A shortage of 40 nurses at Prince George's General Hospital has forced hospital administrators to shift nurses from their regular positions to the intensive care units and begin preliminary consideration of a plan to close some beds at the hospital, according to the president of the nurse's union.
Hospital officials requested two weeks ago that Prince George's County Executive Lawrence J. Hogan authorize the hiring of 20 nurses and 20 other employes, according to deputy hospital administrator Tim Miller. But Hogna responded Wednesday that only three nurses and two laboratory technicians could be hired.
Hogan is still reviesing other hirings for the hospital, according to press aide Barbara Coleman.
Hogan's decision -- and the delay that accompanied it -- are the products of one of the new cost-cutting measures designed to help the county live within the tax revenue ceiling imposed by voters in the November election. Hogan is personally reviewing all hiring requests, and approving few of them.
But the stringency of Hogan's hiring order has angered the hospital's employes, and illustrates a conflict that has developed on several fronts in Prince George's during the past weeks.
The most dramatic example of this surfaced Tuesday, when Hogan abruptly ousted a veteran county department head for failing to clear overtime payments in advance.
Donald Dunker, head of the county's Department of Public works employee since 1951, routinely sent crews last weekend to clean an overnight snowfall from the roads. But he failed to call Hogan to request approval for the crews' overtime pay.
On the day Dunker submitted his memo listing the overtome, Hogan demanded that Dunker retire immediately, even though he already had announced his retirement as of Jan. 27.
In Dunker's place, Hogan Temporarily installed one of hiw aides, Vaughn Barkdoll, who worked as an assistant to Hogan in Congress but otherwise has little governmental experience.
Hogan's explanation for the unusual appointment summed up the bureaucratic struggle. "Vaughn knows the direction Hogan wants to go in, and he understands exactly what Hogan wants to do," press aide Coleman said. "His qualifications for the job aren't the point at the moment."
Although less visible, Hogan's struggle with the staff at Prince George's General Hospital has become Equally intense.
In an effort to control the county's spending, Hogan has established rigid procedures for monitoring everything from hiring and overtime to printing costs and gas mileage. At the same time, some of the county's administrators say the bureaucratic delays and frustrations resulting from the new policies are making it difficult for them to maintain routine services.
Nurses at Prince George's Hospital contend that the slowness of the countr's new hiring procedures will prevent the hospital from ever reaching an adequate staffing level.
The Maryland Nurses Association local, which represents 383 of the some 700 persons in nursing positions at the hospital, has been complaining to hospital officials and Hogan's office for weeks that the hiring review process -- which they say amounts to a freeze -- has made a bad staffing problem critical.
As of Dec. 20, according to union president Patrick Lally, the staff of 39 nurses in the intensive care unit was down by 12, forcing nurses to work extra hours and increasing the number of patients assigned to each nurse. Overall, he said, almost 50 nurse positions were vacant, although hospital officials placed the figure at 40.
The approval of three more nurses for the unit this week, Lally says, "is like feeding a jelly bean to a starving man."
"The bottom line of this policy for the nurses is a freeze," Lally said, "because nursing is a seller's market. A nurse in this area can go out and find a job anywhere. If it takes this long to get a hire approved, the nurses just won't wait, and the word will get around that P.G. is not hiring."
Hogan's aides insist that the hospital's problems are being studied, and the hiring review, above all, is necessary. That leaves the hospital's administrators in the middle.
"We understand the county executive's desire to review all positions for the benefit of the taxpayers," says Raleigh Cline, the hospital's chief executive officer. But he adds: "We're concerned about not hiring nurses as soon as they come here. They can go from hospital to hospital at will and you've got to be able to give them an answer."
"We have a 40 percent attrition rate, which is normal for a hospital," said Cline. "We have to keep hiring nurses. Right now we're not at a crisis state. But if it went on (with no replacements) for a number of weeks we would reach a point where we would have to consider closing beds."
"I expect that (Hogan) will eventually approve the necessary positions," Cline said. "he's just got a lot of things he has to review."