Many of us were directly affected by the devastating impact of COVID-19. But many others, thankfully, were not. While we as a society debated the pandemic — the policy response to it and the reality of it — frontline voices highlighted the human impact.

Labor & Delivery RN Sherice Smith shone a light on the consequences suffered by patients for the world to see:

“One recent shift, I was working on the Post-partum side. I had three moms and three infants. One of my moms, though, had dangerously high blood pressure and had to be on a magnesium IV drip. Based on the level of care and monitoring required, I should not have had more than two moms. So I was already out of ratio. But on top of that, I also had a triage patient over in the Labor and Delivery unit who was on a monitor due to her baby’s lack of movement.

Then suddenly we were hit with two back-to-back emergency rescues in Labor & Delivery. The other two RNs in that unit were also over-extended. But each of them had to take one of the rescue patients. I was pulled to help with an emergency C-section, which meant I had to leave my six patients, including the one whose IV drip I needed to monitor.

The other RN was trying to manage three moms all actively in labor. As I was assisting with prep for the C-section, I noticed on a monitor as I walked by that an in-utero baby’s heart had dropped dangerously. That means the baby is in some sort of distress. Maybe the umbilical cord is choking the baby or something about the mom’s position is causing difficulty. It’s lucky I noticed that in the middle of all this chaos, because about four years ago, the hospital also got rid of all our monitor techs. I ran in to get the baby’s heart rate back up. I repositioned the mom to see if that would work. Luckily, it did.

By the time I got that mom and baby stabilized, I ran back out to help with the C-Section. I still had supplies to give them, but they’d already gone to the O.R.

I went back to the Post-partum unit to check on my patient with the IV drip. Luckily, she was okay, but my patient next to her was now bleeding. This required weighing the pad underneath her now soaked in blood to determine how much blood she’d lost. She’d lost well over 1,000 milliliters, indicating stage two hemorrhaging. I had to call the doctor, get orders, start meds, get her on Pitocin to stop the bleeding. On top of that, I had to do blood draws to run labs because the hospital had also cut the phlebotomists’ schedules. Eventually, I was able to get the hemorrhage under control.”

This story, Smith pointed out, pointed to an even bigger one. “Our hospital administrators call these shifts with emergencies ‘unexpected.’ I prefer to call them unpredictable.” Smith further contextualized her employer’s pandemic staffing choices by reporting that they were a continuation and intensification of ongoing attempts to slash patient care standards. Even with all the protections and advocacy tools we gain through our union, holding management to account requires continued vigilance.