Nurses at Tenet Healthcare-owned Framingham Union Hospital allege unsafe conditions

A recent Globe Spotlight investigation found at least 15 people died after failing to receive professionally accepted standards of care at Steward hospitals because of equipment issues or staffing shortages driven by radical underinvestment by management.

The alleged deficiencies at Framingham Union included a nurse overseeing six patients simultaneously in the emergency room, two of whom had slow heart rates; a hospital floor not having a nurse in charge; patients lying in their own stool or urine because there was no one to change their linens; and nurses unable to provide adequate pain management as a result of inadequate staffing.

“Our nurses have carefully documented these conditions and concerns and have made repeated requests to engage in a meaningful process to address these conditions, only to be met with rancor and recrimination,” Mary Sue Howlett, the union’s associate director of nursing, wrote in an eight-page complaint Friday to the state Department of Public Health.

The union, which represents 300 nurses at the Framingham hospital, has sent a similar complaint to the US Centers for Medicare and Medicaid Services and the Joint Commission, a nonprofit that accredits acute care hospitals.

The union can’t say that anyone died as a result of the deficiencies because the nurses don’t know what happened to patients who were transferred to other hospitals that provide more intensive care, Howlett said.

Nonetheless, she contended that the volume of complaints by nurses alleging staffing shortages at Tenet hospitals in Massachusetts exceeded those she has received alleging the same at Steward hospitals. The union represents nurses there too.

“I have not received the number of unsafe staffing forms from Steward nurses as I have from Tenet nurses,” she said, adding that she could provide specific numbers on Tuesday.

In addition to Framingham Union, publicly traded Tenet operates two other hospitals in Massachusetts, Leonard Morse Hospital in Natick and St. Vincent Hospital in Worcester, according to Tenet’s website. Together, Framingham and Morse constitute MetroWest Medical Center. Tenet also operates two imaging centers and an ambulatory surgery center. Until recently, Steward operated eight hospitals in the state; two recently closed, and the rest are in the process of being transferred to new owners.

Shawn Middleton, a spokesman for Tenet’s three hospitals in Massachusetts, said the nurses’ union was trying “discredit our high-quality organization” and that “we do not condone the MNA’s actions.”

“MetroWest Medical Center remains focused on continuing to provide high-quality care,” Middleton said. “We are grateful for the dedicated physicians, nurses, and staff who prioritize patient care every day.”

David Schildmeier, the nurses union’s director of public communications, said St. Vincent nurses alone have filed more than 1,000 unsafe staffing forms with the union in the past 11 months. He said the staffing levels and working conditions are worse at Tenet than at Steward, and hospital management under Tenet refuses to hear and address nurses’ concerns. In his more than 30 years with the union, he said, he has “never seen behavior like this.”

“The animosity and the retribution and the total disregard for what nurses say about what their patients need — there’s nothing to compare it to,” he said.

The nurses union urged the Department of Public Health to investigate Tenet facilities and speak with nurses about conditions inside.

A department spokeswoman said the state agency had not yet received the union’s complaint. Once it does, the agency will gather information and determine whether an unannounced site visit is necessary.

At Monday’s news conference, Framingham nurses said nurses have lacked basic equipment that protects patients.

Adam Crawford, a 16-year veteran nurse, said that a 37-year-old patient with a high fever in May had seizures but the hospital lacked special pads to place on the bed to protect him. Crawford tried to find blankets as a substitute, but was told that they had been rationed “due to budgetary concerns.”

Crawford tried to arrange an MRI for the patient, but it was delayed for days because it was the weekend, he said. When the scan was done, it revealed the patient had a stroke. The patient ultimately had to be airlifted to another hospital.

“Rationing blankets over a weekend and not having MRI capabilities — those are business decisions,” he said.

In December 2023, the union began filing multiple similar complaints about alleged staffing and equipment shortages at St. Vincent Hospital with federal and state regulators. State regulators ended up citing the hospital for insufficient equipment — portable electrocardiogram devices — but nurses said it wasn’t enough to address “dire” understaffing.

The union alleges that nine nurses who complained about problems at St. Vincent were later fired, which the union has challenged in court.

St. Vincent was the site of the longest nursing strike in state history, which lasted from March 2021 to January 2022, when the nurses ratified an agreement.

Jonathan Saltzman can be reached at [email protected]. Stella Tannenbaum can be reached at [email protected].