Brigham and Women's Hospital

Brigham and Women's Nurses Accuse the Hospital of Ignoring Mass. Order

The Massachusetts Department of Public Health called for hospitals to either maintain a staffed bed capacity threshold of 15% or to reduce non-essential and non-urgent scheduled surgical procedures

Nurses at Brigham and Women’s Hospital have accused the hospital of violating the Massachusetts Department of Public Health's order calling for a reduction of certain non-essential surgeries.

The nurses, represented by the Massachusetts Nurses Association, have asked the state to investigate the whether Mass General Brigham, the company that runs the prestigious Boston hospital, is complying with the order.

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The Boston Globe first reported on the nurses' letter to health officials Monday.

The Baker administration issued the hospital guidance in November, following a DPH order that called for hospitals to either maintain a staffed bed capacity threshold of 15% or to reduce non-essential and non-urgent scheduled surgical procedures, first by 30% as of Nov. 29, then by 50% as of Dec. 15.

The guidance was meant to “ensure adequate hospital capacity for immediate healthcare needs” amid by the COVID-19 surge, according to a news release from the time, with many facilities experiencing staffing and bed shortages that are straining resources all over the state.

Any Massachusetts hospitals facing limited capacity will soon be required to reduce nonessential procedures.

Non-essential and non-emergency surgeries include procedures that are scheduled in advance and do not represent a medical emergency. The order only applies to procedures where delaying won't hurt the patient’s health or where patients won't have to stay overnight, occupying an inpatient bed.

But the nurses union said that Brigham and Women's Hospital is still prioritizing non-urgent procedures, like cosmetic surgeries and tummy tucks, occupying patient beds while other patients wait for them

“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,” the union wrote in the letter on Monday. “Every day, the [Emergency Department] has dozens of patients who are sick enough to be admitted to the hospital but are waiting for a bed. Likewise, when the [Post-Anesthesia Care Unit] is running short staffed, patients are left waiting on the OR tables or their urgent cases get delayed.”

Because the Mass General Brigham was not meeting the 15% bed threshold, it was required to reduce the number of non-emergency procedures, the nurses said, but it didn't do so.

“Almost every day, the [operating room] 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," the MNA wrote in the letter. "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.”

In a statement, Brigham and Women’s Hospital said that the hospital is complying with the Department of Public Health's requirements and plans to continue meeting the updated mandate. A spokesperson noted that procedures tummy tucks are procedures that do not require an inpatient bed and therefore do not fall under the state’s emergency order. 

“Keeping our patients’ needs at the forefront of our decision-making, we are monitoring surgical cases and inpatient beds closely and deciding which cases can be safely rescheduled by using criteria that were developed with a multi-disciplinary group of experts, led by physicians and nurses,” the statement read. “We are carefully balancing against the need to avoid contributing to the wave of patients that we are now seeing who require more intense care as a result of previously deferred care. We are also closely monitoring our patient volume and making decisions on a day-to-day basis that ensure we are doing everything possible to meet the needs of our community.”

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