Under the safety of the state's whistleblower protection law for healthcare workers, several employees from the Department of Developmental Services (DDS) in western Massachusetts, who are unionized with the Massachusetts Nurses Association (MNA), recently sent a detailed letter to the department's commissioner imploring her to intervene in a growing patient-care crisis that is unfolding in many of the region's DDS group homes.
The letter, dated September 21 of 2021, was sent to Commissioner Jane Ryder, but she has yet to reply. Meanwhile, the crisis in care for the state's most vulnerable patients grows.
The clients living in the state's DDS group homes, including those in western Massachusetts, are some of the state's most vulnerable citizens. Nearly all of them have multiple diagnoses with comorbidities, and most are non-verbal. As a result, these clients require around-the-clock care from highly specialized nurses and healthcare professionals.
The lack of staff and a lack of adequately trained staff in these homes are problems that have long plagued the department, and MNA leaders have a well-documented history of trying to address them with management. But the issues have increased exponentially in recent months.
Professional staff and clinicians at the affected homes — which include homes in Hadley, Amherst, Whately, Westfield, South Hadley, and Wilbraham — detailed numerous problems and concerns in their whistleblower letter, including:
- Significant increases in DDS clients being sent to the ER; patient falls; and medication errors.
- Medication errors have doubled since the staffing crisis began in April of 2021.
- There have been 126 documented ED visits by group-home clients through mid-September of this year versus a total of 145 in all of 2020.
- Volunteer staff taking open shifts are often not appropriately trained, potentially putting clients' health and safety at risk.
- The credentials of volunteers filling open shifts are generally unknown to supervising nurses and clinicians.
- Having staff untrained in MAP (the state's Medication Administration Program) violates DDS's policies, but it occurs regularly with volunteer staff and staff who are floated to other homes/facilities without nursing notification.
- When there are no volunteers to cover a vacant shift, DDS management "mandates" staff to work overtime, which means staff members are forced to stay beyond their scheduled shift, often without warning or the opportunity to plan accordingly.
- One MNA leader inside DDS recently commented that a colleague was mandated to work for 48 hours. Mandated overtime can, and often does, result in errors because affected staff are not rested and alert enough to deliver the best care possible.
MNA leaders at the region's DDS group homes call on the department to bring in more staff or outside support, train all staff appropriately, and work collaboratively with elected MNA leaders on short- and long-term solutions.