Background on Pivotal Issue in Brigham and Women’s Hospital Talks: Safe Nurse Staffing for Critical Patients
BOSTON, Mass. – Imagine you have a new set of lungs. You can barely walk or do anything except fight for your next breath. Chest tubes pump excess fluids out of your body. Organ rejection is a real concern. But you’re recovering well, thanks to the expert care provided by your Brigham and Women’s Hospital nurses.
Now imagine your nurse is stretched thin by staffing cuts. Your care suffers. Instead of two patients recovering from serious thoracic surgery, your nurse has three patients, or even four. You need a nurse to walk with you to avoid potentially fatal complications, but your care is delayed. Eventually you are sent to a less critical unit, but must be re-admitted right away.
Now imagine this is happening because it helps a billionaire corporation save money.
This is the reality right now at Brigham and Women’s Hospital. Inadequate nurse staffing is jeopardizing safe patient care. This is a key reason why Brigham nurses are willing to strike. They are fighting at the bargaining table for a restoration of nurse staffing in the area of the hospital where patients go to recover from lung transplants, heated chemotherapy and other serious thoracic procedures.
Nurses who work in this unit have told the hospital twice now across the bargaining table that their patients are suffering. The nurses’ request is simple: Restore nurse staffing levels to what they were last year. The hospital has refused. Management has admitted, however, that following the recent departure of nurses from the thoracic step-down unit, they did not replace the nurses. This created a shortage of specialized thoracic nurses and endangered patient care.
The hospital also admitted that instead of properly staffing the units, it moved nurses around the schedule, “smoothing” over a serious problem rather than addressing it properly. This is emblematic of a wider concern among Brigham nurses. Staffing is a problem in units throughout the hospital. For example, management consistently breaks the new intensive care unit law that limits nurses to one or, at the most, two ICU patients.
Patients are not getting the care they deserve and the reason is profits. Brigham owner Partners HealthCare is destroying the Brigham Way of excellent patient care in the name of its profit margins, even though it made more than $600 million in profits during the last reported fiscal year. The hospital saves money by jeopardizing safe patient care so that Partners can pay its executives outrageous salaries, bonuses and golden parachutes. It cuts back on nurse staffing in critical areas so Partners can stash nearly $100 million in Cayman Island accounts and expand its empire halfway across the world.
This is not right. This is why Brigham nurses are prepared to strike. If BWH/Partners does not start valuing patients more than profits, the 3,300 Brigham nurses will strike for 24 hours beginning at 7 a.m. June 27.
Facts on intermediate thoracic care unit staffing:
- The nurses’ proposal affects three units on the 11th floor (11A, B and D)
- There are 12 patient beds on each unit, for a total of 36
- The average daily census (# of patients) in the three units during two weeks of December 2015 was 34.4; the average daily census during two weeks in May 2016 was 34.6 – virtually identical
- According to a review of hospital-provided data, during two weeks in December 2015, there were 13 days with either 14 or 15 registered nurses working in the units during the day. Fifteen nurses is considered an adequate staffing level. During two weeks in May 2016, there were only 8 days with either 14 or 15 nurses working in the units. On the night shifts, adequate or nearly adequate staffing went from 10 of 15 days in December 2015 to only 5 of 15 days in May 2016
Maureen Tapper is a nurse-in-charge in the TICU. She has worked at the Brigham and in the TICU for more than 12 years. Along with her fellow TICU nurses, she cares for some of the sickest patients in the hospital. These complex patients require constant, vigilant nursing care to prevent potentially life-threatening complications. She was one of the TICU nurses who spoke twice to management across the bargaining table.
“Many of our patients struggle to breathe,” Tapper said. “These patients and families need emotional as well as physical support. The reduction in nurse staffing severely impacts the care the patients so greatly need. Nurses are struggling to provide the best possible quality care in a safe environment. This decrease in staffing by the hospital places both patients and nurses at risk. Our patients deserve better.”
Founded in 1903, the Massachusetts Nurses Association/National Nurses United is the largest professional health care organization and 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. The MNA is a founding member of National Nurses United, the largest national nurses’ union in the United States with more than 170,000 members from coast to coast.