Care Professionals (UNAC/UHCP) represents more than 35,000 registered nurses and health care professionals in California and Hawaii, including optometrists; pharmacists; physical, occupational and speech therapists; case managers; nurse midwives; social workers; clinical lab scientists; physician assistants and nurse practitioners; hospital support and technical staff. UNAC/UHCP is affiliated with the National Union of Hospital and Health Care Employees and the American Federation of State, County and Municipal Employees, AFL-CIO.

Jeff Rogers | [email protected] | 909-263-7230

Anjetta Thackeray | [email protected] | 909-455-5146

SOURCE United Nurses Associations of California / Union of Health Care Professionals