Nurses' list of complaints includes lack of sanitized OR equipment; hospital counters that new state-of-the-art sterilizers have reduced safety events by 51%.
Operating room (OR) and post-anesthesia care (PACU) nurses at Brigham and Women's Hospital in Boston are overwhelmingly demanding the removal of Samantha Rowley, the hospital’s vice president of Perioperative Services.
Nearly 100% of the OR and PACU nurses signed a petition of no confidence in Rowley, who joined BWH in 2021, because of "a series of decisions that have undermined the safety and quality of care provided to surgical and post-surgical patients and caused high turnover because of a culture of management bullying and retaliation," according to the Massachusetts Nurses Association (MNA).
The petition, delivered to senior leadership, was signed by 131 of 132 regularly scheduled OR nurses of nurses and 120 out of 124 PACU and perioperative float pool nurses, MNA said.
"We, the registered nurses of Brigham and Women's Hospital, declare no confidence in Vice President of Perioperative Services Samantha Rowley for a series of damaging decisions that have jeopardized patient safety, degraded our work environment, and made it even harder to retain staff," the petition reads. "A change in senior management is necessary to stop the ongoing harm to patients and caregivers."
The petition outlined several specific issues:
- Poorly planned changes to sterilization procedures have created a lack of sanitized OR equipment, putting patients at risk and causing unnecessary stress among staff.
- A culture of management bullying and retaliation leaves staff fearful of raising important patient safety concerns.
- The hospital's new post-surgery boarding ward is “deplorable,” and puts patients in an unsafe and uncomfortable environment.
- A unilateral change in OR staff schedules has created serious morale issues and pushed experienced nurses away at a time when they’re needed most.
- BWH continues to schedule procedures without sufficient staff to perform them all safely.
BWH addressed the accusations in a lengthy statement released to HealthLeaders:
Sterilization procedures:
"We have made considerable changes to the Central Processing Department (CPD) by significantly investing in additional staff as well as equipment and working on a much-needed overhaul of the CPD workspace. This included installing state-of-the-art sterilizers and enhancing on-site instrument repair. Through this work, we’ve reduced safety events by 51%."
"We’ve also added 16 new full-time CPD positions and increased the certification rate among employees from 25% to 95%. While certification is not required by Massachusetts, we are working to align ourselves with national standards which leads to higher levels of accuracy when cleaning our instruments. Over the last two years, we have seen bioburden decrease by 76%, immediate use steam sterilization decrease by 98%, and CPD safety events decrease by over half."
Hostile environment:
"We support every member of our peri-operative team—including the local leadership team, our physicians, our nurses, our technical staff, and our support staff. They collectively exhibit great expertise, compassion, and skill each and every day."
New post-surgery boarding ward:
"The Department of Public Health has evaluated and approved these beds as safe, appropriate beds for use by patients recovering from surgery staying in the hospital 48 hours or less and who do not require an inpatient bed," according to BWH.
"The space provides privacy curtains, call bells, and all appropriate equipment to care for patients safely and effectively while recovering from certain surgeries. 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."
Scheduling:
"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. We are continuing to work to balance the needs of our patients and our staff," according to the statement.
"Our OR nursing vacancy rates have decreased from 12.3% last December to 10.84%, and we remain focused on recruitment strategies to further reduce vacancies. To that end, we have hired more per diem staff to help create increased flexibility in scheduling and allow nurses to decrease hours as needed. Additionally, we have increased our training offerings to allow additional nurses to be onboarded."
"Our priority is the patient. We create staffing schedules centered on the right provider, caring for the right patient, at the right time."
Staffing:
"While hospitals and healthcare organizations nationwide are facing unprecedented staffing challenges and pandemic-related back logs, we’ve implemented a multi-faceted response to these challenges related to patient volume, acuity, and staffing to best support our staff while providing comprehensive care to patients."
When Rowley joined BWH, she brought with her more than 20 years of professional experience and academic training, according to BWH’s website.
She previously was senior vice president for Surgical and Critical Care Services at Parkland Hospital in Dallas; executive director of Perioperative Services at Mission Hospital in Asheville, North Carolina; and director of Perioperative and CRNA Services at University of Miami Hospital.
Carol Davis is the Nursing Editor at HealthLeaders, an HCPro brand.
KEY TAKEAWAYS
Nearly 100% of OR and PACU nurses at Brigham and Women's Hospital are calling for the ouster of the hospital's vice president of Perioperative Services.
A petition claims that a culture of bullying and retaliation keeps staff from raising patient safety concerns.
Brigham and Women's counters that the allegations are not accurate.