Most nurses believe in setting minimum nurse to patient ratios, according to a recent report by Unison.
The views are at odds with those of the outgoing chief nursing officer for England Dame Christine Beasley, who a few months ago told the Mid Staffs inquiry that she was concerned about introducing minimum ratios because there was a risk that “instead of becoming the floor they become the ceiling”. Other senior healthcare figures have echoed her view - from Dean Royles at NHS Employers to Harry Cayton, the chief executive of the Council for Healthcare Regulatory Excellence, which is carrying out the strategic review of the Nursing and Midwifery Council.
But Unison’s Care in the Balance report, published last week and covered in Nursing Times on 24 April, found their views were not echoed by frontline nurses. Its 24-hour survey carried out on 6 March asked members to take a snapshot of nurse to patient ratios and to divulge how that affected the care they were able to provide.
More than 90% of nurses who responded to the survey were in favour of legislation to set minimum nurse to patient ratios.
And now, interim results from the RN4CAST study provide evidence that inadequate staffing directly influences nurses’ ability to carry out and complete core nursing tasks.
It’s a complicated issue - minimum staffing levels cannot be implemented as a one-size-fits-all across all areas, or it would indeed become, as many have commented, a blunt tool. However, Unison’s report makes it clear that organisations’ self-policing of staffing levels is not making nurses feel able to provide safe care.
The worrying thing about the survey is that respondents felt that when things went wrong, albeit in a multidisciplinary team, it was nurses who carried the can. And yet it is those nurses who are not being listened to when they raise concerns about that very issue.
In fact, at the Unison health conference last week, many nurses stated that their senior managers were concerned about them even filling in the union’s survey or distributing it to their colleagues.
It is shocking to think that this is still happening after all the reports and concerns raised about nursing recently and in the wake of Mid Staffs. Managers who care about patients should want to hear from frontline staff about what is going on in their organisations, and be open to suggestions for improvement.
It is time for managers to listen to evidence about standards of care and work with their nursing teams to find a solution, rather than branding those who raise concerns as troublemakers.