As the shuttering of 41 pediatric hospital beds at Tufts Children’s Hospital in Boston approaches, nurses gathered on Tuesday amid concerns that the closure will severely limit access to care.
Although the Tufts Medicine Health System reasoned in its public announcement of the closure that it would convert 41 pediatric hospital beds at Tufts Children’s into “needed” adult beds, and that it had signed a letter of intent with Boston Children’s Hospital “to ensure that “Continuity of care for pediatric patients and their families has continued to worry nurses ever since they first learned of the shutdown at an early morning Zoom meeting early in the year.
The Boston Children’s agreement will take effect July 1, as the beds at Tufts Children’s will officially go offline. However, nurses say the demand for cots has already stretched.
“Some of the services we have provided are highly specialized,” Mary Havlicek Cornacchia, RN, an operating room nurse who has worked at Tufts for more than three decades, told MedPage Today. “I’m not sure where some of those parents will take their kids.”
In particular, the services being closed include the pediatric intensive care unit (ICU), a medical-surgical floor and the pediatric bone marrow transplant unit, said Havlicek Cornacchia, who chairs the local negotiation unit of Tufts nurses, represented by the Massachusetts Nurses. Association.
She said the emergency department is handling overnight calls from other facilities seeking pediatric beds. She wondered what will happen on June 30, when the hospital stops taking those patients. “The kids are already filling emergency rooms in the state…I just don’t know what’s going to happen to everyone if we shut down our resources.”
Tyra Dukes, RN, who works in the pediatric ICU in Tufts, and routinely hears many of the calls from nearby facilities looking for cots, agreed. “It’s really scary and heartbreaking to think about it when we’re not an option,” she said.
Dukes and her colleagues at Tufts also fear for the families of some of the sickest pediatric patients. She said she is thinking about the uninsured children Tufts treats, adding that the hospital sees many new immigrants who do not yet have resources or connections in the city, and that specialized care appointments are full.
Havlicek Cornacchia is concerned that some doctors may not stay if they cannot place a pediatric patient seen in their clinic in a bed in their own hospital under their own care. She also wondered what would happen to the neonatal ICU if a woman gives birth and the hospital is unable to perform the surgery the baby needs.
Her biggest fear, she said, is that the negative impact of the impending shutdown is “beyond what we see at the moment”.
Tufts did not immediately respond to a request for comment regarding the reason for closing the pediatric hospital beds or rallying his nurses about their concerns about access to care.
However, in its application for the shutdown of essential services to the Department of Health, Tufts stated that for fiscal years 2019, 2020 and 2021 and fiscal year 2022 through February† the mean daily count ranged between 40% and 60% of the available pediatric ICU capacity and between 45% and 67% of the available pediatric ward capacity, including beds for pediatric bone marrow transplantation.
Tufts added in the filing that it “understands the concern and inconvenience.” [the closure] for some patients and their families” but that it “expects no significant impact” services this year.
“There is certainly hope for a turnaround,” Havlicek Cornacchia said of Tuesday’s demonstration against the impending shutdown. “It feels more useless closer to the actual date.”
Part of the problem is the loss of critical staff — 95 nurses have already been affected, Havlicek Cornacchia said.
Two dozen nurses opted for early retirement and some selected severance packages. Some have made the switch to Boston Children’s, others will move on to other facilities. Others are placed in different departments within Tufts.
Boston Children’s did not immediately provide details on whether there is any concern about the increasing number of patients in the coming months or how many nurses have recently joined from Tufts.
Dukes, of the pediatric ICU, says she has decided to stay at Tufts until the shutdown takes effect to help maintain service as best she can. However, she acknowledged that the hospital has already lost about 25% to 30% of affected nurses.
Just days before her 5th anniversary at Tufts, a hospital she’d chosen to join “for the community that’s here,” and that “we’ve worked so hard to build,” Dukes will leave for a new job in an emergency department at another facility. She will continue to care for pediatric patients.
All the while, the proliferation of Tufts pediatric nurses continues as facilities across the country report experiencing a nursing shortage. However, many pediatric nurses cannot imagine changing anything.
Being a pediatric nurse means taking care of not only the patient but also the family, Havlicek Cornacchia noted. There’s so much to it, she says. Sometimes it’s fun, and sometimes it’s hard.
“But being able to take care of a child is just a gift,” Havlicek Cornacchia said. “You enjoy going to work every day because you try to make a positive difference in the lives of these children.”
Jennifer Henderson joined MedPage Today in January 2021 as an entrepreneurial and research writer. She has covered areas such as NYC health care, life sciences, and legal affairs.
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