Oh, Baby

Does Sutter Health understaff maternity unit?

Complaints about the care of newborns at Sutter Medical Center in Santa Rosa prompted state inspectors to investigate the hospital, where they found that, because staff had stopped using the facility's newborn nursery, infants were being left unattended.

A State Department of Health Services report released last week revealed that nurses were looking after babies at the nurses station, in the labor and delivery room, and in the newborn intensive care unit because the nursery was not staffed.

The report includes the following observations, all of which come from interviews with hospital staff:

* "... a nurse was watching a baby in a bassinet at the nurses station and left the baby unattended for a brief period. During this time, a nurse manager observed the baby unattended and removed the baby from the station without the nurse's knowledge.

* "... a nurse had to take a patient to surgery and asked the nurse manager to watch the baby. The nurse manager was watching the baby at the station, but when the nurse returned to the unit from surgery, the baby was at the station unattended.

* "... when coming to the unit several nurses were overheard arguing over who would watch a baby at the station while the mother showered. This staff person has seen babies in bassinets being watched at the nurses station while nurses chart.

* "Staff confirmed they wheel babies to the nurses station and chart while the mother rests or showers and that this happens almost every day/night. Staff also stated they either wheel babies in the bassinets or carry them when they have other things to do."

State health regulations prohibit all these practices. But after two months of review, and Sutter's plan to correct the situation, DHS did not cite the hospital.

Meanwhile, Sutter officials argue that not only was the nursery never closed, the entire DHS investigation is the work of a few disgruntled hospital employees. DHS is required to investigate all complaints it receives.

"The nursery never closed. It's there. It's ready. It's open," says Sutter Chief Executive Officer Clifford Coates. "The difficulty that we're having is that there are some people with some kind of agenda that want to paint us with sinister things [by] telling people that it's closed."

The problem began nine months ago, when the hospital reorganized the way its staff cares for new mothers and babies. Under the new plan -- called "couplet care" -- new mothers and their babies stay in a hospital room together. Mothers are also supposed to have the option of allowing the nursery to supervise their babies while the mothers sleep, shower, or undergo medical procedures.

But rather than assigning nurses to the newborn nursery, Sutter's new model calls for the entire shift of nurses to look after all the mothers and babies, whether they are together or apart. That's apparently where things went awry.

Nurses say Sutter's staffing isn't adequate to care for the patients and support the nursery at the same time. And a few patients definitely seem to have gotten the impression that there was no nursery at all. DHS interviews with patients hospitalized between April and August 1997 revealed the following:

"The patients stated they were told the babies needed to stay in the room and that there was no longer a newborn nursery. One patient indicated she wanted to have her baby in the nursery after having a caesarean section but was told that was not possible and maybe a family member could come and help if she felt she could not take care of the baby ...

"... Other patients indicated that when they asked the nurses if the babies could go to the nursery, especially at night so that the mothers could get some rest, they were told that there was no nursery and that the babies had to stay in the room."

Sutter CEO Coates insists that those were isolated incidents, caused by nurses unhappy about shift changes and negative media coverage.

"It's amazing what a couple of unhappy people can create," Coates says. "This is not a story. It's going to come out that we've actually improved things."

Sutter's critics find it hard to believe that contention. In fact, the $2 billion Sutter Health has battled part of the community since its highly controversial takeover of the previously public Community Hospital of Santa Rosa in 1996. A citizens group collected enough signatures to put the issue on the ballot, leading to an emotionally charged campaign by both sides. State records show that Sutter spent $396,000 on the campaign, which featured -- surprise -- newspaper advertisements touting its maternity services.

 
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