Good Sam ER 'dangerously overcrowded' despite Medicare investigation, nurses say

BROCKTON — The Massachusetts Nurses Association has filed a second complaint against Good Samaritan Medical Center over unresolved understaffing issues at the hospital, the nurses union said.

In October 2021, the Massachusetts Nurses Association (MNA) held a protest to raise awareness about poor working conditions for the hospital's nursing staff, saying the limited number of emergency room nurses caused overcrowding and excessive wait times for patients.

Then in December, the MNA submitted a complaint to the Centers for Medicare & Medicaid Services (CMS) who conducted an investigation into the hospital's conditions.

CMS's investigation found several areas where the hospital failed to meet regulations, including improper documentation and registration of patients due to lack of front desk workers and a "dangerously overcrowded" wait room with wait times up to 14 hours, as stated in the report.

CMS gave the hospital several recommendations to resolve the issues when it released its findings on Feb. 9, but, according to the MNA, there have been no adequate improvements in the last eight months.

"They just have not increased the staffing and haven't made any improvements that are necessary to alleviate the burden on patients and on the people taking care of them," said David Schildmeier, an MNA spokesperson.

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"We still have too many patients not being seen on time."

Good Samaritan, whose parent company is Steward Health Care, did not respond to repeated phone and email requests for comment.

Inside the ER

Liz Erwin, a nurse on the cardiac floor above the emergency room and co-chair of MNA's local bargaining unit, has worked at Good Samaritan for eight years.

She said that when elderly patients come up to her floor after their long wait in the emergency room, sometimes up to 48 hours, they haven't eaten or taken their medications and often were sitting in their own urine or feces.

"It's disgusting," she said. "They understaffed the ER to the point where it's impossible for them to provide acceptable care."

According to Erwin, there is typically one ER nurse for every 15 to 17 patients. The understaffing issues have existed even before the pandemic — at least since 2018, she said.

Good Samaritan has 46 beds in its emergency room. According to CMS's investigation, 673 ambulances brought patients in over five days — roughly one ambulance every 10 minutes.

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The CMS report said that sometimes patients are not registered upon arrival, and some have to be transferred to other hospitals immediately.

On one particular day that was surveyed, there were 83 patients in the department, 26 of whom were waiting to be admitted. Two of those waiting to be admitted were in need of intensive care.

One admitted patient with diabetic ketoacidosis, a possibly life-threatening complication of diabetes, "did not have a nurse and was in the hallway," along with five other admitted patients without nurses.

Twenty-one patients in the waiting room had wait times of five hours or more.

'Shouting into an empty well'

The results of the investigation were released in February, along with recommendations to resolve the issues — like utilizing Code HELP, during which unadmitted patients can lie in hospital beds to "decompress" and prioritizing more urgent cases over stable ones.

However, over the last eight months, "nothing tangible has been done," Schildmeier said.

"Our goal is not to file complaints. Or goal is...to try and resolve issues and get things fixed."

Erwin said that the hospital has trouble retaining new staff and hasn't listened to MNA's retention solutions.

"It's like shouting into an empty well," Schildmeier said.

In the second complaint, NMA asked CMS to continue its investigation into the nurses' working conditions.

"We're seeing it as an opportunity to come to the table with management and hopefully work together to resolve this," Erwin said.

Enterprise staff reporter Chris Butler can be reached by email at cbutler@enterprisenews.com. You can follow him on Twitter at @Chr1sButler. Support local journalism by purchasing a digital or print subscription to The Enterprise today.

This article originally appeared on The Enterprise: Brockton Good Samaritan Medical Center: Nurses file Medicare complaint