The impact of the closing of three Massachusetts public chronic disease hospitals: a multidimensional perspective

The human costs to staff from closure of a general hospital: an example of the effects of the threat of unemployment and fragmentation of a valued work structure

OBJECTIVES

To describe the stressors and stress responses in medical (and to some extent other) staff as a result of the process of closure of a major general hospital. This is the first such clinical description in the literature.

METHOD

Semistructured individual interviews were conducted with 50 senior medical staff and with administrators at a time of imminent closure of the hospital. Information was also pooled from medical unit and other hospital meetings. Impressions regarding the effects on other staff were also noted.

RESULTS

The perceived threat of loss of work, meaninglessness of the closure and erosion of medical values caused manifestations of demoralization and stress, as well as overt medical symptoms and illnesses. Methods of coping included denial and other defences. Treatment included stress counselling at individual and group levels, which provided staff relief through being able to verbalize, label and connect their feelings and distress to valid stressors. However, the overall impact of counselling was limited.

CONCLUSIONS

There must be an understanding of the human costs on staff and patients when hospital closures are contemplated.