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For the first 25 years I was a Charge Nurse in the Nursery and I attended
thousands of deliveries. Because of our Mission to service the poor and
uninsured, we tend to have a high risk population. Many times a mother will
come to the emergency room, ready to deliver, without having any prenatal
care. This puts both her and her baby at risk for infections and other
problems. The baby may be born sick or born too early, needing to be
resuscitated at delivery, which brings up two issues I wish to address.
We have demonstrated our ability to compromise. We stopped performing VBACs
(vaginal birth after cesarean) and our nursery has been downgraded 3 times in 10
years, each time narrowing the level of service offered. We are now at the bare
minimum level of care and resources to protect the health of our community.
SF is one of the most progressive cities in our nation -
it is here and now that we must rethink how we deliver healthcare to our
women and children, especially those in underserved populations. The
division of services and lack of continuity to the detriment of our city's
most vulnerable is not the solution I would hope for. SLH has been a leader and model for the
true integration of healthcare and in an era when healthcare reform is at the
forefront of the national agenda, what we have achieved at SLH is worthy of
applause, protection, and investment.
Mothers and babies are at high risk after
birth and the lack of an appropriate healthcare would jeopardize the
wellbeing of this community. We need a change in policy at various levels, a
commitment for finances from organizations to ensure the welfare of our
families.
A NICU nurse at St. Luke’s
View
Not long ago, a woman came
into St Luke’s in premature labor. She had 26 week twins (which is 6 months
of pregnancy). She was too far advanced in her labor to be safely
transported to the Cal Campus. So we prepared to have her deliver at St
Luke’s. Both babies needed full resuscitation and assistance in breathing.
They were both only about two pounds each. Our pediatric hospitalist was
present and the neonatologist was called in. There were 3 respiratory
therapists available, and thankfully I had called one of our other NICU
nurses who had just gotten off of the night shift to come back and take care
of the 5 sick babies that were in our NICU at the time. A third highly
skilled NICU nurse was with me to assist with the twins. I can not think of
the outcome if I hadn't had these other trained nurses available.
Director of Homestyle
Midwifery's view
The proposed changes in the
nursery at St Luke from a NICU to a special care nursery are a downgrade in
the LEVEL of services that will be provided. What our community needs is an
UPGRADE in the QUALITY of these services so that the nursery is special in
fact and not just in name.
Dr. Kenneth Barnes's view
WHY CAN’T THESE PLANS INVOLVING PHYSICIAN
DEVELOPMENT, RECRUITMENT AND RETENTION BE REINSTITUTED? WHY CAN’T
SERVICE LINE DEVELOPMENT AND CLINICAL INTEGRATION CONTINUE? WHY CAN’T
NURSING DEVELOPMENT ALONG THE LINES PREVIOUSLY STARTED AND SEEN TO BE
SUCCEEDING BE RESTARTED? WHY CAN’T MARKETING EFFORTS BE REVITALIZED?
WHY CAN’T THE ER BE REBUILT AND PSYCHIATRY BE BROUGHT BACK? WHY CAN’T
CPMC MAKE CATHEDRAL HILL A BIT SMALLER AND BUILD A 100-125 BED NEW ST.
LUKE’S TO SERVE THE SOUTH OF MARKET AREA? WE BELIEVE THIS
REVITALIZATION IS POSSIBLE AND ABSOLUTELY NECESSARY. OUR COMMUNITY OF
PATIENTS AND THE PEOPLE OF SAN FRANCISCO DESERVE NO LESS.
ER
Medical Director's Worries
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Since
St. Luke’s financial condition can be explained by the uncompensated work we
do taking care of the indigent, and since the City receives State funding
for indigent health care, shouldn’t the City assume some responsibility for
keeping St. Luke’s alive?
A private practice family
physician's view
We need to be able
to offer our patients full pediatric care including NICU, in order to maintain
our outstanding obstetrics department. We need to be offer our patients
excellent physical therapy both inpatient and outpatient. We need to make the
hospital more appealing and more efficient in order to attract the paying
patients who are now crossing town for emergency and inpatient services. We
need to recruit and retain primary and specialty care physicians who are
dedicated to our diverse populations.
Doctor from the church
that founded the hospital
Sutter Health, has not
bought into our mission, and no longer has plans for us to exist as a
hospital at all! In
2001 we chose to affiliate as a settlement of an anti-trust suit brought
against CPMC/Sutter due to unfair competition. Many believed at
that time in their promises to preserve our mission, to invest and
revitalize, and, yes, even to build a new hospital! That trust has been
badly betrayed… placing corporate profits ahead of the welfare of
patients.
- Medical Director of the
Emergency Department's View
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"The issue is money. St. Luke's has been
losing about $30 million a year. Medi-Cal pays us a lot
less than the cost of care, and a third of what they pay
the City for the same patients. In our ED, 50% of patients are on Medi-Cal,
and 20% are uninsured. The City gets funding from the State
for the uninsured, but does not reimburse us
for the role we play in supporting the safety net. The unfunded State mandate of seismic
upgrades is setting the time frame for this
crisis."
- An Obstetrician's View
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"closure
of St Luke’s Hospital will be felt citywide.
It will likely increase the delivery
numbers at SFGH by 50%, partly because of transportation issues."
- A
Pediatrician's View
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"...this
closure, which reduces the number of qualified caregivers needed to
resuscitate newborns, will have disastrous effects on the women and children
who have come to depend on the quality medical care they receive at our
hospital. Currently 1300 babies are born annually at St. Luke's. The
majority come from low income, minority families. The only other hospital
south of Market is SF General Hospital which is already overburdened. "
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A Cardiologist's View
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"THE DAY AFTER ST. LUKE’S CLOSES,
SOMEONE HAVING A HEART ATTACK SOUTH OF MARKET WILL HAVE NO PLACE TO GO for
acute or continuing care, IF HE OR SHE IS LUCKY ENOUGH TO SURVIVE."
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An Orthopedist 's View
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"Orthopedic
patients, due to the nature of their injuries almost always have impaired
mobility which makes it very difficult for them to access hospital services.
Imagine being 60 years old, having a broken ankle and riding, not one, but
two buses to arrive at your hospital. Our patients are vulnerable, and these
scenarios are common.
"
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An Nurse-Midwife 's View
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"CPMC/Sutter's
plan for "consolidation," is misguided. It is a dangerous plan that ignores
the reality of treating an at risk birthing population. Laboring women
will continue to arrive at our Emergency Department expecting safe births
and for the first time in decades, we will not be there to attend to them.
"
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