Strike Gets Ailing Babies’ Lives Off to a Shakier Start

In her pajamas and slippers, Luc Alvarez hovered tearfully near the elevator of the Women’s Hospital at County-USC Medical Center Tuesday afternoon as the paramedics wheeled away an incubator carrying her newborn twins.

It was a painful introduction to motherhood for the 17-year-old, who gave birth four days earlier to premature babies weighing less than 3 pounds each.

There were lots of tears Tuesday, as parents were told that a strike by county nurses had hit the hospital’s newborn intensive care unit with such force that infants had to be transferred to private hospitals as far away as Newport Beach and Ventura County.

In portable incubators equipped with oxygen tanks, intravenous pumps and cardiac monitors, the sick and tiny patients were whisked away by paramedics. “We even called some hospitals in Kern County, too, because we heard they had some beds,” said Dr. Nancy Edwards, a neonatologist.

Babies in the newborn intensive care unit receive some of the closest supervision and most costly care in the hospital. The infants suffer from a variety of ailments and complications; about a third have been born prematurely. Hospital officials began transferring babies out of the unit on Monday in anticipation of the strike.

Moving dozens of sick babies on such short notice meant that doctors placed infants wherever they could. Dr. Wendy Dauer said that a baby whose parents live in Downey ended up at Ventura County Medical Center. A baby from Woodland Hills was transferred to Hoag Memorial Hospital in Newport Beach. Childrens Hospital of Orange County accepted some babies, as did several hospitals in Los Angeles County.

Informed of the pending transfer, one mother got so upset that she had to be sedated, said social worker Wendy Kohlhase. “We’ve been yelled at and cried on,” she said.

Dauer, who helped shuttle the infants, said, “We tried to keep them close to their homes, but it’s been impossible.

“We’ve got them scattered all over the place,” she said. “It upsets me . . . but I know the babies will get better care this way. We can’t guarantee what will be happening here.”

The parents of these infants are virtually all poor, most live in downtown or East Los Angeles, and many do not own cars. Now they’ll have to “ride five buses or 10 buses” to visit their babies, Dr. Dauer said.

Round-the-Clock Care

Some of the babies in the newborn intensive care unit weigh as little as 1 1/2 pounds and they all require round-the-clock care from specially trained nurses, half of whom did not report to work Tuesday morning.

Doctors did some of the work normally done by nurses. Nursing supervisors also helped out. But hospital officials decided that the best thing to do was to reduce the number of patients.

Of the 40 infants under treatment at the Women’s Hospital on Monday, 10 were sent home with plenty of special hospital feeding formula and lengthy instructions for care. Ten had been transferred out by noon on Tuesday, and 10 more were on their way out Tuesday afternoon. About eight are expected to remain in the hospital as the strike continues. Some are part of an important study whose results would be jeopardized by a transfer, said Dr. Edwards. Others will not be accepted by other hospitals for certain medical reasons.

The mother of one such baby, Carolina Ramos, spent the whole day beside her baby’s incubator after a doctor asked her to assist in diapering and watching over her infant. “I come every day anyhow,” she said, “but usually I don’t stay this long.”

‘This Is a Catastrophe’

Finding spots for the babies was complicated in some cases by financial considerations. Women’s Hospital Administrator Martha Galaif said that placing two infants at UC Irvine Medical Center in Orange was delayed by a discussion of how much money the hospital, which is owned by the University of California, would be reimbursed for the care.

“I told them this is a catastrophe over here. No Los Angeles hospital is making these kinds of demands.”

The private hospitals filled up fast, Dr. Edwards said, because all the county hospitals are competing for spots.

Half the nurses in the newborn intensive care unit at Martin Luther King Jr./Drew Medical Center in South-Central Los Angeles failed to report to work Tuesday morning, said Ruby Grant, nurse manager of the unit. By day’s end, hospital officials had transferred 14 of the 20 babies who were in the unit Tuesday morning.

“We’re trying to transfer them to other facilities,” said Dr. George Franco, “because it’s not safe with the staff we’ve got. Somebody will get hurt. . . .”

Ethics Questioned

Franco questioned the medical ethics of the strike but acknowledged that the nurses have legitimate grievances.

“I don’t know who’s to blame, whether it’s the county or the nurses, that people aren’t here to care for the babies. . . . I can’t believe either side has the patients in mind,” he said.

At Harbor-UCLA Medical Center, six of the 14 infants in the newborn intensive care unit were transferred to nearby hospitals by the end of the day.

Doctors at Women’s Hospital got on the telephone themselves and called their colleagues at private hospitals, trying to line up beds.

At one point, near panic set in when a free bed was located at Cedars-Sinai Medical Center for a baby--and the child’s parents could not be immediately located to give their consent.

“Call a judge and get permission fast, or that bed is going to be taken!” a doctor yelled.

After a series of calls, personnel in the Department of Children’s Services granted permission. Officials were preparing to notify the parents by telegram when the mother was finally found--standing over her baby’s incubator.

“I guess we were so busy we didn’t see her come in,” said Kohlhase.