Quick Take
Administrators at Watsonville Community Hospital say they’ll need to make difficult decisions to keep the hospital operating, which doesn’t sit well with nurses. Meanwhile, there’s a staffing shortage in the hospital’s intensive care unit, and nurses are rallying to keep it and other essential departments open.
Soon after a union news conference Wednesday afternoon, nurses and fellow health care workers dressed in red shirts and scrubs packed into a small conference room where the board of Watsonville Community Hospital had just met. The nurses wanted clarity from hospital leadership about the status of its intensive care unit as talk of a potential closure spread. The board wanted staff to understand the hospital’s current budget crunch and the difficult decisions hospital leadership will face in the coming months.
WCH CEO Stephen Gray told several dozen nurses that the hospital had learned one of the staffing agencies it uses for travel nurses was pulling staff from the facility because the hospital couldn’t make the large up-front payment the staffing agency was asking for. As a result, Gray said, three night-shift nurses were removed from the ICU.
“That’s a pretty big percentage of our night-shift ICU staffing,” he said. In total, the department has 22 nurses, and typically each shift has up to four nurses.
Roseann Farris, a registered nurse at the hospital, said ICU nurses, physicians and other front-line workers were “blindsided” when they heard the department could potentially close the ICU as a result of losing travel nurses. “It’s not only a threat to the safety of all patients in the hospital, but a threat to the broader community,” Farris said Wednesday afternoon.
However, hospital leadership denied that there were currently any serious plans to close the ICU. Gray said a big decision like that would be a worst-case scenario and requires months of discussion and public input.
Gray added that the hospital reached out to the ICU nurses and their union immediately to discuss solutions to the sudden staffing shortage. Day-shift nurses are filling some of those empty night shifts in the interim. Over the next few weeks, nurses will be rotating shifts, while hospital leadership work towards finding solutions and recruiting full-time staff nurses for those positions, he said.
“I want to acknowledge that this has caused a lot of consternation, and that’s totally understandable because it felt like the hospital was closing — or potentially closing — the service, but that wasn’t the intent,” said Gray.
If the hospital’s governing board were to close any department, it would be a monthslong process, said board chair Tony Nuñez. “We have to be cognizant about the impact that we might have on health care in general in this region,” he said.
Nuñez said he told nurses that the board and the community need to start talking about what it would look like if hospital leaders have to make the tough decision to close a department, as the hospital braces for lost revenue due to sweeping federal spending cuts to Medicaid.
The hospital expects to lose between $4.5 and $10 million over the next three years, in large part because the Republican budget reconciliation bill passed in July cuts nearly $1 trillion in funding for the Medicaid reimbursements that public hospitals rely on.
Nunez said the hospital is considering other sources of funding and partnerships. “We also have to start to think about what does Road B look like? What does Road C look like as well?” he said.
Last summer, the hospital board began its search for potential partnerships with regional hospital chains, such as UC San Francisco, CommonSpirit Health (manager of Santa Cruz’s Dominican Hospital) and Sutter Health, to help manage the hospital’s day-to-day operations and cover costs. Nuñez said the board hopes to find a partner within the first half of the year.
Nuñez also added that the hospital is working on acquiring funding through the Rural Health Transformation Program. The federal program is meant to help rural health facilities across the country such as Watsonville Community Hospital.
Farris and other nurses reminded the board what could happen if the ICU ends up on the chopping block – patient deaths and further loss of staff – and offered to help with finding solutions.
“What I see today is that we are in a financial crisis, and we’re desperate enough to start cutting parts of our hospital that are vital,” said Louise Pierce, an ICU nurse. “What will be left and how will our hospital function without its vital parts? Let’s come together to find a solution.”
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