Nurses at Brigham and Women’s Hospital voiced strong opposition on March 15, 2024, against the proposed closure of the hospital’s burn unit, which is part of a merger with Massachusetts General Hospital (MGH). The nurses testified before the state Department of Public Health, urging the state to classify the burn unit as an “essential” service. They argued that centralizing burn care at one location could jeopardize patient safety, particularly in the event of a mass casualty incident.
During the hearing, nurse Brittany Kelleher expressed concern over 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.” Kelleher highlighted the risks associated with consolidating care, emphasizing that current resources may not adequately handle an influx of patients in emergencies.
The proposed merger, driven by Mass General Brigham (MGB), aims to streamline operations and enhance care by consolidating the region’s limited burn care resources. However, the nurses, represented by the Massachusetts Nurses Association (MNA), fear that closing the 10-bed Brigham burn unit will significantly impair the region’s ability to respond to urgent burn care needs.
Nurse Jim McCarthy, vice chair of the MNA bargaining committee, pointed out the pivotal role the Brigham burn unit has played in handling emergencies, citing incidents like the 2013 Boston Marathon bombing. “Surge capacity for burn injuries must exist before an emergency occurs,” McCarthy argued. “We are deeply concerned that this proposal is driven by corporate consolidation rather than patient safety or regional preparedness.”
The nurses cited a recent incident where a patient with severe burns was reportedly delayed in receiving treatment due to a lack of available burn specialists at Brigham and capacity issues at MGH. According to the MNA, “The patient waited approximately five hours for admission, worsening their condition.” However, a spokesperson for Mass General Brigham stated they were unaware of any such incident.
The planned consolidation would merge Brigham’s burn patients into MGH’s 20-bed inpatient unit at the Sumner M. Redstone Burn Center, converting Brigham’s burn beds to intensive care unit (ICU) beds. Both hospitals, located roughly three miles apart, are the only verified adult burn care centers in Massachusetts, equipped with specialized teams and resources.
With the decline in severe burn injuries attributed to enhanced fire safety measures, both burn units have struggled to maintain adequate patient numbers. Dr. Gerard Doherty, chair of surgery at Mass General Brigham, noted that the Brigham unit averages about one patient a day, while MGH treats approximately 300 patients annually. He suggested that consolidating units could help sustain their American Burn Association certification.
Despite the rationale for consolidation, nurses argue that closing the Brigham burn center would not only reduce bed availability but also diminish critical institutional knowledge in burn care. With nearly 40 years of experience, nurse Stefan Strojwas emphasized the importance of maintaining exposure to burn patients. “If we don’t continue to have exposure to burn patients, our experience will eventually peter out,” he cautioned.
The Department of Public Health is expected to make a decision within the next 15 days regarding the classification of the burn unit as essential. If deemed essential, MGB will be required to submit a plan to ensure continued access to burn care services.
In response to the proposed merger, the Massachusetts Nurses Association is advocating for legislative changes to strengthen protections for essential healthcare services. One proposed bill aims to extend the notice period for service closures from 90 days to one year and would prevent hospitals from closing facilities during public health emergencies.
Senator Julian Cyr, who has supported measures to protect essential healthcare services, remarked on the need for a more robust oversight process. He stated, “The current closure procedure is a 90-day notice and a toothless oversight process from the Department of Public Health.”
As discussions continue, the future of the Brigham burn unit hangs in the balance, raising concerns about the readiness of Massachusetts to handle burn care needs in the face of emergencies.
