Nurses at Brigham and Women’s Hospital in Massachusetts voiced strong objections on March 15, 2024, against a proposed merger that would close the hospital’s burn unit. They testified before the state Department of Public Health, urging officials to classify the burn unit as an “essential” service. The merger, driven by Mass General Brigham (MGB), aims to centralize burn care at Massachusetts General Hospital (MGH), raising concerns about patient safety and emergency preparedness.
Nurse Brittany Kelleher highlighted the potential dangers of consolidating burn care, 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 strategy could overwhelm MGH, which is already handling a full capacity.
MGB, which oversees both Brigham and MGH, argues that the merger will improve care by centralizing expertise and resources. The organization has noted a decline in the number of burn patients in recent years, suggesting that a centralized facility could enhance efficiency. However, the nurses, represented by the Massachusetts Nurses Association, counter that closing the 10-bed Brigham unit would leave the region vulnerable to emergencies requiring specialized burn care.
During the hearing, Jim McCarthy, a Brigham nurse and vice chair of the bargaining committee, stressed the unit’s critical role in responding to mass casualty incidents, such as the 2013 Boston Marathon bombing. “Surge capacity for burn injuries must exist before an emergency occurs,” he stated. McCarthy raised alarms about the implications of corporate consolidation, asserting that it prioritizes profits over patient safety.
Nurses also shared concerns about the broader impact of the burn unit’s closure. One nurse reported an incident where a severely burned patient was delayed in receiving care due to a lack of available specialists at Brigham and capacity issues at MGH. The union claimed that this incident illustrates a troubling reality: Massachusetts lacks sufficient burn capacity to absorb the loss of the Brigham burn unit. MGB, however, denied knowledge of such an incident.
The proposed merger is part of MGB’s ongoing effort to streamline operations across its facilities. Under the plan, the inpatient burn unit at MGH would expand to accommodate patients from Brigham, with burn beds at Brigham being converted into intensive care unit (ICU) beds. Together, the burn centers at MGH and Brigham represent the only two facilities in Massachusetts that treat adult burn patients, both verified by the American Burn Association.
Each year, MGH treats approximately 300 burn patients, while Brigham handles about 200. As the incidence of severe burns has declined nationwide due to improved safety measures, both units have struggled to maintain the patient volume necessary for certification by the American Burn Association. Consolidation, according to MGB, would resolve this issue.
Yet nurses argue that the unique institutional knowledge and skills necessary for effective burn care would be lost without continuous hands-on experience. Stefan Strojwas, a nurse with nearly 40 years of experience, emphasized the importance of mentorship in developing expertise in this complex field. He warned, “If we don’t, at the Brigham, continue to have exposure to burn patients, our experience will eventually peter out.”
The Department of Public Health will decide within 15 days whether to classify the burn unit as essential. If it does, MGB will be required to submit a plan to ensure continued access to burn services. In light of this situation, the Massachusetts Nurses Association is advocating for legislation to strengthen protections for essential healthcare services. One proposed bill would extend the notice period for service closures from 90 days to one year and prevent hospitals from closing units during health emergencies.
State Senator Julian Cyr has expressed concerns about recent closures of essential services, including two hospitals previously owned by Steward Health Care. He described the current closure process as inadequate, stating, “The bill would envision a lengthier and more robust review process.”
As the situation unfolds, the impact on burn care in Massachusetts remains a pressing concern, highlighting the delicate balance between healthcare management and patient safety.
