Alex wrote on Jun 27, 2008 12:50 AM:More confusion and contradictory information for the voters to consider. I wonder why the management cuts the hours of the lowest paid staff to save money then tells higher paid nurses to do the work. If this is the trend, Art should lay off everyone and do all the work himself.

its all a smokescreen wrote on Jun 27, 2008 1:10 AM:Watch out, nursing aides who spoke up. Now that you are unionized, the hospital hates unions and tries to fire employees who are pro-union or who speak out.

Sorry that the head of nursing was "visibly offended" -- maybe if the administrators would get out of their ivory towers and go see how the hospital is running, they wouldn't be so quick to pat themselves on the back.

And no, I am not a nurse, or a nursing aide. I am not employed by the hospital, but unfortunately have seen too much of the shenanigans that have been going on with administration.

Bottom Feeder wrote on Jun 27, 2008 5:56 AM:When Ellerbe or CEO Gonzalez refers to the patient, employee, or physician satisfaction survey only percentages are referenced. What is the actual number of responses to actual number of patients, employee, or physicians who are admitted, work, or have staff privlieges?

The actual number of responses is very small even though the percentage sounds good. For example 75% to 90% sounds good Garrahy but not if the actual captured responses are less than 5% of the total number of patients admitted yearly, or the actual number of employees who work at TCMC, or the actual number of physicians who have staff privliges who admit patients.

But then again Garrahy has never requested any clarification or additional information of either the CEO or Ellerbe, she simply swallows what she is fed.

Bottom Line wrote on Jun 27, 2008 6:03 AM:I find it interesting that Ellerbe has more and more decided that only RNs can do the job of a nursing team - which is the RN, LVN, and CNA... As long as the California recognizes all three licenses Ellerbe is wrong to undermine the State's wisdom.

No wonder the RN, LVN, and CNA (ACT) joined the union!

By laying off the LVN and CNA there's more money for the Bonuses scheme for CEO Gonzalez, COO-CNE Ellerbe, CFO Wardwell, VP Coleman and all the other VPs, directors, and managers -- in the meantime the Board of Directors rubberstamp everything that is in front of them - What a sad set of affairs -

Randy wrote on Jun 27, 2008 6:53 AM:Who are we to believe: nursing aides who work the floors, face to face with patients each and every day; or board members, sitting in their ivory tower eating lobster once a month?

STAT wrote on Jun 27, 2008 7:07 AM:Send home ACT early. Now we have other staff over qualified (RN) being taken away from their primary duties or under qualified (Lift Team) doing work beyond their qualifications. Patient care remains, but the quality of that care definately diminishes. Get organized and understand the ultimate goal of the hospital is quality patient care! You want a bond for infrastructure improvement, but the real improvement needs to happen inside the walls of the current infrastructure. These monthly pat-myself-on the back luncheons for the same administrative staff do nothing, but increase unnecessary work for the cafeteria and EVS personnel. Ready....Action!

Shortage wrote on Jun 27, 2008 7:30 AM:With such a severe nursing shortage ( both now and in the future)why would you use a RN to do ACT work? Is this an effective use of an RN's skills? No wonder there aren't enough poeple going into the nursing field when you hear stories like this.

Randy wrote on Jun 27, 2008 8:11 AM:Chalk up Bond Campaign Number 3, Mistake Number One: NEVER, NEVER, NEVER have a meeting of the Board of Directors before the election!

Patient wrote on Jun 27, 2008 9:24 AM:oh really? Cause I was in there this weekend having my baby and not once, but TWICE they served me food with my allergy. So really? The patient care hasn't been hurt? They almost killed me twice!!!!!

Vista Watchdog wrote on Jun 27, 2008 11:50 AM:One more reason why this Government Boondogle needs to be privatized! Transition the Community Hospital District into an Emerency Management District, sell the Hospital to a Private organization, and watch how fast the new construction is completed, and the quality of services improves!

