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UCSD Health ER nurses call out overcrowding as hospital sees ‘unprecedented’ demand

Emergency room nurses at UC San Diego Health’s La Jolla hospital held a rally to point out what they said are unsafe and overcrowded conditions as the health system deals with a spike in patient volume.

UCSD Health nurses with the California Nurses Association made a plea for more staff and resources Thursday outside the emergency room at the Jacobs Medical Center.

“This is not the care we want for our patients or for our own families,” said Estefania Urbano, an ER nurse with UCSD Health.

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Urbano said she worries about long wait times and treating patients in hallways, especially those that might be immunocompromised.

“This is humiliating for patients and, most importantly, an infectious risk to others,” Urbano said.

UCSD Health officials said they have been very busy — seeing historically high numbers of patients.

“Like hospitals throughout California, UC San Diego Health is currently experiencing unprecedented demand for its medical and surgical care — a need which is outpacing available hospital beds,” said a statement from a UCSD spokesperson sent via email. “The impact is most visible in our Emergency Departments.”

The statement also said the hospital system is taking every measure possible to care for patients, which sometimes means using overflow areas or even diverting ambulances because of demand.

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“I have not seen anything like this,” said Jocelyn Belleza, a UCSD Health ER nurse who has been with the system for 20 years. “It has been progressively getting worse to the point that now we need to stand up and request more attention.”

Belleza and others said the situation is not sustainable.

“There’s a high increase in burnout when you don't have any support and there’s a lot of low morale among the staff,” Belleza said.

March has been particularly busy at UCSD Health’s La Jolla campus. There have been two instances where an "internal disaster" was declared, which means ambulances are not able to bring in patients. San Diego County officials said the internal disaster declarations happened on March 2 for about 22 hours and on March 7 for 18 hours.

ER nurses, and the union representing them, are calling for more nurses and other support staff. They said management has brought in some extra help, but it has not been enough.

“All my coworkers and the staff are doing our best to do our job but at the same time we need the space, we need the equipment — all the support we can get from management,” said Maria Tan, UCSD Health nurse and union representative.

UCSD Health is not the only hospital system that has busy emergency departments. Scripps Health officials said they are dealing with a higher number of emergency room patients and recently opened a 16-bed facility at Scripps Mercy in Chula Vista to address the demand.

“We need the county’s help with placing our patients in skilled nursing facilities and behavioral health step-down facilities, as well as decreasing ambulance traffic from emergency rooms to alternative care sites for patients who do not need the high level of care provided at the ER,” said Dr. Ghazala Sharieff, chief medical officer with Scripps Health.

Sharieff said those moves would help transfer patients from the emergency room to other areas in the hospital and thus reduce the pressure. Sharp HealthCare officials also said their emergency departments have seen an increase in patients.

“Both walk-ins and patients that arrive by medics,” said John Cihomsky, a spokesperson with Sharp. “While this increase has stressed San Diego’s EMS (emergency medical services) systems, Sharp has maintained established quality and safety standards and appropriate nurse-to-patient ratios to assure high-quality emergency care.”

Kaiser Permanente San Diego officials said so far this year, patient volume is up about 7% compared to last year.

“Wait times are — generally speaking — the same with (the) vast majority of patients being seen within one hour,” said Jennifer Dailard, spokesperson with Kaiser San Diego.

UCSD Health officials said when possible, they add additional nurses to relieve pressure. They also want to remind the public that minor health issues can be handled with same-day visits to urgent care or even telehealth conferences.