The Royal College of Nursing (RCN) is calling for the new government to urgently invest in the nursing workforce and put into law nurse-to-patient ratios, as the current chronic nursing shortage is putting patients’ safety at risk. Investment includes in nursing education as at the moment cuts are taking place to courses and educators, which will make it very hard to fill any of the over 40,000 current nursing vacancies.
Data from the RCN’s Last Shift survey, of more than 11,000 members, found that 1 in 3 shifts are missing at least a quarter of the registered nurses they need, while in the community almost 4 in 10 shifts were missing up to half of the planned number of registered nurses. Overall, 80% of respondents said there aren’t sufficient nurses to meet the needs of patients safely.
The survey found that chronic staff shortages mean individual nurses are often caring for 10, 12, 15 or more patients at a time. In A&E settings, significant numbers of nurses reported having more than 51 patients to care for. In outpatients, caseloads of more than 51 patients were consistently reported.
There is plenty of evidence of the importance of nurse-patient ratios to patient safety, but all work to try and put these in place in the NHS was abandoned by the Conservative government several years ago. The RCN is now calling for safety-critical nurse-patient ratios to be enshrined in law.
RCN Acting General Secretary and Chief Executive Professor Nicola Ranger said:
“Without safety-critical limits on the maximum number of patients they can care for, nurses are being made responsible for dozens at a time, often with complex needs. It is dangerous to patients and demoralising for nursing staff.
“When patients can’t access safe care in the community, conditions worsen, and they end up in hospital where workforce shortages are just as severe. This vicious cycle fails staff and patients – it can’t go on.”
Nurses told the survey of large numbers of patients in the community not being visited due to lack of staff, which will inevitably lead to increases in hospital admissions and deaths. Nurses in hospitals told the survey of not having enough time to sit with dying patients, or time to make sure patients are fed properly and have adequate drinks.
More nurses are urgently needed, but a survey conducted by the RCN of more than 600 nurse lecturers and other higher education nursing staff, found that more than 6 in 10 reported redundancies, restructures and recruitment freezes. This could have a severe impact on nursing recruitment. The RCN also reports that when students finish their courses, they’ve been told there are no graduate-entry nursing roles available.
A fall in the number of international students, along with rising costs and overheads, are resulting in severe financial difficulties for UK universities, and the RCN is calling for the next UK government to deliver an emergency financial intervention to stabilise higher education institutions within 100 days of taking office.
The RCN survey found that 54 out of 72 universities offering nursing degree courses in England are being forced to reduce staffing costs.
Acting RCN General Secretary and Chief Executive Professor Nicola Ranger said:
“Nursing is a degree-educated, highly skilled and safety-critical profession, but the very people who teach and train the nurses of the future are being made redundant. The financial crisis in universities is threatening to engulf nursing – we need action now to stop a total collapse of courses.
“What is happening in universities will impact the NHS, the care sector, and their ability to provide safely staffed services. The higher education sector educates and trains the vast majority of nurses and without an urgent intervention, ministers and health leaders will face a deepening nurse recruitment crisis.”
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