Don't believe me? Ask yourself this: "Do you enjoy trips to the DMV?" "Want your healthcare provided by the same type of organization?"

smartypants wrote on Jun 27, 2008 12:28 PM:Why are nurses always the Queen-Bees? Don't they make enough money to begin with. They're always the first to complain about everything. They don't own the joint.

What data wrote on Jun 27, 2008 1:08 PM:"We look at the data on falls, on bedsores, on every injury that happens in this hospital," Garrahy said. "Most of our scores (for patient care) are either better than the statewide average or (are) at the average."

Who says that the "statewide average" is adequate, since the "standards" the scores are measured against are arbitrarily created by the same type of self-serving bureaucracy that is charged with maintaining these "standards" in the first place?

Read between the lines, folks. These supervisors are paid to maintain the status quo implemented by those even higher up than them in the hierarchy of hospital authority. They are also well-versed in doublespeak.

They are nothing more than professional liars, who manipulate the intended meaning of language in order to support the "realty" created by themselves or their superiors in any given situation when those below them--- you know, the "complainers"--- start upsetting, challenging or contradicting their delicate illusions of self-perpetuated pseudo-reality.

Once again, the quote:

"We look at the data on falls, on bedsores, on every injury that happens in this hospital," Garrahy said. "Most of our scores (for patient care) are either better than the statewide average or (are) at the average."

Exactly WHAT data are you looking at, Ms. Garrahy? Do you look at ALL of the REPORTED data?

Furthermore, Ellerbe stated: "I have not received one incident report from any of these individuals or their colleagues."

Well, if one never "receives" them (as in never being delivered in the first place) I suppose one could "technically" be stating the truth--- or at least the illusion of it. If I give orders to someone below me to never deliver complaints to me, then I suppose I am technically stating the truth if I were to say "I have not RECEIVED one incident report from any of these individuals or their colleagues."

I'd like to see what the actual number of patient-satisfaction surveys which are returned actually is, verses the total number which are sent out.

I know when I am recovering from an illness, the last thing I want to do is take some damn survey.... particularly if my care or experience was inadequate or negative; I--- like most people--- would want to just wash my hands of the whole experience and focus on recovery because dealing with unfeeling, uncaring hospital bureaucracy is nothing but an exercise in futility which increases stress levels and impedes upon the process of recovery.

I'd like to see the paper trail of these patient-satisfaction surveys.

I'd also be interested in knowing how many of the patient-satisfaction surveys are sent out to patients who do not have proper identification, or are illegal aliens. (Do you really expect someone who is stealing from the taxpayers to fill out a patient-satisfaction survey truthfully, if at all?)

Furthermore, Ellerbe "....noted that any hospital employee can confidentially report any medical problem directly to management."

If a hospital employee can report any medical problem DIRECTLY to management, how does that ensure confidentiality? Direct contact has been established, thus confidentiality has already been breached. There needs to be an impartial, independent third-party involved for such reporting to be truly confidential.

Internal investigations gives absolutely no assurance of quality control or confidentiality since everything and anything can be swept under the rug at the sole discretion of those in authority within the hierarchy of the hospital administration, whose only interest is self preservation--- because anything else indicates mismanagement, incompetence and indifference on their part. (And that simply won't do when they try to justify voting themselves yet another pay increase, would it?)

"To thine own self be true" is a recipe for disaster when the self in question is corrupted beyond reproach because of the very devious nature of the system itself which is created to skew the facts of any situation into the "reality" those in authority wish to present to justify whatever course of action they wish to engage in.

Read between the lines, folks. The bigger gaps, the deeper the (bureaucratic and financial) rape upon patient and taxpayer alike.

Bingo wrote on Jun 27, 2008 1:26 PM:To Bottom Line: You hit the nail on the head! The more staff are sent home early without pay**, the more the hospital shows a surplus. Guess what happens with that surplus. The management team gets a huge bonus, while staff get none or a miniscule amount which doesn't even begin to make up for the amount of pay they are FORCED to sacrifice.
(**Staff always has the option to use vacation pay to make up for the forced time off but then can be denied vacations in the future because they don't have enough time on the books.)

