Registered nurses and caregivers gathered outside Palomar Medical Center Poway on Friday morning to protest what they say were unsafe working conditions during the COVID-19 pandemic, a claim which the healthcare system described as "appalling" and "irresponsible."
The disagreement stems from a waiver Palomar Health received from the California Department of Public Health on Wednesday which allows the Poway campus to assign one intensive care nurse to care for up to three patients, depending on patient acuity. Nurses say they are already overworked. In late April, Palomar Health laid off 317 employees, which the union members said exacerbated issues.
"Palomar Health is already not providing enough supportive services and adding more patients in an assignment to nurses or even caregivers at a time like this is unconscionable," said Grace Vicente, a certified nurse assistant at the Poway campus.
Palomar Health spokesman Derryl Acosta said the claims were sensationalized as the hospital prepares for a possible influx of COVID-19 hospitalizations. COVID-19-related hospitalizations around the county have nearly tripled in San Diego County in the past month -- from 354 on Nov. 10 to 939 reported Thursday.
"To suggest we are prioritizing anything other than patient safety and public health during an ongoing pandemic is appalling," said Acosta in a written statement. "As a healthcare system, it is irresponsible to instill fear in our community. These false allegations by the union are frightening and endanger the health and safety of our community by discouraging people with serious conditions from seeking medical care."
According to Palomar Health, the waiver only applies to one 12-bed unit which has both intensive- and intermediate-care patients located in the same area. The hospital says the waiver has not been implemented, but is in preparation for a potential patient surge or reduction in workforce due to sickness.
"The effect of the waiver will always be determined by the level of care the patient requires and reduces ICU patient holds in the emergency department," Acosta said. "Like many other health systems, Palomar Health is appropriately and proactively increasing capacity to care for our community during this ongoing and unprecedented pandemic."
The protesters, members of the California Nurses Association and Caregivers and Healthcare Employees Union, said the move is shortsighted and places patients and health care workers at risk, and negatively impacts nurses' ability to deliver safe care.
"We know safe nurse-to-patient ratios save lives," said Joanne Meza, a California Nurses Association representative and registered nurse who works at the Poway campus intensive care unit. "We know what it's like when we don't have ratios — we become overworked and patients suffer. We are already exhausted — a waiver does not help anyone."
Meza also said there are other issues at the hospital.
“Palomar claims that they took a hit due to the pandemic. But it is the nurses and caregivers that are taking the hit in the forms of increased patient loads, unsafe staffing levels and inadequate PPE and struggling to fight back dangers of co-mingling of patients," she said.
Palomar Health CEO Diane Hansen said their organization has always provided safe medical care and would never put patients or staff at risk.
“We do our best to cohort the COVID patients in one area and the non-COVID patients in another area, so there is absolutely no co-mingling of patients," Hansen said. "We are doing, as we have from the onset of this pandemic back in March, absolutely everything we can to keep our patients, our staff, our physicians as safe as possible.”
Hansen added that Palomar Health is still trying to add more staff.
Nurses say the hospital's decision to apply for the waiver is premature and Palomar Health administrators who applied for the waiver have not taken sufficient preventive measures to protect patients from short-staffing or provided adequate personal protective equipment.
The hospital denies that claim.
"Palomar Health rejects the nurse's union contention of unsafe patient conditions and inadequate PPE," Acosta said. "We regret the union felt compelled to take this level of action during a pandemic after getting upset they weren't notified of the waiver approval sooner."
California Nurses Association represents about 1,400 nurses at Palomar Health Hospitals. The Caregiver and Healthcare Employees Union represents about 1,700 ancillary caregivers.
