Transcripts For SFGTV Health Commission 21616 20160222 : vim

February 2, 2016 a motion is an order that has been moved. Moved and seconded. Are there any correction to the minutes . Not seen any, were prepared to go. All those in favor please say aye. Opposed. The next item item 3 is the directors report. Good afternoon. I want to give you a quick update. The World Health Organization declared the International Health emergency on monday, february 1. The center for Disease Control has identified additional countries with a virus isnt issue and seeking testing. It also issued guidance to pregnant women regarding sexual transmission to the missed last week, the department has activated and Management Team to respond to Laboratory Testing and share information with medical providers and local communities and last week particularly invited somebody within organizations and certain individuals from Central America particularly to get input and part of that includes representative from the Mayan Community which have several dialects do we want to make sure they are informed. So, we are collaborating with them and work closely with them with the communities in affected areas to make sure they have the information they need. We will also be working with travelers in those areas. As you know, mayor lee announced the creation of a new City Department to address homelessness in early december. We are working very closely with City Employees to help the development of the new department. The new department was created to through the citys budget process which means its a problematic hope will be introduced to the board of supervisors on june 1. Just want to indulge all of our staff. Several hundred staff that worked on super bowl and it went for almost a week. We wrapped up a successful super bowl process ensuring that bay area residents and across the globe have a safe and positive visit to our community. Our Mental Health staff and response abilities ensued in hazardous material, and Communicable Disease also did a lot of work. Sharing information with the surrounding Counties Health departments. So, i want to thank them for all their work. And our public Health Emergency preparedness and Response Branch and Mental Health branch Communicable Disease and control prevention, San Francisco outreach team, inner communications office. I will end my report there. If you have any other questions but if you do what i do want to let you know that one of our employees, richardwhos been working for the department for over 29 years. He started as an industrial hygienist working with toxics including asbestos, radiation, and Hazardous Materials and in the last, in 2007, he was named environMental Health Regulatory Program including food Water Quality health, housing and cannabis dispensary. So we want to make sure that we all give him a good goodbye to his retirement and i know we will be having a celebration for him on march 11 at 6 pm. Theres instructions in and directions in the directors report. I just want to acknowledge him as well. All answer any questions. Thank you, director. Questions for t from the commission . Commissioner pating caucus does anyone have any other questions . Has there are, at this point, been any ceqa reported in the bay area . I think the officer can give you the updated information. Theres been a lot of rumors around. No, there has not yet none in the bay area. Thank you very much. We did no transmission in the bay area. No transmission in the bay area. If we if there are no other questions we thank you and next item item for general Public Comment and would love several request. So, for general Public Comment i will call the list of names and if you could then come up in order. We will have comments limited to 3 min. Each. [calling names] all those making Public Comment of an egg timer and when the buzzer goes off that means your time is up. Thank you. Good afternoon. My name is diana, nurse at San Francisco General Hospital. I want to read you a brief letter from the nurse. Im a resident nurse at San Francisco General Hospital. I would like to make you aware of our continuous problem of missed breaks. We also are never given a 50 min. Rest period and no effort has been made for such. This is not a new problem. It is been ongoing for many years now seems to be worse than ever. The nurses have addressed this issue many times with management with no resolution. It is also a Patient Safety issue. Our unit is frequently understaffed and the nurses are exhausted. It is well known that nurses are tired of no rest breaks, have no meal breaks, make more mistakes. We work hard at the birth center get the birth center is the pride of the hospital just like the Trauma Center. The new hospital is designed in such a way that we require more nurses. We need more permanent nursing positions and not more per diem. The nurses are very concerned the missing your brakes will increase in frequency. We urge you to make the safety of our mothers and babies a priority and to allocate more permanent positions for the birth center. This will not only allow the nurses took meal breaks were consistently, but will allow the nurses to provide optimal care to our families. I want to give you an example of what happens when we dont have enough nurses. I was a nurse of the mother the other day and the baby was not breathing when it was born. I called out for help but because we were short staffed that was nobody around to hear my calls for help. I begin a resuscitation of that newborn. The pediatrician arrived afterwards. They were very upset that they did not get the call in time. There was nobody to make a call. That isnt an unusual situation at the birth center at the hospital. We are understaffed on most days. I also have copies of the 92 emails that went out in the last eight weeks pleading for nurses to come to work. Thank you. I like to turn in letters from the nurses that signed the letter attesting to our shortstop. Thank you. Next, please. Good afternoon. My name is bob eisley. Im a 32 year rn would you like to let your microphone up a little for yourself . My name is bob ivery. Im a 32 year rn working at San Francisco gen. Thomas center. Currently retired. But i do occasionally go back into shifts because this Trauma Center is short staffed. I wish to bring to your attention to numbers. One is 59 . The others 207. 