Q&A Part IV: Luca Carbone, house supervisor

Just days away from the move of University Medical Center services, Luca Carbone chokes up just thinking about it.

It will be reality April 16-18, as Level 1 trauma, burn, pediatrics and acute inaptient services move from UMC to their new home at the downtown Community Regional Medical Center.

But it’s tough to blame Carbone for his emotions. He’s been dedicated to UMC (then-Valley Medical Center) since he started as a fourth-floor intensive care unit nurse in 1978 after graduating from Fresno State.

He’s spent the past 15 years as a UMC house supervisor, and recently sat down to share some of the insight he’s gained over the years:

How do you feel about this move?
I’m glad that it’s here. It’s one of those things – we never thought we’d go to Community to begin with and that we were always going to be County, and then that happened, and now the move is happening. And I’m glad that it is. UMC has been here for quite a long time, but we need to join forces and we need to collaborate so that we can deliver the care that we can give with a sufficient amount of staff, and take care of all the patients we get between the two facilities.

What are you most looking forward to about moving to Community Regional Medical Center?
The joining of staff, that’s going to be one of the major things. The census has been so high here and we’ve been working so short-staffed with the transition and getting things rolling downtown. We’ve been working short-staffed and we’re begging Peter to pay Paul almost every day that I work, every shift. So I think that staff unity is one thing that I’m looking forward to.

The other thing is, I think the patients are going to be serviced better because of all the specialty services that are going to come under one roof. I think the joining of forces with all the specialty services being under one roof and not having to go from this facility to the other for specialty needs is going to really become more efficient, save time and utilize the staff better. Some of the managers have had to be split between two areas, so there’s going to be one manager now in one area so there’s going to be much better oversight.

What worries you about the move?
Initially, I think it’s being received. Both facilities have a lot to offer each other. Being that we’re all going to be under one roof, you’ll be able to call whoever and ask questions as opposed to having to rely on two different facilities. I think communication is the key to making it work and being successful.

We hear a lot about UMC. Tell us, what is so special about it?
It’s the best place in Fresno. It’s my house. It’s been my house. The Level 1 trauma that it brings to play, the caliber of trauma docs and trauma nurses, this is the place you want to come if you’ve had trauma or burns.

The thing that we have to work on from that point on is you sometimes hear, “I want to go there for trauma but once I get taken care of trauma-wise then I want you to move me someplace else.” We go beyond the trauma role and the burn role, we deliver wonderful care. There’s more to it than just the traumas and the burns. The nurses that are here, that have been here, that have stayed here, that have mentored the majority of nurses in town, are still here – I got choked up.

Level 1 trauma, burn, pediatric and acute inpatient services will move from University Medical Center (pictured) to the downtownCommunity Regional Medical Center April 16-18.

How will this UMC move impact what the people from UMC can do?
We bring a wealth of knowledge. We’ve been the backbone of taking care of the indigent and we have experienced so much here from the gamut of people we’ve seen. We’re quite knowledgeable and we’re quite experienced. We come with a full plate ready to take on.

Just having the new facility and the new equipment, the new technology that’s come into play and again, I can’t stress enough how the manpower at Community Regional will help with the delivery of nursing care. The ancillary support team at Community Regional will be very beneficial. It will free us up to be doing more hands-on with the patients.

What will be the toughest part of this transition?
Learning the new facility and learning what it has to offer, how to utilize it to its maximum and getting to know the personnel. It’s like an extended family that you’re having to bring closer to you and getting to know what each has to offer each other and how to intertwine it together to be able to make it work for patient care delivery. We’ve come a long way.

If I’m a patient coming to this bigger than ever regional medical center, what can I expect?
Having been to some of the bigger regional medical centers like Stanford, UCSF and UCLA, I’m hoping to become as they are. To be able to provide the Valley with all the specialty services so that you don’t have to be transferred to San Francisco or to Stanford to get the specialty services that patients in this area require. We’re hoping that we can bring the services to the patient as opposed to the patient going to the service.

What does it truly mean to be an academic regional medical center?
It widens and broadens the scope of the health care profession. It provides us with the specialty needs that are required due to the fast pace Fresno County has grown. I think when we first got started in this endeavor of the regional medical center we did not realize the number of patients we were going to take care of. It outgrew us, it outgrew the initial plans, and we’re having to grow as we move to be able to handle the workload, the patient load and the necessity load of the patients who come to visit the hospitals.

The workload for these specialty docs is overwhelming. I’m really amazed sometimes how much they take on and how much of themselves they give to be able to complete the health care that is needed by the patients who come in to the facilities. My hat goes off to those docs, they’re amazing, it’s an amazing group and it’s a wonderful group to have been a part of.

How important does Community Regional now become to the Valley?
It’s the most important facility. And it has nothing but room to grow and grow and grow. And with the wonderful support that we’ve gotten from our friends of Community, from the donors, I think it’s going to continue to grow. I look back, having been here as long as I have, and look at all the physicians who have stayed in the community and just smile and gloat because a majority of them have come through UMC and now they’re here as attendings and they’re doing their fellowships at the regional medical center.

And they’re all specializing in needs that are required here in the Valley and it’s exciting. It’s a great group of people who care about patients. They’re very devoted. The group that we have comes from all over the world, and so they not only stay and bring to the community their knowledge but some go to their base countries and take that knowledge to them. So it’s an eye-opener for the whole world really what they’ve learned here.

Give me your best UMC story.
I think the best experience is the overall experience that I’ve gotten here. It’s been an incredible family. I’ve seen people come and go. A fine example that I missed out on is there was a reunion for all the ICU nurses and there were like 300 of them who showed up. Everyone was reminiscing. They’ve all got their families and their fields now, but they all took time to come and experience what we had here at UMC.

[UMC is] an open facility where everybody got equal treatment. That, to me, is the overall wonderful experience that I’ve gotten here. Even though some people may have thought they got special treatment, they all got treated equally. And we prided ourselves in that.

This story was reported by Eddie Hughes. He can be reached at eddieh@communitymedical.org.

Thursday, April 12, 2007