Ascension Seton Medical Center Austin nurses are continuing to speak out about the struggles they are facing—particularly in the labor and delivery unit, neonatal intensive care unit and cardiovascular ICU—due to staffing shortages.

ASMCA nurses and representatives of the union that represents 900 of them, National Nurses United, held a rally outside the hospital Sept. 27 calling on Ascension management to meet their needs after months of negotiations.

How we got here

ASMCA nurses and the union held their first strike—which was the largest nurse strike in Texas history—in June, demanding safer staffing policies and improved recruitment and retention initiatives.

But the situation has only gotten worse, according to NICU nurse Lindsay Spinney, who said in the three months since the strike, more nurses have left as improvements have not come to fruition.

“Ascension has been floating nurses between ICUs without proper training and without proper resources,” ICU nurse Amanda Pierce Cheng said during the rally. “The problem with management goes from top to bottom, from our managers on the floor not staffing to the national company refusing to address issues in our ICU and in the rest of the hospital. We’re continuing to see massive turnover. From my cohort of nurses who started in July 2022, half have left.”

Diving in deeper

Ascension is in the process of building a $320 million women’s services facility, which is set to open in spring 2025. But without solutions to the ongoing staffing crisis, Spinney said, the facility will do nothing to improve care.

In the labor and delivery unit, Spinney said staff shortages have caused:
  • Laboring parents having to wait up to 12 hours in the waiting room
  • Windows for epidurals being missed
  • C-sections, both scheduled and urgent, being regularly delayed
In the NICU, nurses should only be caring for a maximum of one or two babies at a time, depending on how sick they are. However, nurses are regularly taking care of three to four babies at once, Spinney said

Spinney added parents have even noticed these shortages, have offered to console other parents’ crying babies, will forgo sleep to stay and feed their babies because “they realize it might not happen in time,” or pay out-of-pocket expenses to transfer to another NICU.

“This is all avoidable. It’s all trauma that should never happen,” she said.

Shortages are also affecting patients in the cardiovascular ICU.

“The hospital is still scheduling these open-heart surgeries that far outpace the nurses required to staff their recovery,” Pierce Cheng said. “Safely recovering a patient after open-heart surgery is more than just finding a stethoscope.”

In the meantime, she said, nurses are continuing to fill out Assignment Despite Objection forms almost daily, which nurses use to document instances they deem as unsafe or inadequate.

“These forms are proof that management is aware of the issues we’re describing today but have refused to do anything about this in our ICU,” she said. “It’s time for safe staffing, and it’s time to sign a fair contract.”

What Ascension is saying

In response to nurses’ concerns, Ascension representatives said in a statement to Community Impact that the hospital has a “workforce development strategy” in place to recruit and retain nurses.

“We believe that differences are best resolved respectfully at the bargaining table and continue to focus on our upcoming scheduled bargaining sessions as we work together to reach a mutually beneficial agreement for all,” Ascension said in a statement.