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Nurses warn Zuckerberg San Francisco General is dangerously understaffed as city confirms first COVID‑19 cases
Summary
At a March 5 committee hearing after San Francisco’s first confirmed COVID‑19 cases, DPH and DHR outlined plans to speed nurse hiring (DPH cited ~165.5 days to hire nurses) while dozens of nurses testified to chronic understaffing, forced overtime, violence and closed beds; the committee referred a resolution to the full board and ordered follow‑up.
San Francisco officials told the Government Audit and Oversight Committee on March 5 that they are moving to speed hiring of frontline nurses at Zuckerberg San Francisco General Hospital after unions and dozens of nurses described chronic understaffing, frequent mandatory overtime, workplace assaults and operational strain — and as the city recorded its first confirmed cases of COVID‑19.
"As of November 2019, the hiring time for nurses was calculated to be 165.5 days," Michael Brown, the new director of human resources at the Department of Public Health, told the committee. Brown described bottlenecks across the hiring flow — funding approval, referral issuance, candidate selection and onboarding — and said DPH is forming a dedicated RN hiring team and seeking additional HR staff to process hires faster.
Anna Biaspis, deputy director of employment services at the Department of Human Resources, described a DHR‑DPH project to reduce nurse hiring from roughly 165 days to 90 or fewer. Her plan includes an intensive job‑analysis for 20 specialty areas, an audit to remove procedural bottlenecks, a continuous testing program to refresh eligible lists more frequently and pre‑approved interview panels and questions to accelerate selection.
But nurses and union representatives pressed for immediate action. SEIU stewards and rank‑and‑file nurses gave extended testimony describing repeated unsafe staffing levels, closed beds because of vacancies, boarded admitted patients, and a spike in workplace assaults concentrated in the emergency department and psychiatric services.
"We have to make sure that we have appropriate full‑time staffing…this is a serious public health issue," Supervisor Asha Safaie said in opening the hearing, citing the newly confirmed local COVID‑19 cases and urging emergency hiring plans that could operate on 30‑day timetables.
Frontline testimony painted a stark picture: emergency nurses said the department routinely runs at or over census with many beds staffed only by travelers or per‑diems; skilled orientation and training programs take six to 12 weeks, meaning any hiring gains require time for onboarding; and some nurses reported being physically assaulted on the job and getting limited follow‑up. "This public‑health nurse’s recommendation is that you address the fact that there is toxic bullying that takes place from administration," a union speaker said.
Hospital leaders acknowledged the deficits. Dr. Susan Ehrlich, hospital leadership at Zuckerberg San Francisco General, said nurses make up about 30% of hospital staff (roughly 900 budgeted RN FTEs) and that vacancies, leaves and modified duties can total about 19.5% of budgeted nurse FTEs (about 10% vacancies). She described steps already underway to expand behavioral emergency response teams (BERT), improve incident reporting and develop workplace‑violence prevention training tailored to high‑risk units.
The committee pressed for faster, concrete steps. Supervisors asked for an immediate emergency plan, data on how many positions are filled by travelers and per‑diems versus permanent staff, and a timeline for DHR’s RN hiring project. DPH and DHR leaders pledged to produce more specific data and to work with unions. Supervisors signaled they would help remove obstacles and involve the mayor's office and controller where needed.
Formal committee action: Supervisor Asha Safaie moved to send Item 3 (a resolution urging inclusion of frontline nurses in decision‑making and expedited hiring targets) to the full Board of Supervisors with a positive recommendation; the motion was taken without objection. Item 2 (the staffing hearing) was continued to the call of the chair with plans for an interim working group to produce an aggressive, short‑term hiring and staffing plan and for follow‑up hearings.
What’s next: DPH and DHR have committed to deliver more granular vacancy and hiring‑pipeline data and to begin targeted changes to shorten RN hiring timelines; supervisors asked that the Mayor’s Office and DHR explore emergency hiring authorities and that unions be included in implementation planning. The committee signaled it would reconvene on an expedited timetable to evaluate progress.
Representative quotes from the hearing
"We have reached an agreement with Local 21," — Steve Ponder, DHR (on item 1; referenced by unions when discussing conversion).
"As of November 2019, the hiring time for nurses was calculated to be 165.5 days, which I find unacceptable," — Michael Brown, DPH HR director.
"Nurses are the front line of defense…If we have a hiring crisis in terms of timeline, we need to figure out," — Supervisor Asha Safaie.
Ending
Committee members, DPH and DHR staff agreed to rapid follow‑up: an internal working group to pursue expedited hires and process changes, additional data from DPH on vacancies and the mix of travelers/per‑diems versus permanent staff, and a return to the committee for further oversight. Unions and nurses said they will continue to press for immediate emergency measures and an independent review of budgets and staffing allocations.
