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Urgent Care

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It came in as an anonymous tip: Nurses, a whole mess of 'em, were said to be leaving Mad River Community Hospital's operating room en masse for the sanctified halls of Eureka's St. Joseph Hospital. The departures, we were told, may well force a shutdown of the OR at Mad River, Arcata's beleaguered private hospital -- at least temporarily. There's just no way it could function with so few nurses left.

It appeared to be head-hunting of the highest order -- a major offensive in what has been a mostly civil competition between the two hospitals. The California Medical Association -- along with countless know-it-alls -- has surmised that the North Coast simply cannot sustain three acute-care hospitals (counting St. Joe's sister facility, Redwood Memorial in Fortuna). Eventually, they said, one or two will have to reduce services.

But which one? Let's take a look: St. Joe's is in the midst of constructing a $120 million expansion -- three stories, 100,000 square-feet. The Catholic hospital was rescued from bankruptcy a few years back by its guardian-angel parents, the SoCal-based Sisters of Orange. (See "Saved!," Dec. 14, 2006). But they seem to have turned things around, recently reporting first-quarter earnings of $1.39 million, plus $724,000 from Redwood Memorial.

Mad River, meanwhile, is one of a relative few remaining independent hospitals in California and doesn't have vast resources to draw upon in times of crisis. Do the wayfaring nurses know something we don't? Are they jumping off a sinking ship? Is this the beginning of the end for MRCH?!

Not so fast, says Mad River's PR department. Yes, some nurses have left, admitted spokeswoman Kathy Byrne, but the OR is not, repeat not, at risk of shutting down, much less the entire hospital. In a carefully worded statement, MRCH suggested that the Great Nurse Migration of 2008 is nothing more than a few fresh-faced nursing school grads looking to "expand their professional horizons in other parts of the country."

That description doesn't match Vicki Small, one of the nurses who recently jumped ship. She worked at Mad River for seven years and said she still loves it there. But in January, she said, the caseload in the operating room began a nosedive from which it has yet to recover, and nurses' hours have been slashed.

"It breaks my heart to leave," Small said. "The staff there is just wonderful. But I'm the only wage-earner [in the household], and I wasn't getting enough hours." Small's last day at MRCH was Saturday. Including herself, she counted nine OR nurses who have either turned in their two-weeks' notice or already left, and all of them, she said, are headed to St. Joe's.

She added that, while several of the Mad River nurses were contacted by personnel at St. Joe's, it wasn't a headhunting mission. "It was just friends contacting friends."

Dr. Gregory Gibb, president of the Humboldt-Del Norte Independent Practice Association, said he's heard a lot of talk in recent weeks from nurses weighing their options. The sentiment he's detected "between the lines" is that nurses are nervous about the drop in business at Mad River and have decided that "they're gonna go with a safer ship."

Neither Gibb nor Small expect this exodus to bring Mad River's OR to a halt, however. Small suggested that they can use traveling nurses, or perhaps hire some of the 150 medical workers fired from Redding's Shasta Regional Medical Center last month. In their statement, MRCH said that more than half the nurses who are leaving will remain available part-time or on-call.

Gibb takes MRCH death rumors with a grain of salt. "People have been predicting the demise of Mad River for 24 years," he said. "I'll believe it when I see it." Besides, he said, if the caseload has really dropped so drastically, how many nurses do they need?

Despite leaving -- or perhaps because of it -- Small is now even more concerned about the future of MRCH. The community needs both hospitals, she said, especially given St. Joe's Catholic scruples, which prevent them from offering the full spectrum of women's health services.

"I certainly hope Mad River survives," Small said. "It's a wonderful little hospital."

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