Nurses condemn closure of nursery unit

RNs at HCA Florida Osceola Hospital protest shutdown

By Martha Wallner

National Nurse Magazine - Oct | Nov | Dec 2022 Issue

Registered nurses at HCA Florida Osceola Hospital in Kissimmee, Fla., held a protest in November and a vigil in December to condemn management’s scheme to drastically slash services to mothers and other patients giving birth, parents, and infants. The scheme, which included closing the nursery unit, officially began on Dec. 12. However, the hospital began making operational changes in units providing birth care this past summer, including reassigning nurses to the neonatal intensive care unit (NICU) without adequate training. The nurses gathered to condemn the impending shutdown of the hospital nursery and to declare publicly their commitment to advocate for improvements in care throughout the hospital.

“We are speaking up for our patients because they cannot speak up for themselves,” said Ginnie England, an RN who has worked in the nursery for eight years. “It is clear to us that HCA’s service cuts are discriminatory and will hit our low-income, high-risk patients and their babies hardest. The units serving mothers and newborns have been short-staffed for many months. We want the hospital to proactively work to retain seasoned RNs and hire more nurses, not reduce services to some of our hospital’s most vulnerable patients, including newborns.”

The hospital has eliminated the dedicated nursery nurses who provided care for most of the issues that may arise with babies generally born healthy. Now this role is assigned to nurses who are watching other patients in labor, which is not safe. The scheme also entails expanding use of the NICU, yet this unit has lost more than 50 percent of its RN staff over this past year. To compensate for staffing shortfalls, the hospital is assigning RNs who will have only completed a minimum of NICU-level training by March 2023.

“I have spent years working in the nursery and I am acutely aware of how much new parents depend on my colleagues and me to support them and their newborns,” said England. “We want the public to know that we are outraged by these service cuts, and that we will continue to advocate for improvements in care.”

According to nurses, the hospital serves a large number of high-risk patients, many of whom are low-income, non-English-speaking immigrants who have not received adequate prenatal care. Labor and delivery RNs report that it is already a challenge to adequately monitor deliveries for these patients due to short staffing. But under the new scheme, RNs would have even less time for monitoring, as they would also be tasked with providing care for the newborns, who had previously been cared for by a nursery nurse from the moment they are born. Now that the nursery is closed, there will be no respite care for new parents; they will be expected to care for their newborns, regardless of their postpartum condition. Now the hospital plans to send those babies to the NICU, using ancillary staff with far less training and non-NICU RNs.

“HCA is claiming that their plans to close the nursery are ‘evidence-based’ and ‘family-centered,’ but the truth is that our patients will be at risk if HCA is successful in implementing this plan,” said Cassandra Gomes, an RN in the labor and delivery unit. “I am very proud to be part of the team of nurses who are standing united to be the voice for our patients, including our newborns, in the face of HCA’s corporate greed.”