San Diego Union-Tribune,
Thursday, January 28, 2010

by Geri Jenkins

As a registered nurse specializing in surgical intensive care at the UCSD Medical Center, it is not just the $3.1 million in Wall Street-style bonuses for the 38 hospital executives in the University of California hospital system that I find so outrageous.

It doesn't stun me that these executives are receiving bonuses of up to $218,728 this year — while lower-paid employees are facing pay cuts, furloughs and hiring freezes — or that the highest bonuses in University of California history are being paid out during a painful recession.

What I am really astonished about is that these executives are getting bonuses for supposedly improving care, when nearly every nurse in every unit in the university medical system will tell you that in the past year or two the quality of care has gotten markedly worse at our hospitals.

Our patient loads are up. Our nursing and other staffing is down. Overtime after our 12-hour shifts is routine. And meal and rest breaks during those shifts are rare. As a result, UC Irvine Medical Center this year has been sharply rebuked by federal regulators.

The UC Davis Medical Center’s own numbers show that units are understaffed one-third of the time, and most of the other medical centers simply violate their legal requirements for levels of nursing care.

As the nursing staff runs frantically around the hospital trying to keep up with these unsafe conditions, for the first time in my experience patients are comforting us. They see the overtime, notice the lack of meals, have heard about the preventable medical errors — and tell us they understand our challenges and that everything will be OK.

It makes me, and every nurse I’ve talked to in the system, want to cry. Or scream. But as nurses, we don’t cry or scream. We try our best, work longer hours and stretch ourselves thinner in the hope that we can overcome the deteriorating care conditions to which our management is sentencing our patients.

So what are their million-dollar bonuses primarily based on? Meeting or exceeding low, medium or high financial targets for the year. And this past year each medical center made record profits due to their efforts. Every time managers staff a unit with one less nurse or other needed staff member, they save money. Every time they add new nursing duties or required documentation without adding staff, they save money. Every time they replace classroom-style staff training with training by e-mail, they save money.

And who suffers as a result of these cuts? Our patients.

Care is delayed. Mistakes are made, despite our best efforts. Necessary patient education and emotional support may not happen.

As a working University of California nurse, here’s my challenge to the Board of Regents that approved the executive bonuses: Eliminate the bonus system. Devote the bonus money and the millions in profits to providing the care that patients deserve — or resign.

Here’s my challenge to the hospital executives walking away with these millions: Refuse the bonuses. Devote the bonus money and the millions in hospital profits to providing the care that patients deserve — or resign.

It’s bad enough for inflated bonuses to go to American International Group or Goldman Sachs executives who don’t produce anything valuable.

It’s even worse when bonuses go to hospital executives for actually degrading the care that patients receive. The people of California, and the patients at our university hospitals, deserve better.