County Gears for Walkout by 5,126 Nurses

With a strike by 5,126 nurses looming for today, Los Angeles County-run clinics and hospitals prepared Wednesday to drastically scale back their operations--including diverting ambulances to private hospitals, discharging or transferring patients and postponing non-emergency surgery.

A walkout, set to begin at 12:01 a.m., appeared imminent--unless a last-ditch effort by Board of Supervisors Chairman Ed Edelman to settle the dispute between the county and the nurses over pay and working conditions produced an end to the stalemate.

Edelman, a former federal mediator, summoned both parties to his Hall of Administration office Wednesday afternoon. Both sides met for several hours with Edelman, but had reached no accord by late afternoon.

About 5:20 p.m., Edelman emerged and told reporters:

“We’re hopeful that before the evening is out we will reach some kind of settlement. We may be getting close.”

Hospital officials predicted that even a short strike could overwhelm the county’s sprawling public health care system and would severly impact private facilities, where most of the patients would be transferred.

When the nurses struck for three days in January, 1988, the county’s emergency and trauma services were severly curtailed, filling emergency rooms at private hospitals in cities throughout the county.

In that dispute a Superior Court judge ordered the nurses back to work.

On Wednesday, county health officials scrambled to draw up contingency plans to handle a nursing shortage, including training doctors and mapping out transfer plans for hundreds of non-critical patients.

“Our health care system is so depleted and so fragile that every element has to be functioning, or all the elements are strained,” said David Langness, a spokesman for the Hospital Council of Southern California. “If you lose one element, then the entire system begins to back up so any contigency plan will only work well for a short amount of time.”

County officials have said they will seek a court order, as they did in 1988, directing the nurses to return to work.

Union negotiators said they did not yet know what they would do if ordered back to work.

The nurses, represented by Local 660 of the Service Employees International Union, AFL-CIO, want a 22% pay raise over the two year life of the contract, plus increased security, such as security guards to escort nurses to their cars at night.

The county Tuesday night made a “last, best and final offer” of a 17.25% increase over two years.

The full impact of a strike at six county hospitals and 47 clinics, should it occur, was not expected to be felt until 7 a.m., when the morning shift begins, said Deborah Williams, an emergency room nurse at County-USC Medical Center and a member of the union negotiating team. Nurses who began work at 11 p.m. Wednesday were expected to finish their shifts, she said.

“There’s a lot of anger out there,” said union spokesman Steve Weingarten. “The nurses are mad at the wages that they’re getting. They’re mad that the county just stood up and walked out” of negotiations.

County nurses--who currently earn between $2,600 and $3,000 a month--claim they make less money than nurses working at private hospitals.

“We want something that is going to rebuild the health care network, not to mention take care of the stress of the nurses,” Weingarten said.

The potential effects of the strike already were felt at several county facilities Wednesday, when the majority of the county’s 64 nurse anesthetists staged what a union official called a wildcat sick-out, forcing postponent of surgeries.

Edward J. Foley, administrator at Harbor UCLA Medical Center, said the sickout forced the closure of three operating rooms at the 553-bed facility in Torrance.

Officials said the emergency rooms at Harbor and Martin Luther King Jr./Drew Medical Center already were filled to capacity and would only accept critical care patients. County officials said the number of patient transfers would depend on the number of nurses who stay off the job.

Richard Cordova, administrator of General Hospital, part of the 1,450-bed County-USC Medical Center complex, said he expects the hospital to begin discharging patients early and diverting ambulances to other facilities.

County hospital administrators said they would also postpone scheduled surgeries for non-critical patients, including heart bypass and abdominal operations.

“The emergency room remains open, but we will ask paramedics to take patients to private hospitals,” Cordova said. “We will probably look at closing down the outpatient services,” where patients walk in for non-emergency care, such as immunizations or routine medical appointments.

“We could take some cases, but there is no way we would be able to take the current workload,” he said.

The giant hospital treats 500 patients in its emergency room each day.

Cordova said he expects some nurses to report to work, supplementing non-union nursing supervisors. He said that when the nurses struck for three days in 1988, the hospital cut in half its number of patients, from 900 to 450.

A recorded telephone message at union headquarters advised nurses:

“After several days of continuous negotiations, county management declared impasse and refused to continue negotiations. Efforts are being made to get the county back to the bargining table.”

Nurses are planning to set up picket lines outside of hospitals today.

Dorothy Moreland, a recovery room nurse at Martin Luther King hospital in Watts, said the effects of the potential walkout could already be seen at the facility Wednesday.

“The recovery room is packed with patients, because they are trying to get all of the patients out of the way before (today),” she said.

In addition, she said that several nursing supervisors skipped work Wednesday, because they knew that they “would have to pull long hours tomorrow.”

County health officials said management employees, including non-union nurses, were prepared to work 16-hour shifts today should there be a strike.

Negotiators met all day and into the night Tuesday in their 20th bargaining session, attended by about 40 people.

Union officials claimed the county broke off talks without giving the union time to “sleep on” the county’s final offer.

But county negotiator Jim Ellman said the union refused to meet any further. He said he has asked the county Employee Relations Commission to appoint a mediator, but, “My impression is that the union is not interested in mediation.”

The parties can either voluntarily agree to a mediator, or the employee relations commission can order one. The commission is not scheduled to meet until Oct. 20.

“We’re prepared to go to court if we need to,” Ellman said, but he declined to say when the county would file a suit similar to the one that resulted in the 1988 court order against striking nurses.

Times staff writers Andrea Ford, Edward J. Boyer and Hector Tobar contributed to this story.

BACKGROUND

Last year, 5,000 Los Angeles County nurses struck for three days before a judge ordered them back to work. They set a deadline of 12:01 a.m. this morning to again walk off the job in a salary dispute with the county, threatening to cause havoc to the county’s vast hospital and neighborhood clinic system that primarily serves low-income patients. The nurses, who have demanded a 22% pay raise over two years, say they are paid far less than those who work in private hospitals. The county has offered a 17.25% raise over two years.