SF Department of Public Health registered nurses and other frontline healthcare staff gathered outside of Laguna Honda Hospital on the afternoon of Thursday, May 9, for a National Nurses Week event that was both festive — and serious.

They acknowledged the critical role nurses and staff played in keeping the hospital open – and the commitments the Department of Public Health has failed to make to ensure quality care. Speakers struck a somber note, and a warning to SFDPH: Tuesday, May 14, through Friday, May 17, members will vote to authorize a strike. 

The 2,200 SFDPH nurses represented by SEIU Local 1021 have been in contract negotiations since February. But so far, SFDPH management have rejected all staffing proposals. In fact, they seem to deny there’s even a problem, citing an official 4% vacancy rate.

They make this claim even as they admit that in 2022-23, there were more than 12,000 missed rest breaks alone, not counting missed lunches, due to short-staffing. There were also 606,000 hours worked by per diem (temporary part-time) nurses in 22-23, representing about 291 missing full-time positions. And from July 1, 2022, to November 24, 2023, there were 245,000 hours of RN overtime.

The negotiations are currently in mediation, which will continue as nurses vote to authorize a strike.

At Laguna Honda specifically, an increase in falls due to short staffing has triggered a state investigation and could even jeopardize recertification. The City has already spent $125 million on the CMS recertification process, including some $40 million just on consultants who are not even licensed in California and who have implemented dangerous policy changes such as removing all the side rails from beds.

Combine the lack of side rails and a staffing crisis that too often leaves only one person to turn patients in bed, and the result is a recipe for falls – which can be catastrophic and even fatal for medically fragile patients like Laguna Honda’s residents. 

Thanks to the heroic efforts of nurses and other frontline staff, Laguna Honda could soon be recertified, which means it could start admitting new patients. But nurses right now are already struggling to keep up with quality patient care as it is. They need more nurses to be able to properly care for their current residents – let alone a sudden influx of new ones. 

“Nurses and staff at Laguna Honda are deeply committed to our residents,” said Kathleen MacKerrow, an RN and clinical nurse specialist at Laguna Honda. “That’s exactly why we’re frankly terrified at the prospect of admitting new residents before we have adequate staffing. 

“Instead of wasting tens of millions of dollars on consultants who have done little to improve patient care, and in some cases have actually implemented non-evidence based practices, they could have provided us with the permanent, full-time nurses and ancillary staff we need to provide the quality of care our residents need and deserve,” said MacKerrow. “Nobody wants to go on strike, but if that’s what it takes to protect our residents from SFDPH’s poor choices, we’re ready to do that.”

The City has had months to respond to many of these proposals and chose to wait until last week to deliver unilateral rejections to almost all of them with no explanation, no counter proposals, and often no discussion. This is not what nurses consider bargaining in good faith.

Read more on this from Mission Local, the SF Examiner, and NBC Bay Area.