County-USC Attempting to Get Services Back in Gear

County-USC Medical Center will attempt today to reopen all its emergency services and outpatient clinics and some operating rooms after a week of ongoing labor unrest among nurses and young doctors at the center, county officials said Sunday.

“It’s a huge facility, and, like a big ship, it’ll take us awhile to steer it back to normal,” said Richard Cordova, administrator of General Hospital, one of the four hospitals at the huge medical center complex. “We’ll just have to assess hour by hour to see what staffing is available.”

General Hospital usually has nearly 1,400 patients. On Sunday, Cordova said, it had 783. The patient load was reduced by a combination of discharges, attrition and transfers to other hospitals, he said. Only limited emergency room services were available.

Ordered Back to Work

The nurses were out on strike for three days last week but were ordered back to work by a court order Friday. They have obeyed that order pending a court hearing on the issue scheduled for Feb. 10.

The Joint Council of Interns and Residents, which represents doctors in training at the center, declared a strike Friday and set up picket lines. But most doctors continue to check on patients.

Contract negotiations continued Sunday between county officials and the Service Employees International Union Local 660, which represents 4,000 nurses employed by the county. Both sides reported that the atmosphere of the talks had improved slightly over the weekend, but that no progress on major issues had been made.

Won’t Authorize Transfers

Douglas Moul, secretary-treasurer of the Joint Council of Interns and Residents, which represents the more than 800 doctors-in-training, said council policy will be to treat patients brought into County-USC on an emergency basis but to refuse to authorize their transfer to wards on the hospital.

“If the faculty (USC medical professors who work at the hospital) wants to transfer patients onto the wards from admitting, they can do that,” Maul said. “But then they’ll have to assume responsibility for their cases.”

The organizations representing the nurses and young doctors contend that unsafe conditions abound at the county hospitals because of a shortage of nursing staff and other reasons.

As County-USC has reduced its patient load, some other hospitals, especially those in the central area of Los Angeles, have felt the impact.

An overcrowded White Memorial Hospital closed admissions Sunday and was taking in only “clear emergencies,” a spokesman said.

“It’s been very, very difficult,” said health supervisor Bernice Hawkins. “We’ve had so many babies born, we’ve got patients in the delivery room waiting for beds.”

Esther Rama, owner of Sharp Nurses Inc., a nursing registry, said one of her supervisors broke down in tears trying to find nurses for hospitals demanding them over the weekend.

“I’m desperate,” she said. “For today, there’s none left (on my list). Some people are already working full time during the week and are back on now over the weekend.”

Full Schedule by Tuesday

Cordova said General Hospital plans to resume some elective surgery today and, if all goes well, resume a full operating room schedule Tuesday.

A separate controversy arose at the busy Women’s Hospital in the medical center, where one of every 200 babies born in the United States is delivered.

According to the Joint Council of Interns and Residents, USC’s chairman of the department of obstetrics and gynecology threatened the doctors-in-training in a mandatory closed-door meeting late last week by suggesting he would be unable to give anyone who went on strike the necessary recommendation to take the annual board exams.

That department head, Dr. Daniel R. Mishell Jr., is president of the American Board of Obstetrics and Gynecology. The board administers the exams that formally certifies physicians in obstetrics and gynecology.

‘A Direct Threat’

“It was a pretty direct threat,” said one young doctor who refused to give her name.

“Everybody was dumbfounded . . . because he’s the big honcho. He helps write the questions, administers the exams. When he says that if you go out on a strike that’s unauthorized time, well, you can’t perceive it as anything less than a threat.”

Mishell said in an interview that he told the young doctors that they can take no more than one month vacation during the year and two weeks’ sick time to qualify to sit for the board examinations.

“I just tried to explain what the risks were to them . . . because they could have thought they could go out and be risk free,” he said. “I just didn’t see how they could take time off now because most of them had already used their vacation and those who hadn’t hadn’t requested vacation time to go on strike.”

In the ongoing contract negotiations, nurses are seeking a 19.5% pay raise over two years. The county has offered 14.5% for two years or 20% for three years. According to the unions, salaries for county nurses and supervising nurses range from $24,936 to $34,536 annually.