Operating Against the Numbers : Medicine: Gang fights keep St. John’s hospital hopping. And the county medical center overflows with people seeking care for minor problems.

There was a time when the emergency rooms at St. John’s Regional Medical Center and the Ventura County Medical Center were quiet on Saturday nights.

But not anymore.

In the wake of a surge of gang violence in Oxnard in the last few years, St. John’s sometimes resembles a ward in a battle zone. As doctors work to save the lives of the city’s wounded youth, fellow gang members sometimes try to duke it out in the waiting room.

And at the Ventura County Medical Center, officials struggle to care for a steady stream of people--almost all without insurance--who need care for relatively minor problems.

The emergency rooms at St. John’s and the medical center are the two busiest in the county, with about 91,000 people treated at the two locations last year--an increase of about 30% over a decade ago.

It is not unusual anymore for St. John’s, a private Catholic hospital in the heart of the oldest section of Oxnard, to put out “code yellow” calls to let staff know they have a major medical emergency. Extra doctors and nurses then stop what they are doing and run to the emergency room.

Sadly, officials at St. John’s say, a greater number of the trauma cases involve young victims of gang violence, an escalating problem on Oxnard’s streets.

So far this year, there have been nearly 35 cases of gang violence in the city. Most of the wounded have turned up at St. John’s.

Doctors at the Oxnard hospital estimate that St. John’s treats three or four victims of shootings or stabbings each week. Several years ago, it saw one or two victims a week.

“We not only see the gunshot wounds and the stab wounds but the hand-to-hand combat just from fighting,” said Allen Hooper, the doctor in charge of the emergency room.

And the hospital has been faced with another problem--gang confrontations in the waiting room.

“After a gang shooting, a whole ton of people show up,” said Debbie Laubscher, a nurse at St. John’s. “Sometimes the rival gangs come in to try to finish the job.”

Laubscher said one night a gang member wielding a pipe sneaked in the back door. He was thrown out of the building, she said.

Tim Worley, director of security at St. John’s, said hospital officials are asking the gangs in Oxnard to declare the hospital a neutral zone.

He hopes the issue will be resolved within the next few months.

Complicating matters, St. John’s has 14 beds in its emergency room, forcing staff at busy times to place beds in the hallways to handle the overflow of patients.

The emergency room at the new St. John’s hospital, scheduled to open next summer, will have 20 beds, plus state-of-the-art equipment, officials said.

“Ten years ago, our population (of patients) was about 20% to 30% lower,” Hooper said. St. John’s officials estimate that they cared for about 36,000 people last year. Of that number, 20% needed emergency care, 50% needed non-life-threatening urgent care and 30% came for primary care.

At the county medical center, officials estimate that of the 53,000 patients the hospital treated last year, 10% needed emergency care. Routine care accounted for 70% of the visits and urgent care accounted for 20%.

Most of the patients seen at the hospital either are uninsured or have MediCal benefits, hospital officials said.

“Because the hospital is county-funded, we see a lot of primary care,” said Nat Baumer, director of the emergency room at the county medical center.

Increasingly, Baumer said, patients who turn up in the emergency room are there because they cannot afford a private doctor. Under law, the hospital cannot turn away anyone who is sick.

“A lot of people who come here have nowhere else to go,” nurse Pauline Green said. “That’s why we see so many people with sore throats and colds.”

People with less serious problems can expect to wait at least two hours to see a doctor at the county hospital on a busy night.

Baumer said he knows of a case where a little girl died because her parents got tired of waiting and took her home without seeing a physician.

“They waited about an hour on a Saturday night,” said Baumer, who has been working in the emergency room since the 1970s. “The child ended up dying of dehydration, something that could have been avoided if they had waited for a simple dollar-and-a-half IV.”

The hospital staff members assess each person’s ailment when he or she walks in the door to establish priorities and avoid such tragedies, he said.

“Our job is to select out those who need emergency treatment, and then focus on them while 30 other people wait,” Baumer said.

On a recent Saturday night, Baumer took a sip of strong coffee, put on a white smock and made his rounds. Nearly a dozen patients waited behind curtain walls. The waiting room was packed.

“We make order out of chaos,” Baumer said. “That’s our job.”

One man needed treatment for pneumonia; another required stitches on a finger that was sliced to the bone.

A 3-year-old boy was bleeding from the eye and a little girl was covered with a rash.

Then, shortly after 9 p.m., Rosalba and Augustine Abarca rushed in with their son, Juan, who was suffering a serious asthma attack. The boy’s skin was turning purple as he struggled to fill his lungs with air.

Baumer put out a call for extra help and several pediatric specialists converged on the emergency room to render assistance. Within minutes, Juan, 6, was breathing normally.

After the boy was transferred to the pediatric unit, Baumer continued visiting patients with more routine ailments.

“I just hit a stride and I keep on going,” he said.

But Baumer said the hospital is offering alternate care to those not facing medical emergencies.

Over the past year, the medical center has opened several outpatient clinics--in Oxnard, Ventura and Santa Paula--to try to cut down on the number of primary-care patients seeking treatment at the emergency room.

“I think it is the most efficient way to care for people,” Baumer said. “It frees up the emergency room for emergencies.”

Baumer estimates that at least 500 people who would have been seen in the emergency room have been diverted. Even so, the hospital’s emergency room continues to be jammed.

“We are just going to keep getting busier and busier,” Baumer said. “There will never be a shortage of work. There will never be a shortage of patients.”