What Survey wrote on Jun 27, 2008 2:17 PM:I've been a patient in the hospital twice and NEVER received a survey. Yet Ellerbe states they are sent to EVERY patient. Makes me wonder about the validity of her other statements.

Retired LVN wrote on Jun 27, 2008 2:22 PM:While my Mother was in the hospital dying of Cancer, I observed not only her care but her various roommates and found that the CNA's were the main caregivers of personal hygiene and that the lack of them meant it was delayed hours or even till the next day. A bedsore should never be admitted by hospital administration as a score that is "better than statewide average or at the average." This is the bottom line: Profit is always the first priority, patient care is not measured by the small percentages of surveys returned, it is measured by the QUALITY given which needs to be measured by eyewitness accounts. SO Administrators get out there and work the floor for a day and see and hear the PATIENTS and their FAMILIES to measure the QUALITY of care given. I wish my Mother had received quality care in her dying days, but that can never be remedied, just a sad reminder to try as hard as possible to never be a patient in your hospital. So very sad.

UWUA wrote on Jun 27, 2008 3:11 PM:As a former union steward, I encourage the ACT's to review their union handbooks to find out if being "flexed off" is allowed and LEGAL.
In your handbooks it should state the number of hours that you were hired to work.
Even if you don't find that kind of information in your handbooks, you do have the right to file a grievance on this practice and/or file a complaint with the Labor Board.
I know of an employee that has been "flexed off" BEFORE she even gets to work. So this business about flexing off employees that are working is only partially true.
The patients are the ones who are suffering and paying the price for this horrendous way of doing business.
Some have been given another patient's meds. Some have soiled their beds because they could no longer wait on their RN to assist them to the commode.
Tri-City will NEVER EVER have my vote for infrastructue improvements as long as Gonzo is given unwarranted bonuses, and unnecessary upper management positions are not eliminated.

Offended wrote on Jun 27, 2008 6:25 PM:Suellyn Ellerbe was visibly offended???? She says that any hospital employee can confidentially report any medical problem directly to management? As a bedside nurse I am offended also. I am offended that when I do have the temerity to inform management that patients are at risk, I am labelled as a troublemaker. I am offended when I am told I don't have to provide the little extra comfort measures to a patient. I am offended that management is turning a blind eye to the additional amount of mental and physical stress they have heaped on staff as a result of the cuts. It's nice that Suellyn can show her offense "visibly"; I sure wish I could.

Alex wrote on Jun 27, 2008 9:03 PM:All of the above responses indicate a disturbingly uncaring style of management at the hospital. We must vote the 3rd bond down and hope that a non-profit group takes over the hospital.

econ- wrote on Jun 28, 2008 12:05 AM:The contracts for the three "satisfaction" surveys cost upwards of $500K. They are statistically worthless. So why are they used as a factor to calculate the bonuses?

Dump the bond issue and write in a people's mandate for an independent outside audit, like from the IRS.

