Brigham and Women's nurses call for leadership change

Jun 15, 2023

By Ross Cristantiello

Hundreds of nurses at Brigham and Women’s Hospital in Boston signed a petition calling for the removal of the person that oversees all aspects of surgical care at the hospital.

Nearly every registered nurse specializing in operating room (OR) procedures and post-anesthesia care (PACU) at the hospital has signed the petition, according to a release from the Massachusetts Nurses Association. The nurses said they have lost confidence in the leadership of Vice President of Perioperative Services Samantha Rowley and demanded her removal.

The nurses accuse Rowley of being responsible for decisions that undermined the safety and quality of care for surgical and post-surgical patients, as well as a “culture of management bullying and retaliation” that is causing a high level of turnover among the staff.

“A change in senior management is necessary to stop the ongoing harm to patients and caregivers. The hospital must work with us to immediately address these problems. It must place patients and staff above profits,” the nurses wrote in their petition.

The petition was delivered to hospital leadership on Monday, according to the nurses. It was signed by 131 of 132 regularly scheduled OR nurses and 120 out of 124 PACU and perioperative float pool nurses.

“Providing safe, high-quality care to our patients is at the very core of our mission,” a Brigham and Women’s spokesperson said in a statement to Boston.com. “Our Peri-operative Leadership Group (PLG) – an executive, multidisciplinary leadership committee intentionally embarked on a journey two years ago to renew our focus on quality improvement and patient safety. This has required us to closely monitor data and trends, identify opportunities for improvement and act on them. It also necessitates increased transparency, accountability, and collaboration among all team members to change outdated practices and move forward with a goal of doing even better for our patients and their families.”

The nurses laid out specific complaints. They claimed that changes to OR staff schedules “created serious morale issues,” causing experienced nurses to leave the hospital. They also accused Brigham and Women’s of scheduling procedures “without sufficient staff to perform them all safely,” further contributing to high staff turnover and poor conditions.

Responding to the staffing complaints, the hospital spokesperson said that high demand has led to a backlog of patient cases, and Brigham and Women’s reopened all operating rooms earlier this year for the first time since the pandemic began.

“While we would like for all staff to be able to work their preferred schedules, this may not always be possible, and our priority in creating staffing schedules must be patient care,” the spokesperson said in a statement.

OR nursing vacancy rates dropped from 12.3% last December to 10.84% currently, according to the spokesperson. More per diem staff has been hired to increase scheduling flexibility.

The hospital estimates that, by October, it will have had a total of 22 new nurses and 6 experienced OR nurses. This, the spokesperson said, is leading to fewer case cancellations. There were 5,972 case cancellations in fiscal year 2022, and 3,902 to date for fiscal year 2023.

The nurses took issue with the hospital’s new post-surgery boarding ward as well, calling it “deplorable.” They said changes were made despite nurses and other staff members voicing concerns. Patients are being put in an “unsafe and uncomfortable” environment that does not let PACU staff provide the best care, the nurses said in their release.

The beds in question have been evaluated and approved by the Department of Public Health for patients recovering from surgery that do not require inpatient beds, the spokesperson said.

“We are confident that this space meets the needs of both patients and our staff well while also addressing the capacity issues that hospitals across the nation are facing,” they said.

Another concern the nurses have is centered on changes to sterilization procedures.

“Poorly planned changes to sterilization procedures have created a lack of sanitized OR equipment that puts patients at risk and causes unnecessary stress among staff,” the nurses said in their release.

The hospital has overhauled its central processing department, including adding “state-of-the-art sterilizers,” the spokesperson said. The hospital has added 16 new full-time positions in the department, and increased certification among employees there from 25% to 95%. “Safety events” have also dropped by 51% there.

Brigham and Women’s was recently ranked among the best in the country.

Despite some of the statistics provided by the hospital, nurses at Brigham and Women’s think major change is in order.

“We need leadership overseeing the OR and PACU that listens to nurses and makes decisions that maintain patient care excellence,” Jim Mccarthy, a PACU nurse and vice chair of the Brigham and Women’s MNA chapter, said in a statement. “We are losing nurses because of the harmful decisions being made by current perioperative leadership and patients are feeling the negative effects. Brigham patients and nurses deserve new leadership that puts our needs above corporate profits.”

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