Strike by Many County Nurses Slashes Care

A nurses strike hit Los Angeles County’s vast public hospital and neighborhood clinic system Tuesday, sharply reducing care at facilities that serve thousands of low-income patients and provide emergency treatment throughout the county.

Local 660 of the Service Employees International Union, which represents the 4,000 nurses employed by the county, launched the strike at 5 a.m., after the collapse of negotiations.

Union officials claimed that about 60% of the day-shift nurses remained off the job, a figure that County Health Director Robert Gates said “might be in the ballpark.”

Participation Drops

But when the evening shift reported to work, strike participation had dwindled to 42%, according to figures released by the health department. Absenteeism ranged from 85% at Martin Luther King Jr./Drew Medical Center in South-Central Los Angeles and 60% at Harbor-UCLA Medical Center in Torrance, to 27% at County-USC Medical Center.

At 200-bed Olive View Hospital in the San Fernando Valley, 16 of 22 night-shift workers stayed away and at the 106-bed High Desert Hospital in Lancaster, two of the nine night nurses struck.

In response to the strike, county officials curtailed treatments, diverted ambulances from emergency rooms, discharged patients early, accepted no new transfers from private hospitals, closed outpatient clinics and put doctors and supervisory personnel to work doing jobs usually performed by nurses.

On Tuesday night, Los Angeles City Fire Department helicopters were deployed to transport critical trauma victims, who would normally be sent to county hospitals, to private emergency medical facilities.

One victim of a double shooting at Maple at 29th streets was airlifted to St. Joseph’s Medical Center in Burbank, fire officials said. A teen-ager who was shot in the chest in the 3100 block of West 8th Street was flown to Childrens Hospital.

County supervisors took a hard line after a closed-door afternoon meeting with their negotiators.

Supervisors Chairman Deane Dana, a Republican on the officially nonpartisan board who has favored a tough stand in labor talks, said the negotiating team recommended “that we should hold firm and we concur.”

“We believe we will be able to operate for several days,” Dana told reporters. “People in the hospital are being served adequately.”

Supervisor Ed Edelman, a Democrat with strong ties to organized labor, said, “It appears we are on a collision course without much hope of resolution.”

Dana said no negotiations were scheduled. County negotiator Elliot Marcus said he opposes resuming talks while the nurses are on strike.

Negotiations broke down shortly after 3 a.m. when union negotiators turned down a county offer of a 14.5% pay increase over two years or 20% over three years. Nurses’ representatives asked for a 19.5% hike over two years.

Scenes from the strike, first ever by county nurses, ranged from traditional picket lines around hospitals to unhappy patients turned away from appointments.

Outpatient Clinics Close

Kristen Hicks, 21, drove more than 50 miles from the fringes of Palmdale to Olive View Hospital for an appointment with a dermatologist for treatment of a painful rash.

“I can’t believe no one can see me,” she said after finding out that her appointment was canceled. She was told she would have to wait three hours in the emergency room for treatment.

At County-USC, all 50 outpatient clinics, which serve about 900 patients a day, were closed. Administrators shifted patients from ward to ward and discharged as many as possible.

One key area, the medical admissions office, where patients are sent after emergency care, was so crammed with ill people at 9:15 a.m. that it was impossible to walk through it. Many of the patients were waiting for admission for intensive care for ailments such as heart attacks and gastrointestinal bleeding. County-USC is the largest hospital in the system, with 1,454 beds.

At King hospital, which has a capacity of 350 patients, 59% of the nurses failed to report for the morning shift. As at the other county hospitals, the emergency room was closed to all but life-threatening cases.

At Rancho Los Amigos Medical Center in Downey, nationally known for orthopedic surgery and rehabilitation, “We have been able to maintain the rehabilitation programs,” administrator Yokoyama Susumu said. “So far I would say morale is good. In a crisis situation, people really rally.”

Rancho Los Amigos Actions

At the burn unit at Rancho Los Amigos, only one of six nurses showed up, said Gina V. Baldemore, head nurse. Because of that, she said, regular bath treatments for burn victims were postponed. “They can forgo it for a day but you risk infections if you wait much longer than that,” she said.

The one nurse, Liz Feliciano, said she volunteered to work without pay. “I do believe in the strikers and it’s not easy being the only one here but it’s also not easy to think of those patients not getting adequate care.”

Olive View Medical Center administrators canceled all but emergency surgeries and admissions and sent 10 patients home early, according to Administrator Douglas Bagley.

More than 300 were turned away from the hospital’s outpatient clinics, all of which were shut down by the strike.

Strikers, their cause sanctioned by the Los Angeles County Federation of Labor, AFL-CIO, saw their picket lines respected by other union members. At King hospital, a Teamsters Union truck driver refused to cross the picket line. But the laundry inside got delivered anyway when a hospital staff member drove the vehicle to the hospital, King officials said.

One county official, who spoke on condition that he not be identified, said he believed that the supervisors and their staff had become convinced that the nurses would back down after a few days on strike. That, the source said, explained the hard line.

Union leaders, however, said they were determined to hold out for an immediate and large pay raise.

The union is seeking a retroactive increase to Oct. 1, and a series of boosts early in the contract to quickly bring Los Angeles County nurses up to the general range of those working for private hospitals. The county has refused the retroactive request, saying it would add several million dollars to the cost of the contract.

County officials have agreed that nurses are currently underpaid but that the county offer would bring them up to what Dana called “somewhat above” the private sector level.

Another issue is the wording of contract provisions dealing with grievances and levels of staffing. County officials want more freedom in handling grievances, nurses want strong language to prevent understaffing.

As the first day of the strike drew to a close, county officials faced a new threat from another group of medical practitioners, the interns and residents.

Unhappy with the county’s handling of a separate issue, the Joint Council of Interns and Residents scheduled a strike vote at 5 p.m. today, according to union official Dr. Mark Segal. That vote comes after a long dispute between the doctors and the county over the county’s desire to turn over portions of the county hospital system to private enterprise, with the interns and residents working for the private operators.

Segal said a physicians walkout was not imminent. But even the threat of a doctors strike could strengthen the hand of the striking nurses.

Pressure on both sides to settle could come from private hospitals. While not affected in the short run, these facilities could be financially affected if the strike continues.

Dr. Sol Bernstein, medical director of County-USC, said that when indigent patients are taken to private hospitals for emergency treatment, they are eventually transferred to county facilities. The county is required by law to care for indigents. But with county facilities refusing most admissions, the private hospitals will be forced to treat indigents, at payment levels far below those of patients with private insurance.

Times staff writers Stephanie Chavez, Alan Citron, Gerald Faris, John Hurst, Victor Merina and Claire Spiegel contributed to this story.