July 2022: We started this petition months ago in hopes to help resolve the working conditions in one Dept, but since then we have seen things deteriorate further throughout the entire hospital. Many RNs are working without breaks, recently departments have gone out of ratio forcing RNs to care for more patients then they safely can, RNs have worked over 24 hours straight in several Depts. RNs are working in ICU with no Charge RN, no rapid response and the response from the employer is to buy the RNs pizza. With all the staffing concerns going on Saint John's is even now implementing on August 1st a plan to speed up ER admissions by skipping the foundation of safe patient care by stopping the practice of RN to RN handoff report. This is unacceptable. This is why the RN members of California Nurses Association have called for an informational picket to speak out to the community. 

Nurses at Saint John’s work tirelessly to keep patients safe as the hospital leaves them short staffed on a daily basis. They are frequently expected to work 12 hours without being provided breaks and often without a charge nurse and minimal support staff. All the while the hospital has implemented a ruthless throughput program that further threatens safety with the goal of making more revenue by pushing patients in and out faster. The combination of aggressive throughput and understaffing leaves nurses with the burden of simply making it happen at their own expense and at the expense of the patients. Nurses are burned out and demoralized by trying to do their jobs to care for patients under these conditions.

We are picketing because we are tired: Tired of working through breaks, working extra shifts, and being short on supplies. Nurses are tired because we’re not just the Nurse here: We are the ED Tech, the nursing assistant, the Transportation, the Security Officer. We need support! And we need supplies! This doesn’t feel safe. If Nurses aren’t safe, PATIENTS aren’t safe!

The lack of Providence’s ability to attract, recruit and retain experienced nurses has been well know to our community for years. We have been very public with our union contract negotiations in the past and our community action at the beginning of the Covid crisis when Providence withheld necessary PPE and suspended nurses when they refused to work without protection. Our community actions brought thousands out to circle our hospital honking horns and marching along side the nurses and WE THANK YOU! Now we need you again. We need to be able to staff our hospital and work through a shift with a break. We hope you can share this petition and join us on the streets of Santa Monica on August 1st, 11:30am-1:30pm at the sidewalk in front of Providence Saint John's Health Center. 

Jan 2022: We the RNs on PCCU at Providence Saint John’s, are reaching out to you regarding serious staffing and patient safety concerns. We signed this petition to show we all share the same concerns that need addressed now.

On PCCU, we care for patients who are either barely stable enough for transfer from ICU or patients who can't go to ICU because they have no beds available. Post-surgical, trauma, medical, neuro/strokes, flaps/craniotomies, BiPAP, High-Flow, titratable drips, highly unstable patients and occasionally, an actual cardiac patient. The CA ratio law states that a "telemetry" unit is defined as "stable cardiac patients" which does not define our unit, rather we are a step-down or as our name implies Post CRITICAL care, with patients who could require ICU or are not stable enough for the other floors yet.

This is incredibly dangerous for both the staff and patients, since we are 100% NOT a "telemetry" floor like management likes to advertise us as being just so they can give us the 4:1 ratio rather than the 3:1 ratio we should safely/legally be at. Only management calls us Telemetry. The orders placed on EPIC by the MD's are "admit to post critical care" or admit to "step-down" and sometimes even "admit to PCCU stroke unit" which is sad because none of us had any idea we were a "stroke unit".

One of the sources of our problems is that PCCU has been separated into 2 floors. We use rooms 2248-2296 (25 beds) on our 2nd floor PCCU and rooms 2302-2324 (12 beds) on our 3rd floor overflow. Since we are on 2 separate floors, we require 2 charge RNs and 2 Break RNs per shift just to get by. We do not have enough staff to be on 2 floors, and if things remain unchanged, we will lose more RNs who no longer can tolerate working in an unsafe unit.

Our "overflow" is on the 3rd floor Ortho unit which is not designed to care for PCCU status patients. We do not have the equipment required to care for our patients there. We do not have the bedside monitors; we must rely on the monitor-techs to call us if anything happens to our patients. Most of our equipment has been broken for months. We do not have simple things like suction canisters or Oxygen set up in every room, an EKG machine, supplies that are readily available to us on our 2nd floor. We don’t even have access to certain medications because the Omnicell where we access medications is designed for Ortho patients and restricts access to medications that we use all the time. The supply room on our side of Ortho is completely unorganized and is rarely restocked. This results in us constantly wasting time (time that we don't have) searching for supplies or having to run downstairs to 2nd floor to find something. This is especially dangerous when a patient is coding and we must run around wasting time looking for emergency supplies that we should have immediate access to, but don’t.

Almost every shift, we do not have a Break RN on either floor and sometimes we don't even have a Charge RN on one or both floors! This goes for both days and nights. Our assignment sheets show we have no break RNs, 1 maybe 2 CNAs if we are lucky, and many of us have "primary care" patient's meaning we must be our own CNA because we can't give all 20+ patients to 1 single CNA.     

The number of missed-meal penalties we have go unresolved by management... breaks have become luxury on PCCU, not a legal right! Many of us never ... not even once take a 15 min break, much less a lunch break, especially if we must be charge because we simply cannot leave our new inexperienced staff unsupervised. However, we unfortunately tend to always clock in that we took our breaks ... only because we don't want to get in trouble with management and deal with more issues than we already do. Many of us have been uncomfortable and typically unwilling to speak up or "stir the pot" since many of us are newer RNs and management is unsupportive.

We recently lost 4 full-time night shift RNs (3 were regular Charge RNs), we will lose 4 more, night shift RNs (2 of these do Charge). There's usually only 2-3 actual PCCU staff RNs on the floor and the rest are either travelers (with barely 1 year of experience) or float-pool TIPs who still have not even completed their 1 year. Unfortunately, this creates more problems for PCCU staff as we must oversee these RNs as they are VERY new (this is not their fault, they are still learning but our unit is not in a state where we can teach new RNs, there simply is NO time).

Aside from nightshift losing half its staff, the remaining staff is mostly new graduates or have less than 2 or 3 years of experience. Several of us had merely 6 months into training as new RN when we were pushed to be a Charge RN overseeing the unit, and we were NEVER oriented/trained to be charge, we were thrown into it. We continue to be relief-charge RN quite often, without any Break RN in a critical care unit full of new grads and inexperienced travelers while many of us only having few years of experience ourselves. The blind leading the blind on PCCU...

We often comfort our RNs while they cry or have mental breakdowns (while holding ourselves together) reminding them that they are not bad nurses, but this is a poorly managed hospital that sets us up to fail by putting profit above patient safety and staff retention.

We tried to speak up before, but management only says, "I’m sorry to hear that" or "I'll look into this" so we gave up trying. But enough is enough, this is how we all feel on PCCU, we need real change to address serious staffing and patient safety concerns NOW.

These concerns need addressed or PCCU will continue to have a high turn-over rate of RNs and work in unsafe conditions for staff and patients caring for very high-acuity patients who are trusting us with their lives.

Sincerely,

RNs at Providence Saint John’s in Santa Monica CA