MGB’s refusal to address a pandemic-related surge impacting the Brigham and Women’s Hospital OR is putting patients at risk and burning out nurses
BOSTON, Mass. – Nurses from Brigham and Women’s Hospital, represented by the Massachusetts Nurses Association, have called for an investigation into whether Mass General Brigham is complying with the DPH’s order to reduce non-essential, non-urgent scheduled procedures in a letter sent Monday to the Department of Public Health.
Brigham nurses do not believe MGB is complying with the DPH’s order to maintain 15% staff bed availability or to reduce by 30% (and further to 50% as of December 15) non-essential, non-urgent scheduled procedures from the 2019 volume, as evidenced by a lack of patient beds, long holds on patients needing beds following surgery, patients with traumatic surgical needs going without a surgical room or adequate staff, and patients waiting in the emergency department while cosmetic and other non-urgent procedures continue to be prioritized in the operating room, taking up already insufficient staff resources that could be used for urgent cases.
“Patients experiencing emergencies, such as orthopedic trauma or brain injury, are seeing their cases delayed while non-urgent surgeries take up valuable time and staff resources. In one recent instance, a woman who entered the BWH ED with a brain bleed was forced to wait because of the delays associated with the high surgical volume,” the MNA wrote to DPH on December 13. “Every day, the ED has dozens of patients who are sick enough to be admitted to the hospital but are waiting for a bed. Likewise, when the PACU is running short staffed, patients are left waiting on the OR tables or their urgent cases get delayed.
“Almost every day, the OR starts without enough core staff. Yet the hospital continues to run the OR at a high volume, disregarding its own staffing standards and the recommendations of the Association of Peri-operative Registered Nurses. Nurses on orientation are being pulled into cases where they are not competent. The hospital is also relying on travelers who do not have proper experience. As a result of these hazardous conditions, at least four OR nurses have quit in recent weeks. The continued high volume of procedures, combined with the staffing and skill mix problems, is negatively impacting the quality of patient care, and burning out the nursing workforce.” For a copy of the letter, email jmarkman@mnarn.org.
When the Baker-Polito Administration announced the initial DPH order on November 23, it was described as a strategy to “conserve inpatient hospital capacity and to protect patients and the healthcare workforce” as the state faces a surge in patient volume and acuity due to deferred care from earlier in the pandemic and a surge in COVID-19 cases. MGB has acknowledged it is not in compliance with the 15% bed capacity and therefore must reduce non-urgent procedures. It has also acknowledged, in testimony filed on November 9, 2021 with the Health Policy Commission, that “burnout and emotional exhaustion are palpable across Mass General Brigham.”
Despite this, Brigham nurses report that non-essential, non-urgent scheduled procedures such as tummy tucks, removal of excess arm skin and sex reassignment surgeries continue unabated, and there are significant numbers of patients who are boarders in the ICU and ED. MGB says it is trying to avoid another deferred care surge, but refused to plan appropriately for the current surge, ignoring for months calls by nurses to staff appropriately and take steps to improve recruitment and retention. Nurses are calling on MGB to protect patients in need of urgent care right now by complying with the DPH’s order and listening to nurses’ recommendations on how to improve conditions at the bedside for patients and nurses.
MGB clearly has the resources to comply with the order and listen to nurses. On December 10, the same day the DPH changed its order to 50% of non-essential procedures, MGB announced it had made $442 million in profits in fiscal year 2021, ending September 30. MGB received $232 million from the CARES Act this year, on top of $546 million received last year, according to the Boston Globe. The organization reported $15.7 billion in total revenue.
Instead of using its resources to ensure safe conditions in the Brigham OR, ED, PACU and other hospital units, MGB is spending on expansion. In October, the Boston Planning & Development Agency approved a $1.9 billion expansion at Mass General. In June, MGB filed intent with the city to spend $250 million on an expansion at Brigham and Women’s Faulkner Hospital. MGB is seeking state approval for three new ambulatory care clinics in Westborough, Woburn, and Westwood costing an estimated $400 million.
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Founded in 1903, the Massachusetts Nurses Association is the largest union of registered nurses in the Commonwealth of Massachusetts. Its 23,000 members advance the nursing profession by fostering high standards of nursing practice, promoting the economic and general welfare of nurses in the workplace, projecting a positive and realistic view of nursing, and by lobbying the Legislature and regulatory agencies on health care issues affecting nurses and the public.
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