Nurses at Brigham and Women’s Hospital in Massachusetts voiced strong opposition on March 15, 2023, to a proposed merger that would close the facility’s burn unit. During a hearing before the state’s Department of Public Health, they argued that the closure would jeopardize the region’s capacity to provide critical burn care, especially in emergency situations.
Brittany Kelleher, a nurse at Brigham, expressed serious concerns about the plan, stating, “It sounds like a very bad plan to send all patients to one burn hospital at one time, if there is ever some sort of tragedy.” She emphasized that the current proposal fails to adequately prepare for mass casualty events, which can overwhelm a single facility.
Mass General Brigham (MGB), which oversees both Brigham and Massachusetts General Hospital (MGH), argues that consolidating the burn services would streamline expertise and improve overall patient care. The organization has pointed to a decline in burn patients as a rationale for the proposed closure of Brigham’s 10-bed unit.
At the hearing, Jim McCarthy, a nurse and vice chair of the Massachusetts Nurses Association (MNA) bargaining committee, highlighted the burn unit’s historical significance in responding to emergencies, such as the 2013 Boston Marathon bombing. “Surge capacity for burn injuries must exist before an emergency occurs. It cannot be created after the fact without unacceptable risk to patient outcomes,” McCarthy stated.
Nurses at Brigham also raised alarms about recent incidents that underscore the potential dangers of losing the burn unit. They recounted a case in which a severely burned patient could not be transported to Brigham due to the unavailability of a burn doctor and MGH being at capacity. According to the union, the patient waited approximately five hours for admission, worsening their condition. The union contended that this incident reveals a significant lack of burn care capacity across Massachusetts.
In response, a spokesperson for MGB denied knowledge of the specific incident described. The proposed consolidation would see MGH’s 20-bed inpatient unit at the Sumner M. Redstone Burn Center take in patients from Brigham, with burn beds at Brigham being converted to intensive care unit (ICU) beds. The two burn centers, located roughly three miles apart, are currently the only facilities in Massachusetts verified by the American Burn Association to treat adult burn patients.
Despite a nationwide decline in severe burn cases due to improved fire safety measures, the ongoing struggle for both burn units to maintain sufficient patient volume raises concerns. Dr. Gerard Doherty, chair of surgery at MGB, noted that Brigham’s unit cares for about one patient per day, while MGH treats approximately 300 patients annually, and Brigham about 200 patients, according to the Boston Globe.
The MNA argues that the loss of Brigham’s burn unit would not only reduce the number of available burn-specific beds but also diminish the institutional knowledge critical for effective burn care. Nurse Stefan Strojwas, who has specialized in burn care for nearly 40 years, emphasized that mentorship is vital for nurses in this field. He warned that without exposure to burn patients, nurses would lose essential skills necessary for handling potential mass emergencies.
The Department of Public Health is expected to decide within 15 days whether the burn unit at Brigham will be deemed essential. Should it be classified as such, the hospital system will be required to provide a plan ensuring continued access to burn care services.
The Massachusetts Nurses Association is advocating for legislative measures to strengthen protections for essential health services. Proposed bills would extend the required closure notice to the Department of Public Health from 90 days to one year and prohibit hospitals from closing any units during health emergencies, such as a pandemic.
State Senator Julian Cyr has noted that concerns over the closure of essential services have persisted for years, with recent examples including two hospitals formerly owned by Steward Health Care. He criticized the current closure process as lacking rigorous oversight. “The bill would envision a lengthier and more robust review process,” Cyr stated.
As the debate unfolds, the future of the burn unit at Brigham and Women’s Hospital remains uncertain, with nurses and community members advocating for the preservation of vital healthcare services.
