The union that represents nurses at Brigham and Women’s Hospital has accused the hospital of cutting on-duty staff to unsafe levels that put critically ill patients at risk.
The accusations, denied by hospital officials, are being aired as a new state law on minimum nursing staff levels takes effect. Under the law, nurses working in intensive care units can be assigned no more than one or two patients at a time. The Brigham, Boston’s second-largest hospital, has 110 adult intensive care beds.
“We’re seeing we just don’t have enough ICU nurses,” said Patricia Powers, a nurse at the Brigham and chairwoman for the Massachusetts Nurses Association at the hospital. “They are breaking the law daily.”
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Claire O’Connell, an ICU nurse for 19 years at the Brigham, said staffing changes over the past several months have made it difficult for nurses to take lunch and bathroom breaks.
“You have to rely on your neighbors to keep an eye on the other patients,” O’Connell said. “They want the same outcome with less staff, and that’s just not possible.”
Brigham spokeswoman Erin McDonough said the hospital never assigns an ICU nurse to more than one or two patients.
“Brigham and Women’s Hospital’s staffing meets all regulatory requirements and, perhaps more importantly, enables us to provide the highest quality, safest possible care to our patients,” she said.
Union officials said the Brigham has not maintained its nursing workforce, but McDonough said the hospital staffs 2,666 full-time nursing positions, 28 more than it did a year ago.
The Massachusetts nurse staffing law took effect Sept. 28, but state regulators are still developing guidelines for implementing it. The Health Policy Commission, an agency that also monitors health care costs, is in the process of drafting rules.
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“The HPC has not yet issued its regulations required to fully implement the law and is currently engaged in the deliberative development process, including extensive research, meetings with experts and stakeholders, and a public listening session,” the commission said in a statement. It has scheduled a public hearing for Oct. 29.
Nurse staffing has long been an issue for the Massachusetts union and its national affiliate, National Nurses United. The state union had been preparing a nurse staffing referendum question for this fall’s election ballot, but withdrew it after legislators passed the new law in June.
“Hospitals should be following the law,” said David Schildmeier, a union spokesman. “In some places it’s working.”
Union leaders and Brigham officials have clashed in recent weeks over the hospital’s flu vaccination policy and Ebola response protocols. The two sides plan to negotiate a new labor contract next year.
“This is the third in a series of attempts by this newly elected Mass. Nurses Association leadership team to mislead the public,” McDonough said.
Tim Gens, executive vice president of the Massachusetts Hospital Association, also criticized the union for its “attempt to create the false impression that there is a patient safety crisis.”
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Priyanka Dayal McCluskey can be reached at priyanka.mccluskey@globe.com. Follow her on Twitter @priyanka_dayal.