Wednesday, October 11, 2006


Disappearing Wilcox nurses and doctors not good for Kauai or for the state

Imagine that you're in a hospital bed and the call of nature comes, so you push the button for help--and don't get any. A letter writer to the Kauai Garden Island News described exactly that nightmare situation and more:
One bedridden patient was left lying in his feces for over an hour. Another patient fell and was lying on the floor for over an hour before anyone found him. There are other situations like this; enough issues that Medicare has been notified of the unsafe conditions at Wilcox Hospital.
Hawaii Pacific Health and its nurses have been involved in a 100+ day dispute involving the number of patients to be assigned to a nurse. Nurses remain on strike and HPH is flying in replacements at minimum staffing levels. Along the way, according to an article in that paper today headlined Broken promises and broken trust:
Some 24 physicians, three midwives and a nurse anesthetist have left the Kauai Medical Clinic, a subsidiary of HPH, in the past three years, according to Dr. Peter Kim, the founder of the Kauai Medical Group. This represents more than a third of the 64 physicians and eight nurse practitioners in the medical group, a medical group which has served Kaua‘i'’s healthcare needs for the past 40 years. Four of the physicians who left were the only board-certified specialists residing on Kaua‘i in the fields of cardiology, oncology (cancer) and gastro-enterology; Kauai is now without local board-certified coverage for these important specialties.
In addition to the loss of these specialists, it appears that HPH has fired its licensed professional nurses, all of them, according to this letter yesterday:
I am a Licensed Practical Nurse. I gave 28 years of excellent care to my patients at Wilcox Hospital.

Now, Hawaii Pacific Health has rewarded my loyalty by firing me and all the other LPNs.
This is bad enough for the citizens of Kauai while the weather is good, but what if another Iniki strikes or a tsunami or other disaster hits? With already inadequate staffing in the absence of a disaster, what will happen when even more doctors and nurses are needed in extraordinary circumstances?

I've written about the danger of allowing the attrition of doctors to continue: Disappearing Doctors: Hawaii looks for quick but questionable fixes, Hawaii's medical infrastructure deteriorating, unready for disasters and the followup: Update: Lights out in the ER--Hawaii's deteriorating medical infrastructure. I'm concerned that we are simply letting this problem roll on, which it will, unless some government entity intervenes for the public good.

Every once in awhile--not nearly often enough--the nurses strike on Kauai breaks into the news on Oahu. This morning there was a short letter to the editor in the Star-Bulletin, Wilcox nurses deserve respect, a better deal. To learn about the situation in Kauai and find out what you can do to assist the nurses, check out the many letters and articles in the Garden Island News. The Hawaii Nurses Association has a website here.

Oahu advocates should pay close attention to the situation in Kauai. If HPH succeeds there, this island is probably next. We also have a stake in keeping doctors in the state and in keeping hospitals on each island fully staffed. Should a disaster strike Oahu, we would have to count on other hospitals to share the load.

Right now, we are headed in exactly the wrong direction. We are not building the capacity and flexibility we will need in the face of disaster, quite the opposite. We're setting ourselves up for real trouble.

If it takes government intervention to settle this strike, we the people may have to join the nurses in calling for action.

Even in fair weather, patient safety needs to be preserved. Think, it could be you, your spouse, your child or your older relatives pushing that call button but getting no response because of understaffing.


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