Union: UC hospitals not prepared for crisis

UCSD Medical Centers in La Jolla and Hillcrest are among hospitals that the University Professional and Technical Employees union is warning may be ill-prepared to handle the influx of patients that would follow a terrorist attack.

UPTE represents 330 employees at the two UCSD hospitals and 2,100 at UC hospitals statewide. They say low wages and long hours lie at the root of the staffing problem.

Representatives of UCSD medical centers fiercely deny the union members’ contention, saying they are taking advantage of public anxiety over terrorism to gain leverage at the bargaining table.

“”I think it is unconscionable that any labor union would use scare tactics to achieve their aims at a time like this,”” said Dr. Jake Jacoby, commander of the UCSD Medical Center Disaster Medical Assistance Team.

Members of the union said the Sept. 11 attacks were first mentioned by UC negotiators during a negotiation session and not brought up by them.

“”We are not trying to use the current climate to scare people,”” said UPTE organizer Terry Bunting. “”The university is using it to shut down negotiations and suppress negotiations.””

Bunting said that during their last negotiation session, the union was encouraged to accept a final offer of 1 to 2 percent merit raises because of a looming recession and war.

Both sides have subsequently set a date to meet again.

“”We were so aghast that they would bring it up and not take the problem more seriously,”” said UPTE Local 9119 President Jeliger Kalmijn.

The problem in a medical crisis, according to the union, is that current low staffing levels would exacerbate a medical crisis if a situation similar to that of Sept. 11 arises. Jacoby said the medical centers are well prepared to deal with a crisis by following their disaster plan.

Workers are leaving UC hospitals for better paying jobs elsewhere, and little is being done to hire qualified replacements and retain current employees, said UPTE member Wendy Mullen, a clinical social worker at UCLA.

UPTE is asking for a wage hike to mitigate the 10 to 15 percent increase other employers can offer.

“”Clearly, to say that any one hospital is prepared to deal with a disaster of that magnitude is unrealistic,”” said UCSD Medical Centers spokeswoman Leslie Franz. “”Their need is about day-to-day [issues].””

Referring to what she sees as similar needs in both day-to-day and crisis situations, Bunting said, “”I don’t see how they can go from one to the other.””

Jacoby said he disagrees.

“”They are confusing daily [operating] systems with disaster planning,”” Jacoby said. “”They don’t understand how hospitals work.””

On a typical day, emergency rooms are busy assisting patients with minor injuries that do not require immediate attention. During a medical emergency, a triage system would be put in place to separate the different levels of needed attention and help the most needy, Jacoby said.

The San Diego medical disaster plan, like others across the nation, draws heavily on resources from within the region, state and at the federal level. Additionally, patients would be spread out to different hospitals to alleviate any possible strain, Jacoby said.

Doctors from out of the area would be flown in by the National Disaster Medical System, as they were to treat burn victims at the World Trade Center.

“”The situation worked well in treating victims in New York,”” Jacoby said.

Jacoby said San Diego also benefits from the presence of many military installations which could, as they have done in the past, provide assistance with doctors, hospital space and supplies.

The notion that support would have to be brought in from out of the area, according to Kalmijn, is evidence that the understaffing is equal to poor disaster planning.

Jacoby disagreed, saying that understaffing is a characteristic of a disaster, that any single hospital would be understaffed to accommodate the sheer volume of people, and that is why disaster plans take advantage of other resources.

UCSD Medical Centers have rehearsed what they call a well- designed medical crisis and disaster preparedness plan. They drill every six months and learn form these exercises, Franz said.

UPTE said its lab technicians and pharmacists are often overworked, working double shifts of more than 12 hours in one day. The sheer number of hours of work causes exhaustion and stress that leads to errors that could prove horrible in a situation if bioterrorism occurs in San Diego, according to Mullen.

“”If a disaster strikes and people want to be tested, if our lab is inundated with tests, there will be delays and an increase in error,”” Mullen said.

Jacoby noted the already high volume of lab work processed to show that the lab are capable.

“”Every day the hospitals process hundreds, if not thousands of micro-organisms and lab tests without having a problem,”” Jacoby said.

Kalmijn disagreed. A problem does in fact exist, especially when in the middle of the night lab technicians have a backlog of work to do, he said.

Dialogue between the two sides regarding wages and staffing levels happened well before the Sept. 11 attacks, Mullen said, but the attacks highlight the staffing problem.

“”The [UC] hospitals are understaffed. UC can stick its head in the sand and pretend this isn’t a problem, but we think that is ill-advised,”” Kalmijn said.

As commander of the Disaster Medical Assistance Team, Jacoby said he is upset that, if the situation is as bad as the UPTE contends it is, they have never contacted him to address the problem.

Kalmijn said the union has continually brought it up with UC officials in their negotiations.

Both Jacoby and Kalmijn said they are willing to sit down and discuss appropriate disaster response with each other.

Both sides repeatedly emphasized patient care as their utmost concern now, especially during a disaster, and that any contractual dispute will not deter their commitment to patient care.

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