Working nurses in the CCU.
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FRAMINGHAM – MetroWest Medical Center in Framingham has merged its ICU/CCU & CVU units, due to staffing issues.

This staffing problem is in addition to the staffing it has in its maternity ward.

For the last three weekends, ambulances have been diverted from the Tenet-owned hospital in Framingham for labor & delivery patients, due to nursing staffing issues.

MetroWest Medical Center has a 12-bed intensive care unit (ICU).

MetroWest Medical center used to have its own cardiovascular unit (CVU). The unit was a step down unit for those who could leave ICU/CCU.

Hospital staff told SOURCE in December, the CVU physically moved to the ICU because there were not enough nurses to staff both units on two different floors.

MetroWest Medical Center is down to about 2-3 ICU/CVU nurses per shift in January, said one staffer, who requested to remain anonymous.

SOURCE media has emailed the PR spokesperson for the hospital multiple times in the past couple of weeks, with no response.

That staffing level is below the safety plan MetroWest Medical Center filed for the fiscal year, and it could be below the state-mandated staffing level.

“This is a major patient safety issue,” said another staffer, who asked to remain anonymous.

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This means for example, is there are 6 ICU patients (2 patients per nurse for ICU ratio law) and a cardiac arrest happens on the floor, there will be no nurse to take the patient/the ICU nurse has to attend to the cardiac arrest, and thus the hospital goes over its state-mandated ratios.

Below are the plans MetroWest Medical Center filed for Fiscal Year 2023 for both the combined ICU/CCU and the then-separate CVU. Under the plans both units would have 4 registered nurses (RNs) per day shift, 4 for the evening shift and 4 for the night shift.

Since Halloween, a half dozen RNs have resigned from the ICU & CVU, said a nurse who resigned last month

Last week, MetroWest Medical Center was advertising for a registered nurse CVU step down.

The ad said “This role provides direct clinical patient care. The role will assume responsibility for assessing, planning, implementing direct clinical care to assigned patients on a per shift basis, and unit level. The role is responsible for supervision of staff to which appropriate care is delegated. The role is accountable to support (Chief Nursing Officer) CNO to ensure high quality, safe and appropriate nursing care, competency of clinical staff, and appropriate resource management related to patient care.”

Less than 24 hours ago, MetroWest Medical Center began advertising for a Registered Nurse “CVU Step Down 32 hours Rotating.”

MetroWest Medical Center in filing their staffing plans indicated the combined ICU/CCU unit averaged 6.9 patients per day and 9.6 patients per day in the CVU unit.

Combined that would be 16.5 patients per day, with 4 or less nurses on per shift.

State law (Chapter 155 of the Acts of 2014, An Act relative to patient limits in all hospital intensive care units) establishes patient assignment limits for registered nurses in intensive care units (ICUs) in acute hospitals licensed by the Massachusetts Department of Public Health and in hospitals operated by the Commonwealth. The law provides in part that “in all intensive care units the patient assignment for the registered nurse shall be 1:1 or 1:2 depending on the stability of the patient as assessed by the acuity tool and by the staff nurses in the unit, including the nurse manager or the nurse manager’s designee when needed to resolve a disagreement.”

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By editor

Susan Petroni is the former editor for SOURCE. She is the founder of the former news site, which as of May 1, 2023, is now a self-publishing community bulletin board. The website no longer has a journalist but a webmaster.