Staffing/Safety Issues

[kgm92]

Hello!

I know unsafe staffing ratios are a commonly discussed topic on allnurses, but I'm hoping to get some advice/feedback of a slightly different nature. Are there any success stories of nurses advocating to administration? Did anyone have their situation improve?

A little background info on my conundrum...

I've been a nurse for about a year, first in med-surg, now in L&D at the same hospital. I've been out of my orientation for almost a month now, and to put it bluntly, it's terrible. And not in the new nurse/it will get better way. We are chronically short-staffed and it is incredibly unsafe. One night in my 2nd week out of orientation, we all had 3 or 4 patients, including the charge nurse. All of my pts should have been 1-1 according to AWHONN guidelines (pre-E Mg w/ cervidil/natural laborer and her delivery & recovery/c-section recovery and then another laborer after I transferred her). The charge nurse even had to go back for a section at one point because the rest of us were all delivering. Nights like this are not a rare occurrences, but weekly. People are waiting in the waiting room for hours, getting epidurals/starting Mg in triage, etc...We've had very close calls, and I know one of these days we'll run out of luck. They can't retain staff and I've lost count of how many people have quit in the short time I've been there. I went to school in CA at a properly staffed hospital, so I know how great L&D can be, but I fear for my license (and my pts lives) every shift. ): My husband is a student (aka no income) or I would have quit by now. This hospital is supposedly "the place to be" for L&D, and sadly I doubt the other few hospitals in the area are much better…

So my question, has anyone been able to improve this situation? For personal career goals, I'm working on IBCLC education and looking into grad school, but it doesn't fix my current problem. I'm considering consulting with more experienced nurses and drafting a letter to administration requesting staffing guidelines and a diversion policy at the least (right now we don't have one, as far as I know). But there are people in orientation (for several more months) and job openings posted online, so management keeps saying "oh it will get better".

Sorry this is so long, but I'm at a loss. Would love to hear any ideas of how to improve this situation. Thanks.

[LibraSunCNM, BSN, MSN, CNM]

Holy crap that sounds horrific! Epidurals and Mag in triage?? I see you're in Louisiana, so I'm guessing any attempt at organizing labor could be extremely difficult. I guess start by approaching hospital administration as a group and see what happens. Maybe drop a tip to the local news station/paper about what goes on there? Otherwise I'd have to talk with my feet.

[kgm92]

Thanks for responding, Libra!

I met with our director yesterday who promised that they had a few contract nurses coming and to "hang in there"…but that doesn't really help us right now. I know an experienced L&D nurse is drafting a letter of sorts. And you're spot on about the culture here…very hard to mobilize or advocate for ourselves (which in turn, makes it hard to advocate for our patients). I start four in a row tomorrow night and am terrified to go in...