TCMC RN wrote on Jun 28, 2008 1:13 AM:Wow, some really powerful statements from my co-workers. Sadly enough I have to sit here and agree with so much of it. I have to say that I take offense to my CNO SueEllyn to sit there and say that some of the tasks that I perform are "menial." I feel that taking care of the "whole" patient is part of my job. If that means, bathing, wiping behinds and turning my patients that is what I do. Not only does this kind of talk put bad blood between our support staff ie: our CNA's/ACT but it makes me sound like I expect to be treated superior to others and that is not the case. I could not do my job as well as I do it without the help that I get from my right hand which are my ACT's and lift teams. WE as a TEAM get our job done. It is obvious patient care is suffering the effects of you flexing off the staff mid afternoon. Post op surgical patients are not getting walked as they should be. I heard an orthopedic surgeon just a few weeks ago telling family members that their loved one survived surgery but they needed to be at the hospital all the time to remind the nurses to turn the patient as her work load was too much to handle! I was somewhat mortified that this older gentleman now felt like he had to remind the nurses to do what they should be doing. Yes, we are busy and for this very reason this is why we need our ACT's full time. Don't cut from the bedside, cut the fat from the top. We need to have positive discussions going on in our community right now if we even have a prayer to pass the bond for the 3rd try. It is stuff like this that the hospital just doesn't seem to get. The responsibilities of the RN for one shift for one patient are just over the top. Now multiply that x 5 on a Med Surg floor and x 4 on a Cardiac/Tele floor. This is why we need our support staff. As much as I want to have full support and respect for my Administrative Leaders, there are comments like were made in this article about being "offended" when someone raises an issue that make me just want to cringe. Get a grip, it has been many years since you have donned a pair of gloves, opened a syringe, touched a patient. Out of no disrespect, times are different. Bring the aides back to the bedside full time and back to the night shift. Patients need assistance 24/7 at 11pm when the aids go home, the patients still need to have their needs met. Admissions don't stop coming in from the ER. We have tried this AID cut back 3 or 4 times in my many years at the hospital. When the complaints start rolling in, the AIDS are brought back. It is sad that we have to function that way. The timing is bad to bad to be "ticking" off the community. Those people whom are going to vote. Re-think this one, it is real.

Bottom Line wrote on Jun 28, 2008 6:14 AM:Board of Directors are informed by the public's contact through letters or phone calls about the problems of poor patient care. I noticed on the TCMC website that (Sterling, Tweedy, Shallock)of Board members have a hyperlink to email them. I have emailed all three of the poor treatment and overcharging on my bill.

Only one board member responded. She was kind and empathetic and referred me to various sources including the CEO. All sources and the CEO were notified and resolution occured. This is why I support a public hospital -- a private hospital board has no committment to the public with the costs being even greater medical costs to me.

Disappointed wrote on Jun 28, 2008 3:08 PM:I am very disappointed that Reno and Garrahy decided they need more proof before they will believe statements about poor patient care arising as a result of staffing cuts. Why do patients have to suffer first before something is done? Being nurses at one time, they must be aware of the numerous studies over the past decade that associate poor patient outcomes with decreased staffing levels. Yet they say they look at TCMC data on injuries, falls and bedsores and want more proof. How many MORE patients will have to suffer inuries, falls and bedsores in order for these two retired nurses to believe what studies have already proven?

Do your job wrote on Jun 28, 2008 4:53 PM:This article brings up several issues to mind. 1. Why is it that we are about to have the failed bond issue revisited and yet our "local news" is pretty silent on the subject (unless the NCT is spoon fed a story directly from the hospital PR department)? 2.It's obvious that there is some sort of discord ongoing among TCMC employees as the RN staff and now the ancillary staff have recently unionized. The staffing cuts have a definite negative impact on patient care and safety. TCMC administration appears to accept the risks and consequences.

great comments wrote on Jun 28, 2008 5:20 PM:It is kind of sad that people have to speak up in this kind of format, since hospital administration has terrorized people into not talking, even to the point of going to people's houses and threatening their jobs if they don't keep quiet.

"What data" has it right when he/she mentions that Ms. Ellerbe may never have "received" the surveys because it is quite possible that orders were given to someone below her to never deliver complaints to her. Recently, Ms. Ellerbe had promised to be at a meeting of physicians, and people went out of their way to be there. Ms. Ellerbe canceled at the last minute, stating that Dr. Gonzalez had called an "emergency" meeting. This is the type of ivory-tower mentality that the hospital administration thrives on and shows lack of respect for employees and doctors alike. Administration has not been responsive to employees or physicians. If anyone speaks up, if their job is dependent on TCMC at all, their superiors are told they are "troublemakers" or they are threatened with termination. It is time the community knew about what has been happening at TCMC so that the current board of directors can be voted out, since they go along with all the nonsense.

