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Letter to the Editor:
Nurses Say Kaiser Oakland Is Shortchanging Patients
Let me begin by stating two simple truths.
One: The front line staff at Kaiser Permanente Oakland are dedicated to insuring that patients receive the best and most appropriate care possible.
Two: The Kaiser Permanente Hospital system is the MOST fully integrated health care delivery system in the world.
But despite these ‘truths’, inpatient care as we have come to expect it, is under threat from the corporate practices that are in essence designed to unnecessarily put profits before patient needs.
Let’s talk about facts.
According to a report, “Nursing Shortage Fact Sheet,” published by The American Association of Colleges of Nursing, the number of new RN positions needed by the year 2020 will be 1.2 million. That includes nearly 500,000 replacement RNs who will leave the profession for expected reasons (retirement, illness, etc). The shortages are expected to hit hardest in the South and the West. Turnover rates are running about 14% with vacancies stagnating at about 8%. In the Northern California Kaiser system that would would put conservative shortage estimates at about 1500 RNs across the region. There has not been a meaningful new graduate program in the Kaiser Oakland (or any KP Northern CA facility) for greater than five years now.
Kaiser corporate states that California Nurses Association is “distorting the facts” and that it is “not trying to cut positions.” Distortion, as it turns out, is Kaiser’s corporate game plan. While it may not be eliminating positions, as RNs leave the system, the vacancies created are actively being blocked from being re-posted at the regional level. That leaves fewer and fewer RNs at the bedside to deliver the same level of care.
Couple that practice with regionally directed, stricter “criteria” that compromises a physician’s ability to admit based on independent assessment of the patient and you have a recipe for disaster. I have asked doctors directly if they are feel pressure to not admit to the hospital and the majority answer “yes”, but none would make such an admission on the record for fear of reprisals.
Claude Watts (identified in your article as interim senior VP and area manager for KPEB) made several statements that are based, in part, on distorted propaganda.
1. “And if there are fewer nurses in a specific unit, it’s because there are fewer patients present.” (See comments above r/t to corporate meddling in the admission process.
2. “We pride ourselves on taking care of our patients and being fair to our employees.”
A. On 9/20/13, in a letter sent to RNs homes from Anita Zuniga, (VP of Patient Care Service, Kaiser Foundation Hospital & Health Plan) advised that the because of “CNAs lack of agreement” with fixing “imbalances that leave hundreds of nurses idle each day” that KP would suspend the “No Cancellation” clause of our contract that guarantees our hours. Keep in mind, this is the 3rd time in 5 years KP has come to the union to correct “imbalances” it created by mismanaging RNs schedules through poor oversight. This last round of talks consisted of KP announcing what it intended to do to correct it’s own mistakes and then refused to budge one iota away from that plan during bargaining. I was there at the table during these discussions. KP management wants what it wants, end of discussion, no bargaining what-so-ever. Sacrificing 10-25% of your income each time you miss a shift is what KP calls fairness.
B. November 2013, Kaiser closes Hayward Inpatient Pediatrics redirecting patients from that area to Oakland. In a letter from Charlene Boyer, CNO KPO delivered to RNs after this announcement stating the action would consolidate Pediatric resources and that pediatric patients could be taken care of by RNs with specialized pediatric training. On paper, looks good. In practice, if your child is 14 or older, weighs >50kg and has a particular diagnosis, that child gets shipped to an adult floor regardless of whether or not there is an available bed in pediatrics. 22 RNs were displaced by that action. Outgoing CEO George Halverson got a $6,000,000 bonus on top of $3,000,000 salary for meeting “benchmarks” (read, “cuts”). That 2 million dollar bonus would have funded Kaiser Hayward Inpatient for another 2 full years!!
I could go on, but it’s easy to see what’s really happening.
I keep hearing, “the face of health care is changing”. More accurately, the face of health is being changed, and not for the better.
Reduction in services, overworked and understaffed units , incentives for patients being denied appropriate care, huge profits, obscene bonuses. Shame, shame, shame.
Craig Cedotal RN
Kaiser Permanente Oakland
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