59 is the time last month that the Emergency Department was on the version. I know members of this commission are very concerned with that. We have been over 50 that version for the last three months. The other number i want to give you is 207. 207 are the number of not licensed, budgeted beds that we can operate in the hospital. Obviously, that number is inadequate to keep us off of that version more than half the time. 207 is also the number of the budgeted beds in the new hospital. In other words, there is, according to the report that was given to us in our meet and confer with senior hospital management, no new increase in hospital beds. However, eight surgery beds will be cut and eight icu beds will be open. Eight icu beds requires one to one or oneto staffing. There is, as far as i know, no Budget Proposal to increase the ftes in the new hospital. In addition, although eight new search beds will be cut the bulk of the hospital beds will now be flexbeds and will be able to accommodate higher acuity patients. However, that requires more nurses. There arent any new ftes. You will hear from these verses that they are short staffed as it is, and going to the new hospital is not going to solve that without a Budget Proposal in the budget to hire and train new nurses. I am as concerned about this as i know this commission is. Because ive heard your give and take at the San Francisco general gcc and i know how important that version is. It seems the problem is growing and is not going to be cured. So, i urge you to do whatever it is that the commission can do to urge the mayor to hire permanent nurses and give us the training budget to bring them up to speed. Thank you. After our next speaker, will [calling names]. Hello. Good afternoon my name isim a registered nurse on the medical surgery oncology unit in San Francisco general. Ive been there for eight years. We have been having a perpetual problem with staffing. Generally speaking, we are each nurse is assigned forfive patients. In the last i would say your and a half theres been a push to discharge patients within 20 min. Of an order coming through, but our support staff has been cut. On a daily basis, we work without nursing assistants and we dont have break nurses consistent. Every once in a while we do. So, those 20 min. That you are pushed to deal with that person particularly. In our population the discharge is not an uncomplicated discharge. Many of these people do not have a place to go. They dont have clothes. So, we need to arrange clothing for them to volunteer services, transportation, also, they have problems with medication that need to be discussed with them. So, were put under an awful lot of pressure to discharge patients within this timeframe and we try to do our best. We have patients that as soon as we turn somebody out within a very short time we see another patient. So, the previous 34 patients we have, you are trying to balance the patients that you have that are still need a certain degree of medical attention that does not them to be discharge and your new patients coming in that the level of care is high. So, without the support people, we are really juggling an awful lot and put a lot of pressure. We dont have our full crew of hired nurses in our units. Were using a lot of the as needed nurses, who are currently working fulltime. They worked three shifts per week like a regular fulltime nurse. So, we really wonder why were not given more staffing. Our acuity in the hospital with the new facility is going to go up higher because theres a change in the way the patients are being divided on these particular units. Theres a lot of concern with the nurses for the safety of the patient and also the quality of care the patients will be receiving. We do take pride in our work and we want our patients to leave in a good safe and knowledgeable manner so that when they go home they will be able to maintain their health once theyre discharged from us. Thank you. Thank you. Thank you. My name is. Ive been under set San Francisco general for 10 years and am here to ask that you factor a break leaf nurse into your budget. Will 22 of the california code astonishes the nurse patient ratio. The ratio should be one nurse for every three patient. Common practice is for nurses to break each other, which is problematic as the nurse providing relief has twice the patients. Not only putting her out of compliance with title 22 and the mou, putting her patients and licensure at risk. More than once ive been in a difficult situation of having a patient [inaudible] while relieving another. With patience under my care under unattended. Several of us to to to forgo official patients knowing our patients while inadequate coverage. I myself have not taken a full break in over nine years. The designated budgeted break nurse will alleviate this problem in the breakand the nurse on break can rest knowing her patients will be getting their intended attention. One month ago