tcmc employee wrote on Jun 28, 2008 9:13 PM:I have worked at Tri-City for 3 year. The people I have met there are some of the most caring and giving people I know. As for reporting any problems, you can go to a supervisor, manager. director or even Dr. Gonzalez's. There is also a phone number you can call and speak your mind, and it will be investigated, by an outside company. Not TCMC employees. There will always be issues in any hospital or company. It's how they are taken care of when things happen, that matter. I know there is no way someone would go to a superior with a complaint regarding a patient and have it disregarded. For the ones who have written bad things, are you or have you been an employee or patient at TCMC? If not, don't talk about things you really don't know about. Next time you need to go to the ER, go to TJ, Mexico!

sounds like someone is a plant wrote on Jun 29, 2008 4:19 AM:"Tcmc employee", it is obvious you are a "plant" or a "ringer", as yours is only the 2nd positive comment re: the hospital.Perhaps the administration and PR dept put you up to it, since you are a newbie and probably try to do as you are told?As far as whether or not people posting here are employees or patients at TCMC,I would say most of us have had first-hand experience with problems there,and work there,otherwise we would not be speaking up.As far as an "outside company", that is mularky plain and simple.As someone mentioned above, when complaints were presented to the administrator, she agreed to be at a meeting, and then at the last minute decided not to show up.So much for any "outside agency".

to TCMC employee wrote on Jun 29, 2008 4:26 AM:As far as going to the E.R., I don't need to go to TJ -- there are plenty of other options in San Diego. I can choose to go to a different hospital than TCMC. As Scripps Encinitas expands, more people will choose to do that.TCMC is far from the only game in town.
Have you tried complaining to the CEO or anyone close in rank to him? If you did, you would probably not be an employee there anymore, especially if you were at all pro-union, they would find a way to get rid of you.

It is quite unfortunate, as TCMC used to be a great hospital, even when they have had junky administrators in the past. But the current administration with its bulldog and strangulation tactics, is making the hospital go down in flames. As a TCMC doc, I am not going to vote for the bond. I helped support it in the past but this administration is completely incompetent and the only vote they have from me is NO CONFIDENCE!

Disappointed wrote on Jun 29, 2008 10:49 AM:To TCMC employee: I have been at TCMC for 15 years, and I agree with you that we have some of the most caring and giving nurses and staff at our hospital. I believe that is why Garrahy and Reno don't see the change in their (all too inadequate) indicators yet. Nurses and other staff have been working frantically trying to make sure patients are not experiencing major injuries. The frenzied pace at which we are now required to work will not stay effective for long. According the to president of the Joint Commission that gives TCMC accreditation, "...what we see is a cascade of small errors that penetrate defenses that we’ve created and harm occurs only at the end of a sequence of errors..." He goes on to say that we should be looking at ways to identify and prevent the small errors in order to be successful in reducing the rates of adverse events. But Garrahy and Reno say they want more proof. All they have to do is ask the nurses about the negative impact the staffing cut has had on patient care, AND GIVE THEM A FORUM TO ANSWER WITHOUT FEAR OF RETALIATION. Why do they have to wait until patient injury numbers increase? Doesn't that go against what the Joint Commission is trying to achieve? Shame on them; they were nurses at one time; they should know better.

Randy wrote on Jun 30, 2008 9:41 AM:The bond is not designed to be a referendum on the current TCMC administration. Even if Scripps acquired the hospital, the first thing on the agenda would be to pass the bond.

Randy is right wrote on Jun 30, 2008 11:18 AM:If Scripps acquired the hospital they would raise standards as they have a reputation for providing quality health care. That is what we really need! If by voting down a bond we can force Tri-City to close and allow Scripps to come in, start from scratch, and do it right, we would vote to fund the bond in a flash. At that point it would win by a strong majority and we would have what we want an need in North County - quality health care. Why don't you ask that question during a poll or survey? Afraid of the answer? I bet even the few quality nursing staff from TCMC that post here would admit that they would be honored if Scripps came in and offered them a chance to be associated with a hospital that really provices quality health care. The bond passed in the Escondido area so it is not that people do not see a need, and they are willing to pay, just not into Tri-City. It should be condemed!

