Often when there is a gap in nurse staffing based on patient acuity and census, nurses are forced to prioritize what aspects of care must be done immediately, what can wait, and what can be omitted entirely (Kalisch et al., 2009). When essential aspects of nursing care are missed, patient safety is at risk (Agency for Healthcare Research and Quality, 2019). Some aspects of care are crucial to patient wellbeing such as close attention as needed, vital sign assessment, and patient discharge teaching (Griffiths et al., 2018; Simpson & Lyndon, 2017). Delays in care that affect timely diagnosis and treatment increase risk of maternal morbidity and mortality (Society for Maternal-Fetal Medicine et al., 2021). Selected examples are listed in the table; however, no doubt perinatal nurses could readily add to the list. They are drawn from my many years as a perinatal patient safety consultant to hospitals and health care systems across the country in which our team was asked to identify probable causative factors and potential solutions after an adverse outcome for a mother or baby. There is a perception among some in administrative roles that nurse staffing standards are goals to be met when conditions allow, represent the ideal, or that they are unrealistic on most days. This perception is false. Inadequate nurse staffing based on acuity and census increases risk of adverse patient outcomes.

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