today nurses at the, general in washington, a similar hospital, one in arbitration the right to a complete break. The buddy system, the same system we use at San Francisco general would be untenable. From page 30 of the arbitration, which you have at least one copy of their, nursing requires knowledge, expense dedication and concentration. Tempered with compassion and patience. To successfully care for patients in need. The related stress both physically and mentally, warrant occasional a moment away from their assigned task at the nurses break should be free from worry and concern and altered the nurses colleague is providing necessary attention to the assigned patient. If that nurse has her own patients doubling the potential workload, even for 15 min. , time away from work is not really a break. So, in conclusion, i can urge you to include a break nurse into your budget plan. Thank you for your time. Thank you. Hello. My name isim a registered nurse at San Francisco general. Im here today to urge you to reexamine the hospitals budget to ensure that there is adequate staffing to meet the requirements under title 22. Title 22 requires that acting ratios be maintained at all times. In currently, the hospital is not doing that. Often nurses have to work out of ratio during lunch break and on transport when they have to take patients to opt in procedures. I currently work on 40 but the situation is not unique to this unit. I examined the 70 day period staffing period on my unit. Nine people at a time provided during the day shift. 11 people at the time provided during the night shift. Although break coverage was provided, it was not enough to meet the hospitals obligation under the law. We had to work out of ratio. What if i told you as a patient, if theres enough people i can save your life. Im not sure what the disconnect is as it relates to 12 through backing regulations but this commission is unique position. You can help our managers to help us provide better care to the citys residents and visitors. By passing a budget to reflect the actual staffing needs of the hospital. As a General Service San Francisco general serves the most vulnerable population. It means you condone the delivery of substandard care. That you see nothing wrong with continuing breaking the law. That you are okay with, missing the house and the safety of the patients and staff at San Francisco General Hospital. I urge you to help San Francisco general leadership to make the hospital a safer place by passing the budget and meet the hospitals needs and obligations under point title 22. I want to leave you with a dispute resolution that is moving forward as we speak. This is on 40 the nurses on 40 our target we can no longer continue to violate the law. We must do something about it. Barbara garcia is it surely speaking shortly because we not receive the adequate response from the leadership at San Francisco General Hospital. I know they want to help us but you have to help them to help us. Thank you. Thank you. So, [calling names]. Thank you, commissioner chow. I can safely acknowledge i face retiring at [inaudible]. To shut me up by eliminating my job classification code and putting me out of a job. The design executive director report and shifting the reporting periods for three out of county discharge summary. I placed the record requests an immediate disclosure request to obtain the out of county discharge data from your 13, 14 and 15 i lost track of that request adjuster member and yes you get 90 days later dph has failed to respond or even acknowledge the next day that november 6 records request. This Commission Still has not provided out of county discharge data which is been repealed the requested over the last several years. So, it is interesting that when you get here most acute care report coming up on the agenda, but also the report of audi county places are increasingly necessary to place longterm care medicare patients including those with tbi, dimension, mental dimension, mental illness, etc. Page 20 of that upcoming report mentions some patients prefer being placed in San Francisco rather than being dumped in the out of county facilities. But nowhere in this report are there any quantitative data. Stratifying the number of out of county discharges that are being made. Commissioner chow and commissioner singer have greatly disappointed me i not inquiring and how the lgbt, transgender, elderly, and disabled San Francisco are being dumped out of the county. This commission has a duty to investigate its report it publicly. Commissioner chow even on this commission way too long. You need some fresh blood. So that we get at out of county docket yet to get off your rear end, sir. Next speaker, please. Im sasha . Hello everybody. I have a petition that nearly 800 people have signed about the renaming of the hospital and i have a poem though that i would like to read to you now. Im a nurseive been a nurse at the hospital for a long time and im not a poet. San francisco general nurses to whom it may concern, please answer several questions id really like to learn. I told you what to call us that you make its mission real. This identity is a very rotten deal. Our hospital in public place, how can i explain the city took its name awake and give it at facebook name. Mark Soderberg Davis money and for that we give thanks but why on earth take the name awake and give it to the banks. Wells fargo foreclose on houses and a profit from displacement. Your patients are discharged from here and left unpaid in. Taxpayers help wells fargo while you learn to be mean. The bank of america. Name has a patriotic flair. The naming unit after it would see