Alex wrote on Jun 30, 2008 11:35 PM:If Scripps took over Tri-City, there wouldn't be a need for bonds. Tri-City, please follow up on Randy's suggestion-- poll public opinion of the alternative of turning the hospital over to Scripps, requiring no bond, and poll that against the District's alternative of passing a bond and keeping the Tri-City Board and administration in control.

TCMC Employee wrote on Jul 4, 2008 12:06 AM:I am not a plant or ringer. I am an employee who likes my job and the people I work with and the people who come here for care. United States of America, "Freedom of Speech" So many are ready to make bad comments. Some from employees, and some from the community. What ever any one feels or thinks, about the administration at TCMC, the bottom line is "North County needs this Hospital". How about using our "Freedom of Speech" to communicate with each other and work on real ideas to make our hospital all it can be. Then we wouldn't need a bond or having TCMC shut down, and loosing wonderful health care professionals that just want to do what they love. Taking care of their community. All the complaints I have read so far won't do much good, unless they are backed up with 'Solid Ideas' to improve TCMC. How about we save one day to post comments to help. Say July 10th. Everyone who has some idea to improve the hospital, post it here. Be honest and sincere in your ideas. If you just want to trash TCMC, please save it for another day. July 10th. Post your best ideas and lets see what happens. Every success started with an idea...

TCMC Employee wrote on Jul 4, 2008 12:25 AM:I have read many comments that "Randy" has posted. He never says anything good for Tri City. He thinks Scripps could come in and start from scratch. Maybe "Randy" is a plant or ringer for Scripps. Maybe he has a vested interest in seeing Tri City fail? Just a thought.

Bottom Line wrote on Jul 6, 2008 9:07 AM:To TCMC Employee - Randy was on the board from 1998 to 2002 when the board was expanded from 5 to 7 members. What a mistake - the two new board members Halfon and Horton [allegedly] manipulated, and even partake in deception of facts including but not limited to setting policies that did more harm to the process of democracy. With Garrahy by their side, and the persuasion of two other board members that CEO Gonzalez should be given plenty of rope, e.g., pass policies to stifle discourse of board members, implement bonuses, recruit doctors giving them gifts of public funds - the public's attention was shifted from watching the CEO, his cronies, while Horton gleefully ate dinners with Gonzalez. Thankfully the people booed Randy and Halfon off the dais. Randy has always been a supporter for Scripps and even boasts that he will not use Tri City even though he's a mile from the hospital.

Guess what - Randy is telling everyone he's running for the board. Will voters go backwards? or will they show Randy he is washed up here just like El Centro!

tcmc employee wrote on Jul 12, 2008 4:10 AM:My idea is 1 person from each dept. not management, or supervisors, or Directors or VP's. Just the every day worker bees. 1 person from each dept gets to gather and shares ideas. Ideas on how to raise money, or an event for the community to come and meet the staff of TCMC. Every one from billing to OR, Cafeteria, to the gift shop. Have booths for each dept, and the community can come by and ask question, pickup pamphlets with information on the dept and who to call if they need help or questions.

Our slogan is "we are "ALWAYS HERE FOR YOU" lets practice what we preach. We can be here for a job. Or we can be here to make a difference, there will be troubles from time to time. You will find that everywhere you go. It's when we have a patient, who is scared, alone, we have to take the time to stay with them, listen to their concerns. Make them feel like they are not alone. The way we would want to feel if we were in their place,

That's my ideas. Any one else have a thought? Let's hear it.

TCMC EMPLOYEE wrote on Jul 13, 2008 10:37 AM:It's past July 10th, Where are the good ideas? Do people just want to complain?

I know there are people out there who have ideas. Don't let TCMC go without a fight.