National Nurses United

National Nurse magazine July-August 2014

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8 N A T I O N A L N U R S E W W W . N A T I O N A L N U R S E S U N I T E D . O R G J U LY | A U G U S T 2 0 1 4 NEWS BRIEFS CALIFORNIA T here are many aspects of Jenevieve Jaylani Dagatan's untimely death that remain a mystery, but one thing that appears clear is that the 6-month- old baby was not even seen by a pediatrician until almost 12 hours after her worried parents brought her into the Kaiser Perma- nente Hayward emergency room on two separate, consecutive visits in the middle of the night on April 4, 2014. The incredible delay that little Jenevieve suffered before actually being examined by a pediatrician and receiving appropriate treat- ment is exactly what pediatrics RN Kristine Richter and her colleagues feared would happen when Kaiser announced in 2010 that it would be shutting down its Hayward hospital's inpatient pediatrics unit and not opening one up at its replacement hospital in nearby San Leandro. Despite the opposi- tion of RNs, members, parents, government officials, and community residents, Kaiser closed the unit in November 2013 with little communication to members—just five months before Jenevieve and her parents walked through the doors of Kaiser Hayward's emergency room. The giant hospital chain claimed it could provide better care by consolidating pediatric servic- es in Oakland and Santa Clara, but essen- tially left members in southern Alameda County without any local facility to take their sick children. Despite posting record profits of $2.7 billion in 2013, the pediatric unit closure was just one of many patient services in recent years that Kaiser has cut, consolidat- ed, or restructured in a huge push to keep patients out of the hospital and treat them at home, which is the cheapest—but not neces- sarily the best or safest—site of care. For example, at its Manteca hospital, Kaiser has so drastically cut services that RNs and the patient community fear the hospital will be shut down entirely. So as 18,000 Kaiser registered nurses and nurse practitioners opened contract negotiations in late July, reversal of this wholesale degradation of patient care within the system is high on their list of bargaining demands. When Kaiser representatives failed to show up to their first scheduled bargaining meeting with RNs on July 31, the nurses marched to Kaiser's nearby headquarters and took over the lobby to deliver their opening statement. Nurses detailed how call center nurses are overburdened because of too-early discharges and how patients are blocked from in-person medical appointments; how urgent care clinics have been closed or had hours reduced; how patients are held in emergency rooms or under observation status for days instead of being formally admitted; how patients are inappropriately placed in units providing lower levels of nurs- ing care than they actually need; how labor and delivery and newborn nursery units are routinely and dangerously understaffed; how surgery is being sped up too quickly; and how patients are being prematurely discharged home or into hospice settings. "When Kaiser closed the pediatric hospi- tal unit in Hayward for 277,000 southern Alameda County patients over the objection of nurses and community members, we told Kaiser it would be dangerous," reads the nurses' statement. "We, the 18,000 Kaiser Baby's death exposes danger of Kaiser's service cuts, say RNs as they start negotiations

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