Nurses and supporters outside Watsonville Community Hospital on Tuesday.
(Kevin Painchaud / Lookout Santa Cruz)
Health & Wellness

Watsonville Community Hospital nurses protest staffing issues, virtual doctors, as contract negotiations begin

Nurses at Watsonville Community Hospital held a news conference Tuesday to highlight the departure of 42 nurses since new public ownership — Pajaro Valley Healthcare District — reduced the number of part-time positions available. They say they want a union contract with the district that addresses this and other daily challenges nurses face at the hospital.

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Nurses from Watsonville Community Hospital say changes to employment arrangements at the publicly owned facility have led to an exodus of health care workers, causing labor shortages they warn are risking patient care.

The group of dozens of nurses held a news conference outside the hospital Tuesday night as part of a nationwide day of action hosted by National Nurses United to call attention to what they say has been a large-scale departure of nurses from the hospital. The news conference comes after the nurses union and the district held their first bargaining meeting last week for a new contract. The most recent contract expired May 15 and has been extended for 30 days.

The workers say the hospital has lost more than 42 nurses since it transitioned to public ownership last year and reduced the number of part-time positions available. Those nurses who remain say they are stretched thin. The nurses say they also face other daily issues at the hospital, such as broken or damaged equipment that does not work in critical situations, and the use of virtual doctors, which creates barriers to providing the best care, especially for people who are critically ill.

“The loss of large numbers of nurses and continued loss of our nurses is just one layer of a very big problem,” said Tiyana Shields, a registered nurse in the hospital’s intensive care unit. “A lot of us are scared for the safety of our patients, for our licenses, for our ability to work and be good nurses.”

Quiché Rubalcava, a registered nurse in the emergency unit who has worked at the hospital for 20 years, pointed to a decision the hospital’s administration — Pajaro Valley Healthcare District — made last year to reduce the number of part-time positions available to nurses and convert 90% of the nurse workforce at the hospital into full-time workers.

He said the 42 nurses left the hospital because they could not accept a full-time position due to life circumstances, like caregiving responsibilities at home. Ultimately, Rubalcava said, nurses want the hospital administration to provide the option for more part-time nursing positions.

“These nurses want the administration to restore the flexible scheduling we once had,” Rubalcava said. “For these nurses who have experienced the pandemic, the bankruptcy, and believe in this hospital — that’s what they’re asking for, that’s why they’re here. Because they want that work-life balance back.”

Nurses and supporters outside Watsonville Community Hospital on Tuesday.
(Kevin Painchaud / Lookout Santa Cruz)

Interim hospital CEO Matko Vranjes said the previous model of part-time nursing did not work because there were gaps in staffing that had to be filled by contract nurses. It was also not economically sustainable, he said, because when part-time staff agreed to work additional hours, which many did, they were compensated at a higher rate, sometimes time and a half, but in most cases double time.

“We had part-time nurses that were earning really high six-figure incomes, so closer to $300,000 as a part-time [employee],” he said. “And it just was not economically sustainable for the facility.”

Watsonville Community Hospital declared bankruptcy in December 2021 following 20 years of for-profit ownership and annual losses of about $20 million. A coalition of nonprofit organizations and local governments launched a fundraising campaign to purchase the hospital and transfer ownership to a newly created health care district.

The Pajaro Valley Health Care District became the official new owner of the hospital in September and immediately launched plans to both to make the hospital profitable again and to regain trust of the community that had felt neglected by non-local, for-profit owners. In addition to renegotiating contracts with its insurance company partners, the district said it had to change staffing schedules to cut back on costs.

After becoming the official new owner of Watsonville Community Hospital this past September, the district reduced part-time nursing positions from 112 to 18. Part of the reasoning behind the decision, they said, was to create a consistent full-time workforce and reduce reliance on costly traveling nurses.

Nurse Tiyana Shields speaks to the gathering outside Watsonville Community Hospital on Tuesday.
(Kevin Painchaud / Lookout Santa Cruz)

When the hospital’s nurses learned that the transfer of ownership would come with a big change in their shift schedule, they denounced the decision and said it would deteriorate the already unsafe working conditions at the hospital.

The hospital, led by then-CEO Steven Salyer, pressed on, saying it was a difficult but necessary decision. Salyer served at the hospital for just under two years before he announced his resignation in March. Days after that announcement, the hospital appointed Vranjes, the hospital’s current chief operating officer, as interim CEO as it searches for a permanent replacement.

Vranjes said Tuesday that since the reduction of part-time positions, the number of traveling nurses on site has gone down. He said the hospital was in compliance with the number of nurses it is required to have staffing each shift in accordance with Title 22, a state code that regulates nurse-to-patient ratios.

Vranjes also said the hospital’s administration is working to bring more doctors to the hospital in person. With ownership of the hospital back in public hands, he says he’s hopeful the facility will be able to upgrade equipment.

“We are an organization that just exited bankruptcy,” he said. “We’ve gone through many years of different ownership and different levels of investment. And the beauty of our situation now is that we’re publicly and community owned as a nonprofit. All of the funds that we generate through patient care will be reinvested in the organization.”

Annabelle Covington, a registered nurse in the labor and delivery unit who has worked at the hospital for over 20 years, said the hospital has continued to lose nurses consistently even after the exodus of those 42 nurses immediately following the reduction of part-time positions. She said that has created unsafe staffing levels in her unit.

“We are short staffed on every single shift, on every single floor,” Covington said. “We do try to hire new nurses, but when they come into a situation, they’re scared, they don’t want to stay.”

Shields, the ICU nurse, said staff shortages at the hospital also have to do with decisions by management about how many nurses are permitted to be on the floor during a shift.

Nurse Barbara Schubach outside Watsonville Community Hospital on Tuesday.
(Kevin Painchaud / Lookout Santa Cruz)

“When I come to work, what kind of moral strains am I going to have to put up with? If we only have two nurses on the floor and we need four and I’m watching the patients suffer for that, that’s not why I got into nursing,” Shields said. “I’ve actually called for help, saying I need another nurse here now in a critical situation and I was told that we did not have one. That should never happen. Ever.”

Vranjes said the district’s administration is open to suggestions about what might work to address the challenges nurses are facing.

“We’re really trying to demonstrate that this is a different day, a different era. We, as community members, own the hospital, and so there’s not a corporation that’s here trying to dictate our direction to us and trying to forward their initiatives,” Vranjes said. “As a community, we’re trying to accomplish something and trying to make sure that this organization is sustainable and here for our community for many years to come.”

Vranjes said the health care district is currently making progress in its search for a new CEO and that he is very pleased with the pool of candidates. In the coming months, candidates will go through a screening and interviewing process by an ad-hoc committee of board members. Vranjes said the district hopes to have a candidate selected by the end of July or August.

Despite Salyer’s departure, Vranjes said, the administration has continued to move forward with a strategic planning process. The board hired Chartis, a health care consulting firm, to shepherd the district through this process of creating a new organizational plan for the next three to five years. The district expects to have a draft strategic plan in place by the end of July.

— Hillary Ojeda contributed to this report.


FOR THE RECORD: This story has been updated with additional information from interim hospital CEO Matko Vranjes, on the Pajaro Valley Healthcare District’s CEO search and strategic planning process.