Robinson Abueg, a pharmacy receiving manager with UCSF, unpacks a package of Pfizer COVID-19 vaccinations at UCSF. (Photo via Maurice Ramirez/UCSF)

At the University of California San Francisco Medical Center at Mount Zion, approximately 12 nurses are needed to staff two floors for one shift, according to Maxine Lorenzana, a nurse at UCSF.

But several times in the past few weeks, only two have been scheduled to work, Lorenzana said.

Lorenzana was one of many nurses and hospital staff who spoke out at a Tuesday news conference about understaffing at UCSF, alleging the health system has endangered both nurses and patients by not scheduling enough staff members at a time.

“We’re suffering,” she said.

Jamille Cabacungan, a fellow nurse at UCSF, said that UCSF has been “chronically short staffed,” even before the COVID-19 pandemic, but that the pandemic has severely exacerbated the problem.

More nurses have had to call in sick during the pandemic, Cabacungan said, while others left after enduring the mental toll of increasing numbers of patients, insufficient support and unsafe conditions.

Across the state, the pandemic has exacerbated a trend of nurse shortages, according to research by the UCSF Health Workforce Research Center on Long-Term Care. Using survey data, the researchers estimated that there is a current shortage of over 40,000 full-time nurses in California, driven in part by nurses leaving due to increased stress during the pandemic and the risk of COVID-19 exposure.

In a statement, UCSF said it has been at the “forefront of the response to the COVID-19 pandemic,” providing personal protective equipment, vaccines, daily symptom screeners and free COVID-19 testing. But Cabacungan said nurses at UCSF were forced to fight for these measures at the beginning of the pandemic.

Even when there are enough nurses on staff, Lorenzana said, her center still lacks nursing assistants, staff to assist with transports and certain specialists, leaving nurses with additional responsibilities on top of caring for their patients.

Because of this, nurses constantly juggle monitoring patients with other duties, such as helping on intake for new patients, she said. In some instances, Lorenzana said patients have been able to leave their floor while nurses are occupied elsewhere, and others come to the hospital with potentially dangerous items such as weapons or illegal drugs because nurses don’t have the time to formally check their belongings.

In other cases, the medical center can’t continuously monitor patients who require it because there aren’t enough nurses to sit in the patient’s room or the nursing station constantly, according to Lorenzana.

The end result, she said, is unsafe conditions for both nurses and patients.

“We don’t take our jobs lightly. We know the impact that it can have if we miss something or if we’re not able to provide the care that we know we should be able to,” Lorenzana said. “Yet UCSF has manufactured and created all these constraints that essentially make it impossible for us to do our job well.”

Marissa Diaz works as a nurse in a unit that provides specialized treatment for patients with cancer. Diaz said she feels “a constant state of dread” worrying that her unit lacks the capacity to meet the level of care her patients need.

To fill the gap in staffing, Gabriela Diaz, another UCSF nurse, said that nurses often text each other begging them to work extra shifts. Since the beginning of the pandemic, Diaz said she had received two to four text messages almost every day from a fellow nurse asking her to work.

According to Cabacungan, UCSF nurses have been communicating these concerns since the beginning the pandemic through quarterly meetings with the administration and other opportunities, but they continue to feel unheard and unacknowledged.

UCSF Health has requested 210 travel nurses to fill gaps in staffing, the health system said in a statement, but has had difficulties due to high demand for nurses during the pandemic. Cabacungan said they have also offered overtime pay and other benefits for working extra shifts but said both this and hiring travel nurses — who work for months at a time on a contract — are only short-term solutions to the problem.

“The university cannot rely on making nurses work more hours, that will only increase our mental and physical fatigue,” Cabacungan said. “The solutions that they are proposing are not sustainable.”

In a statement, UCSF Health said they continue to meet patient care standards and state-mandated nursing ratios, and are working to recruit more nursing staff.

“Our nurses have gone above and beyond over the past 18 months to provide top-notch patient care,” the statement said. “We are grateful to them for their professionalism and are dedicated to providing the support they need to weather this pandemic.”