Westlake’s ER Staff Is Bitter About Closing

The most monumental injuries the emergency room doctors at Westlake Medical Center tended to Monday were a dog bite and a broken leg.

Not surprising, considering the ambulances stopped coming last Friday and the sign for the emergency room disappeared over the weekend, replaced with a hand-lettered note spelling out ER in red magic marker.

As the emergency room was set to close its doors today at 5 p.m., that left the staff little to do but watch as the last entry point to the 25-year-old community hospital turned into a ghost-town clinic.

“It’s emotional packing up,” said nurse Marlene Whitwam, who started working at Westlake in January 1973. “Everybody has been on the verge of tears all day. If anybody looks at us cross-eyed, we start to cry.”

After weathering months of uncertainty since international hospital conglomerate Columbia/HCA acquired the small hospital in late 1994, the emotions of emergency room employees ran the gamut from resignation to outright bitterness about the closure. They’ve known their fate since January, when Columbia announced plans to sell the hospital, but it’s still hard to face.

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“It’s sad,” said Dr. John Kudirka, a 10-year veteran of the Westlake emergency room. “We’ve been together a long time. Morale is down. This has been a big family in the ER. When you work with trauma, you work as a team.”

Kudirka, who will practice at Los Robles Regional Medical Center once Westlake closes, said Tuesday’s closure will leave the area dangerously low on emergency services.

Los Robles, also owned by Columbia/HCA, is only a few miles from Westlake as the crow flies, but Kudirka said the time ambulances spend on the freeways can make a critical difference. Patients from Malibu, Agoura, Calabasas and Westlake Village as well as eastern Thousand Oaks will be rerouted to Los Robles in central Thousand Oaks.

“I’m really afraid for the community,” Kudirka said. “They don’t understand--a few minutes can save a life.”

Hospital employees plan to hold a rally at 8:30 a.m. Wednesday to protest the closure. They still hope the new owners of the facility, cancer specialists Salick Health Care Inc., will decide to keep the emergency room open when they convert the full facility to a cancer treatment center.

Sources said Salick’s purchase agreement with Columbia does not allow the Los Angeles-based company to compete directly with Los Robles. But employees said a good showing at the rally could persuade Salick to break the contract.

“If there are a lot of people here it will send a very clear message to the new owners,” said emergency room director Frank Gillingham.

Columbia/HCA announced plans to sell Westlake and shut down the emergency room in January, saying the facility was no longer profitable. But some members of the medical community said the closure had little to do with Westlake’s profitability.

Physician Barry Pollack, who has worked at Westlake since 1991, said he believes the real issue is competition with Los Robles. He asserts that Columbia/HCA deliberately chipped away at Westlake’s resources for the last year to decrease its business viability.

“If they say any different, it is just smoke and mirrors,” Pollack said. “Their intent is to eliminate the competition. The bottom line is, I think it’s wrong.”

Through a spokeswoman, a Columbia/HCA official declined to comment Monday on the company’s motivation for selling Westlake.

While the patient load was dwindling at Westlake, preparations were underway to accommodate the increased number of ambulance deliveries and walk-in injuries at Los Robles.

Mary Lajcik, manager of the Los Robles emergency room, said the hospital plans to have two physicians on staff at all times from now on instead of one. A waiting room has been converted to hold more beds, increasing the number of available emergency beds from 11 to 17, she said. The waiting room is being expanded into another part of the hospital.

When Westlake stopped receiving ambulance traffic over the weekend, Lajcik said Los Robles did not feel much of an impact.

“We were steadily busy, but we did not have an increase in census,” she said. “What we did notice was a few more ambulance runs.”

Nurses and doctors at Westlake said they have heard of patients waiting three or four hours to be seen at Los Robles. Lajcik said she had not heard about that incident and that patients at Los Robles are usually seen “within the hour” they arrive.

Despite the Westlake emergency room’s lame duck status--many community members thought it closed down months ago--the staff said they have seen a number of critical patients in the last week, demonstrating the need for a second emergency room in the Conejo Valley, they say.

They point to the construction worker who fell two stories and pierced his liver last week, saying he would have died if he hadn’t had his accident just blocks away from Westlake. Then there was the man who walked in from his home across the street with a dangerously slow heartbeat. And the woman whose husband stopped breathing in Westlake’s parking lot while she ran in to get medical attention.

“From a moral and ethical standpoint, this community should have a hospital,” Gillingham said.

Gillingham and the other doctors at Westlake said they aren’t concerned about their own careers. It’s easy for them to pick up shifts at other hospitals. But they said they worry about the nurses.

Some are going to work in Simi Valley, some at Columbia’s hospital in West Hills and about three or four of them, including 24-year veteran Whitwam, are headed to Los Robles.

For Whitwam, things will be different at Los Robles. Instead of having a secure job with benefits, she’ll be paid per diem. All her seniority will be lost and she expects to be working many night shifts. She’ll also lose the camaraderie she came to love at Westlake.

But in the past year of waiting, Whitwam said she’s learned a lesson. Medicine is business, just like anything else, and in business, merging, slashing and downsizing are the norm.

“I don’t hate Columbia,” Whitwam said. “I just think this is a sign of the times.”