The chilling effects of President Donald Trump’s “Big Beautiful Bill” have caused nurses to be furloughed across Santa Clara County’s hospitals.
Dozens of local nurses have been furloughed over the past few months, creating staffing shortages across the entire public health care system, according to nurses and union representatives. They also pointed out furloughs at the St. Louise Regional Hospital intensive care unit in Gilroy have caused longer wait times in the emergency room. Valley Medical Center is also experiencing an overwhelming number of babies being born due to patient transfers.
“Every furlough shift removes skilled hands from the bedside, slows down patient care and increases delays in treatment — consequences that fall squarely on our most vulnerable community members,” James Mount, negotiator for the Registered Nurses Professional Association and ICU nurse at St. Louise, told San José Spotlight.
A spokesperson for Santa Clara Valley Healthcare, the county’s hospital system, said furloughs are common practice at hospitals and made when staffing levels exceed patient demand.
“Staffing decisions are made to ensure high-quality care continues for all our patients,” the spokesperson told San José Spotlight. “If there isn’t the patient demand for staffing levels on a given day, any steps taken are aligned with the mutually agreed upon union contract.”
Santa Clara County faces tough budget decisions as it’s set to lose more than $1 billion a year due to Trump’s bill, which slashes funding for vital services including Medi-Cal and food stamps.
Medi-Cal represented roughly $1.9 billion in funding received by Santa Clara County last fiscal year. The county receives that money through reimbursements for patient care at its four county hospitals and multiple clinics. Last fiscal year, the county spent more than $6 billion on its health care system, or half of its $12 billion budget. This year, the county is expected to spend more than $7 billion on its hospitals.
Half of county hospital system patients pay through Medi-Cal. The rest pay through a mix of other means and Medicare, a separate federal program serving patients 65 and older and patients of all ages with certain disabilities.
Even though Santa Clara County voters passed Measure A last month to increase sales taxes by 0.625% in an effort to help fund health care services, the estimated $330 million in expected annual revenue only covers a fraction of what is lost from federal cuts.
Going against contract
Several nurses — who asked not to be named due to fear of retaliation — said some workers have been furloughed without the option to work in another unit or improve their education, going against the contract the nurses union has with the county. They said it’s the first time in their years-long careers with the county they have been pushed to take time off work.
“If you’re furloughed, you have to use your (paid time off). You don’t have a choice,” one nurse told San José Spotlight. “Some people are running out (of vacation time), and so pretty soon they’re not going to have any pay.”
In addition to furloughs at the ICU in St. Louise, nurses said furloughs have taken place at O’Connor Hospital’s ICU, the neonatal intensive care units at Regional Medical Center and Valley Medical Center and the labor and delivery unit and newborn care at Regional, among other units.
At St. Louise, furloughs have caused ICU patients to wait in the emergency room for 12 to 24 hours, nurses said, with many nurses not taking their breaks.
“The morale of the unit is quite poor. People are quite upset,” another nurse told San José Spotlight. “They’re consistently running the ICU short staffed compared to past times. They were running short to begin with, and then now they’re also furloughing nurses on top of it.”
Hospitals in California are legally required to have one nurse for every two ICU patients. For the medical-surgical unit where patients are recovering from surgery, the staffing ratio is one nurse for every five patients.
But it’s not as simple as ratios. Mount said the county can’t accurately predict patient demand, especially when emergencies happen.
“Like firefighters and police officers, how can you say you don’t think there will be any fires today or crime will be less today?” Mount told San José Spotlight. “You should always staff for the unexpected in areas like critical care and, the very least, staff to the ability of your (registered nurses) being able to get their deserved breaks.”
The Santa Clara Valley Healthcare spokesperson said the county will follow the appropriate process to comply with its labor agreements, and is doing everything it can to preserve vital services.
“Santa Clara Valley Healthcare is exploring every option to protect existing service lines due to budget cuts resulting from H.R. 1,” the spokesperson said. “This includes reviewing all contracts for savings potential, identifying synergies across the enterprise system and working directly with staff to identify where costs can be reduced or services can be better aligned.”
Patient transfers
Last year, the county bought Regional Medical Center from HCA Healthcare to save services the for-profit corporation slashed in the East San Jose hospital, including obstetrics, labor and delivery and newborn care services.
The county restored maternity services in October when it moved maternity nurses from O’Connor to Regional. However, nurses said some mothers who were being seen by doctors at Regional have been transferred to Valley Medical Center to deliver their babies.
One nurse told San José Spotlight there hadn’t been a patient at Regional’s NICU unit for three weeks. Nurses who transferred from O’Connor to Regional expected to continue their regular volume of work, but have instead been furloughed.
Allan Kamara, vice president of the Registered Nurses Professional Association and a nurse at the Valley Medical Center emergency department, said obstetrician-gynecologists were telling mothers to go to Valley Medical Center for their delivery. Meanwhile, he said the labor and delivery unit there is overflowing with patients.
“(Regional Medical Center) continues to have a very low census and very few deliveries since reopening, while (Valley Medical Center) is experiencing an overwhelming number of deliveries, putting a significant burden on the VMC staff,” Kamara told San José Spotlight.
The county spokesperson said they aren’t aware of physicians telling patients to deliver at Valley Medical Center, and that Regional’s deliveries “are on par” with what O’Connor once had.
“Regional Medical Center is in its early stages and we anticipate continued growth and improvement in patient census,” the spokesperson said. “The overall patient census at Regional has grown from about 90 on the day of acquisition to around 200 on most days.”
A nurse said Regional’s NICU unit has started to receive patients again after San José Spotlight inquired about the transfers to Valley Medical Center.
Nurses are calling for the county to cut administrative and procurement costs first before laying off frontline workers.
“Cutting bedside (registered nurse) positions causes exponentially more harm to public safety than reducing management roles,” Mount said. “For a short staffed public hospital system already stretched too thin, weakening frontline care is not a solution.”
Contact Joyce Chu at [email protected] or @joyce_speaks on X.