What a Steward closure could mean for the Massachusetts nursing workforce

Healthcare leaders are addressing ongoing concerns over the future of Dallas-based Steward Health Care's nine Massachusetts hospitals, their patients, employees and trainees as the health system continues to battle financial challenges. 

Many of Steward's hospitals have various medical and nursing student programs, including post-graduate learners, Robert Goldstein, MD, PhD, commissioner of the state department of health, said during a March 13 public health council meeting. Should any of the health system's hospitals close, this could impact future healthcare workforce training. 

"We're working to catalog all of these to identify the number of students in each of the facilities and then to think about eventual placements should a facility need to no longer take students of any type," Dr. Goldstein said. "It is a big issue, I would say in particular it's a huge issue in nursing, because there are very limited nursing placements across the state, and as everyone knows, we have a nursing workforce shortage."

Judith Pare', PhD, MSN, is the director of the division of nursing education at Massachusetts Nurses Association and an associate lecturer for the University of Massachusetts-Boston. 

Dr. Pare' told Becker's she fears that if the hospitals close, the existing nursing shortage could worsen.

"It is just one more layer of this crisis," Dr. Pare' said. "We will have to deal with it just like we dealt with the onslaught of the COVID surges, and I don't say that lightly. I'm very proud of the fact that nurses are nothing if not resilient. We will have to regroup. We will look at potentially the use of simulation where we need to if we can't reassign students should that occur." 

Dr. Pare' has been in communication with nurses at Steward's Massachusetts hospitals, with many of them residing in the communities where the hospitals are located. 

"Their number one concern is the patients that they serve," Dr. Pare' said. "God forbid a hospital closed — that would shut off access for their neighbors, for their family members, for their congregation. That is a concern. Where will these people get care?"

The areas where many of Steward's hospitals are located include some of the most marginalized, ill, and poor patients in the state's population, Dr. Pare' said. 

"My overwhelming concern is we cannot have these hospitals close," Dr. Pare' said. "It will devastate healthcare for our already marginalized patients in the Commonwealth."

Monitors from the state health department's bureau of healthcare and safety are currently in eight of Steward's nine hospitals to monitor supply levels, acute patient safety concerns, and staffing levels. 

"If anything comes from those monitoring events, we do what is necessary following that, meaning we do a formal investigation either under our state licensure authority or under our authority granted to us by CMS to make sure that we're following up, a corrective action plan is put in place, and quality is maintained in the system," Dr. Goldstein said during the public health council meeting.

Dr. Pare' shared her concerns over nurses leaving the field all together should a hospital close.

"There are jobs out there," she said. "I don't want a nurse leaving nursing because they are discouraged, frustrated, and unable to feel like they've made a difference. Every morning I get up and I feel privileged that I can contribute and make a difference. I want every nurse at night to say, 'I'm exhausted, this is the hardest job I've ever had, but I did make a difference.'"

Steward has repeatedly said that it has no plans to close its hospitals and is instead looking to transfer ownership of all nine hospitals in Massachusetts. 

"We are working with state officials and others to transition ownership of the Massachusetts hospitals in a way that everyone agrees is best for patients, our employees, and the Commonwealth," a spokesperson for Steward said in a statement shared with Becker's. "We are committed to continuity of care in our communities."

Most recently, New Bedford, Mass.-based Southcoast Health expressed interest in buying Steward's Fall River, Mass.-based Saint Anne's Hospital.

"Southcoast Health is actively engaged with appropriate stakeholders in discussions about our region's evolving healthcare landscape," David McCready, president and CEO of Southcoast Health, said in a March 11 statement shared with Becker's. "We believe strongly that the best solution for our community and its people is for St. Anne's Hospital to join the Southcoast Health family."

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