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More than 60 nurses at San Jose’s Regional Medical Center rallied outside their workplace this week to demand better working conditions and more staffing.

They say the hospital’s violations of state-mandated nurse-to-patient laws is putting patients at risk and overworking nurses to the point of burn out, which is why many are leaving the profession.

California is the only state that legally requires hospitals to have a certain number of nurses to patients in every hospital unit. For example, hospitals should provide one nurse for every two patients in intensive care and one nurse for every four patients in emergency rooms.

“But that is not what is happening,” ICU nurse Michelle Lorang said. “We are seeing nurses in the ICU caring for three patients.”

She said short staffing leads to delays in care and poorer outcomes, especially in units where matters of life and death can change within minutes.

It also leads to nurses being overworked and unable to provide proper care to the growing list of patients they need to care for.

“It’s a very scary situation for our patients,” Lorang said. “And for us.”

Declining staffing

There are currently less than 545 registered nurses at Regional Medical Center which is a 28 percent decrease from last year, according to data from the California Nurses Association.

Lorang said she would guess half of those who no longer work at the hospital probably left to work at another place with better working conditions.

“Some have left the profession entirely. Some have taken early retirement which might be considering it too. And some have just taken extended leaves to say you know what, I need to take care of myself or my family,” she said.

The problem at the hospital is cyclical. As short staffing increases so does the amount of nurses getting overworked and burned out. This results in more nurses leaving and which then requires the remaining nurses to do even more.

“No nurse should be forced into having to decide whether to remain at the bedside and face disciplinary action or leave their patient without optimal coverage.”

Linda Vences, Regional Medical Center nurse

Violeta Mendoza, a nurse who worked at Regional Medical Center for 40 years before retiring in 2018, said the problems at the hospital have just gotten worse over time.

“We do not take care of patients the same way when I was young,” Mendoza said. “Now nurses are on computers and not bedside and they have too many things they need to do.”

She said it has created an environment where nurses are rushing to make sure that the essentials are taken care of and skipping rest and meal breaks in order to make it happen.

“But then they get in trouble for not taking breaks,” Mendoza said. “Even my friends here are scared to talk to the news because they don’t want to get in trouble at work.”

Linda Vences, a nurse at Regional Medical Center for two decades, said management has been disciplining “outspoken nurses who fail to take their breaks.

“No nurse should be forced into having to decide whether to remain at the bedside and face disciplinary action or leave their patient without optimal coverage,” Vences said.

And that is exactly the choice many feel they have had to make too many times, which is why the county is experiencing a nurse shortage, nurses said.

“It’s a cooperation created problem, not a nurse created problem,” Lorang said.

Placing blame

The problem, in her opinion: corporate greed.

“People are tired, but if contracts were followed appropriately, and people were paid appropriately, there would be more nurses at the bedside,” she said.

She said working conditions were especially disheartening as HCA Healthcare sits as the wealthiest hospital system in the nation. The private health care facility operator raked in more than $3.7 billion in profits in 2020, according to the nurse union, National Nurses United, which is about a 7.1 percent increase from 2019 profits, data showed.

HCA Healthcare CEO Samuel Hazen also collected $30 million in compensation in 2020 — the most out of all CEOs of publicly-traded health systems.

“We heard about the federal money on the news but we definitely didn’t see it,” Lorang said. “We didn’t see it in direct care patient equipment or protective gear for our nurses.”

“We have a lot of very tired and sad nurses. We became nurses to care for people and that’s who we are inside. But we can’t do it in the current conditions — at least not to the standard that lets our hearts and our souls rest.”

Michelle Lorang, ICU nurse

In fact, many resources were cut like the maternity ward in the summer of 2020. All those services for mothers and their babies were then consolidated into the emergency room unit.

“That was a sign to us that the more cuts were coming,” Lorang said.

Nurses at Regional Medical Center also did not get any raises or bonus pay during the pandemic, protestors shared.

“What we got was lip service,” Lorang said. “You’re a hero, but here, do more with less. You’re a hero but stay an extra four hours. You’re a hero but do you really need all that time off?”

To her, COVID exacerbated the already strained resources in the hospital, which should have been a wake up call for HCA to invest more in staffing and resources.

Lorang continued that she believes HCA has the power to rectify the conditions in the hospital, but until then, things at the hospital will likely continue to deteriorate.

“We have a lot of very tired and sad nurses,” she said. “We became nurses to care for people and that’s who we are inside. But we can’t do it in the current conditions — at least not to the standard that lets our hearts and our souls rest.”

Regional Medical Center did not respond for comment.