Nurses on strike in Massachusetts have accused Saint Vincent Hospital of potential patient dumping, a practice in which patients are inappropriately discharged and face potential harm as a result.

The Massachusetts Nurses Association, which represents over 700 nurses striking over poor patient care at the hospital, filed a request for the Massachusetts Department of Public Health to investigate a “troubling trend of potential patient dumping” that “put patients at serious risk for harm and affect the health and safety of patients,” reported news outlet Framingham Source.

According to the International Risk Management Institute, patient dumping is a statutorily imposed liability that occurs when a hospital capable of providing necessary medical care transfers a patient to another facility or turns them away, often due to an inability to pay.

Over the weekend of October 16, nurses on strike saw and assisted individuals in three separate incidents who appeared to be unattended or recently discharged from Saint Vincent Hospital, despite being in “various states of compromise,” the MNA wrote in its complaint. It also asked the DPH to investigate two other events in which serious harm was posed to patients because of hospital CEO Carolyn Jackson’s decision to close beds and services in an attempt to break the strike.

“The patients are under-resourced, physically fragile, and lacking agency and voice … more importantly, because of this the hospital has an obligation to ensure that these patients are properly assessed, stabilized and discharged in an appropriately safe manner irrespective of their insurance status or resources,” the MNA wrote in its complaint.

In one incident, striking nurse Patricia Warman aided a distressed patient lying on the ground outside the ED who was unable to stand. Warman contacted hospital security multiple times and called 911 twice but received no help from either. She and other strikers attempted to transport the patient somewhere for help when someone from the hospital came out and said they had called a cab for the person. This concerned Warman due to the disoriented state of the patient and their inability to stand.

A female patient was also seen wandering outside the ER, with no shoes, dressed in a hospital gown and hospital ID bracelet. Disoriented, the patient said she was discharged and waiting for a cab, despite having no money. Hospital security did not respond to assist, the nurses flagged down a police officer who escorted the patient back to the ED.

In light of the strike, the hospital brought in replacement workers, but other full-time nurses still working say they have provided inadequate care and neglected patients, according to the MNA. The association is asking the DPH to investigate two sentinel events that occurred after the hospital CEO closed beds and services needed to help patients. It says the move is an attempt to end the strike, which has gone on since March due to disputes in negotiations between the nurses and Tenet Healthcare, the parent company of Saint Vincent.

Nurses have filed a total of eleven unfair labor practices against Tenet for its actions prior to and throughout the strike, including making unlawful threats to striking nurses and engaging in retaliation and discrimination. They also accused it of promising benefits to non-strikers and of bad faith bargaining tactics.

The main issue in the dispute is patient conditions, with nurses accusing the hospital of creating an unsafe environment with poor working conditions and inadequate staffing during the pandemic that resulted in a mass exodus of 100 nurses. They also said that personal protective equipment like protective gowns was sufficiently supplied, with some nurses donning trash bags. This led to hundreds of nurses becoming infected with the virus, according to the Framingham Source.

A proposed deal to end the strike fell through in August due to Tenet demanding that nurses accept an unprecedented and punitive back to work provision and to retract all unfair labor practice charges. The nurses objected to the retraction, saying that a negotiated resolution to such charges must be included in a final Return to Work Agreement. They also feared that replacing highly skilled nurses with less qualified ones would undermine any patient safety improvements specified in the agreement.

Both Mayor Joe Petty and city councilor and chair of Public Health Sarai Rivera have called out Tenet for its actions, as have unions and the Massachusetts Congressional Delegation in letters to Tenet CEO Dr. Saum Sutaria. Tenet’s approach violates long accepted standards for the conclusion of a work stoppage and jeopardizes the safety of the patients who will be subject to care from more inexperienced replacement staff,” wrote the delegation “Of more concern is Tenet’s decision to purposefully close desperately needed beds and eliminate services as a punitive ploy to force the nurses to end their strike, using patients and our communities as pawns in their anti-union strategy.”