Patient Load Is Shifted to Private Care : Nurses, County Meet as Doctors Extend Protest

Nurses resumed talks with county officials Saturday as doctor trainees continued their job action at Los Angeles County-USC Medical Center and private hospitals grappled with a surge in indigent patients who were diverted away from the troubled public system.

Many services at County-USC Medical Center were slowly being resumed Saturday after Friday’s court order had ended a three-day nurses’ strike. Nurses were back on the job, but union officials said they were “keyed up and watchful” as they await word on their demand for a 19.5% pay increase over the next two years.

County Chief Administrative Officer Richard Dixon said that talks that went into Saturday night resulted in “no concrete progress.” However, he said, “a more positive atmosphere reigned than has been the case in the past.”

Effect of Order

Despite the temporary order barring them from striking, “The nurses will do informational pickets before and after work,” promised Betsy Hamilton, spokeswoman for Service Employees International Union Local 660, which represents about 5,000 county-employed nurses.

Rick Cordova, an administrator at General Hospital in the downtown complex, said employee shortages created by the strike forced the hospital to pare its patient count from 1,400 to 800. He said the hospital was diverting emergency cases, delaying elective surgery and sending some non-critical patients home earlier than usual.

“Heart attacks and other intensive care medical cases are being treated elsewhere, but we will gradually reopen these services shift by shift,” Cordova said.

Private hospitals, which accepted scores of indigent emergency patients who normally would have been treated at county hospitals, reported overflowing emergency rooms in the downtown area.

“Some private hospitals have hired nurses from registries to staff extra beds and many have told us that they are full or beyond capacity, some with more patients than they have ever had,” said David Langness, vice president of the Hospital Council of Southern California.

‘Working Well’

“We have opened an extra wing and have all kinds of cases--medical, obstetrical, surgical and some criticals,” said a nursing supervisor at California Medical Center downtown. “We’ve had some nurses coming in for extra shifts, but everything is working well.”

Meanwhile, residents--young doctors who are undergoing hospital training--continued to protest for a second day, occasionally leaving their picket line at County-USC to check on bedridden patients inside. About 30 of the hospital’s residents were involved in the job action; 66 were scheduled to be on duty Saturday.

The doctor trainees are disputing the county’s plan to “contract out” physicians by placing new residents under a pact with USC instead of the county.

Wesley Noritaku, a pathology resident, said the residents are concerned about whether USC will honor a special fund established by doctor trainees in 1974 which spends $1.45 million a year on medical equipment and materials the hospital cannot or will not buy.

The fund, financed by the doctor trainees’ own salary increases as part of their contract, is currently controlled entirely by the residents. It was recently used to pay for heart monitors and intravenous solution poles used to carry the bags that dispense intravenous liquids, according to residents.

Carrying the Bag

“You never see a patient carrying their IV bag at Cedars,” said Monty Polonsky, a resident in internal medicine.

He said medical care at the hospital “will get worse” if USC takes over from the county. “We will not have any say so.”

While county officials expressed concern over the action by the doctor trainees, most of their attention Saturday was focused on the negotiations that followed last week’s unprecedented nurses’ strike.

The strike, the first by nurses in the county’s history, hit County-USC and two other downtown hospitals, as well as three outlying hospitals and 50 county-operated clinics and health centers.

County Administrator Dixon indicated that the county plans to stand firm on its offer of a 14.5% wage increase over the next two years.

“That is our last, best and final offer,” and is higher than any other offer made by the county to 29 bargaining units representing thousands of county employees who have already settled their contracts, he said.

Militant Viewpoint

However, union spokeswoman Hamilton said that if the county fails to increase its offer “there will be very serious risks.”

She said nurses are being called to mass meetings at noon and 6 p.m. Monday, in a location not yet determined.

Union officials said nurses believe that the three-day strike gave them the upper hand in talks that have failed to progress in six months.

The nurses’ negotiating position is also buoyed by a nationwide nursing shortage that looms particularly large in California, union officials said.