Comment on: Exclusive: Trusts will need to find more nurses
Currently to plug gaps, recruitment drives are being done from other countries. Though this should only be a short term fix, and will not solve long term shortages of nurses in this country. The emphasis on nurturing home grown staff and the improvement of retention of staff is very much lacking from what I've heard. It seems there is only retention premia for the most difficult to fill vacancies, where staff don't stay for long. Nurses work bank shifts for extra money to make ends meet; paid at similar rates to normal rates. However as they are meeting service requirements, they should really be paid overtime rates (especially if there is lack of staff or increased numbers of patients or complexity of care). Due to lack of retention, staff leave more readily, either to work elsewhere or to leave the profession entirely. This then adds to the cost of employers of advertising and recruiting new staff, time and costs to cover senior staffs for interviewing, training costs of new staff, allied costs associated with recruitment - DBS checks, references, occupational health screening. Staff and resources are directed towards specialist areas such as Emergency Departments, Intensive Care, Hyper-Acute Stroke Units, etc; as they are high profile areas; however this then leaves massive gaps in care of the Elderly and those with long-term conditions, as resources aren't being put into those areas.
A combination of minimum staffing levels with acuity scores of each patient for additional staff should be implemented. Ratio 1:8 was the figure plucked out due to evidence of increased mortality rates from around this level. It would make sense not to run things so close to the bone, as set as a minimum of 1:6 (registered nurse:patients) and (minimum of 1 healthcare support worker) on general wards (and more registered staff for higher dependency areas). Then based on the patients requirements and acuity levels; add more staff (registered and non-registered staff) as required. But all of this would cost a lot more money. However, how much are lives worth and the improvement of outcomes for patients? There would also be less burnout of staff and making less mistakes if not stretched to the limits of safe care.
Does down-banding also mean de-skilling for these posts? I thought having higher skilled staff was necessary for higher standards of quality, safety and care. Have I missed something, other than basic finances? Maybe people at PwC could like to cover these shifts during the next few months.
Anonymous | 7-Oct-2013 0:12 am Sounds likely. Most nurses continue to work through their breaks, passed finish times to complete paperwork, burn out due to stress, tiredness, and sickness, and continue to receive lower pay relative to historically male dominated professions. Now also have to pay more into pension contributions and retire later as women generally live longer than men. When patients suffers or dies, it will be the nurses' fault as they're the ones around to be complained at. Its nurses who have to improve or lose their registration. The government can't lose either way, whoever elected, and their policies looks similar. Still people appear to do nothing about it, aren't voting, aren't leaving, not striking or changing jobs. Except those that have lost their registration or have retired. It sounds like institutional abuse of staff has paralysed the care system. Some patients will be lucky to receive 10 minutes of care in an hour.
If or when strikes become more effective, the laws will change and a no-strike policy would be implemented like with the police. Excellent care, requires enough skilled and experienced front-line staff and needs investment, development, support and resources. All of this is expensive and costs money. Front-line services are made up of front-line staff. We keep hearing that politicians, bankers, business entrepreneurs, etc requires competitive remuneration to do their job; so do skilled nurses. Otherwise people will choose to work elsewhere, or not train as nurses or leave nursing altogether. An increment increase, only for those who could get one; is NOT an increase in pay bands. Any rises so far has been well behind cost of living rises. It feel like some of the public have been confused, like with most other government propaganda. Pay peanuts... Privatisation will cost tax payers more money to fund health + social care, while directors and shareholders cream off the profits. Staff who could leave would probably be more inclined to do so. If the government cares so much, they can volunteer their time to help local services and give back to community.