Nurses warn of dangerous dips in safe staffing levels
Most nurses believe that staffing levels have regularly dipped below safe levels over the last year and want mandatory ratios for the number of staff per patient introduced, according to a Nursing Times survey.
Asked whether staffing had regularly fallen below safe levels on their ward over the past 12 months, 72% of respondents said that it had.
The findings reinforce concerns about staff cuts made by NHS trusts desperate to save money, which have consistently been highlighted by the Royal College of Nursing in its ongoing Frontline First campaign.
One respondent said: “The ethos of quality care is paid lip service to by managers and government who are determined that care will be delivered by the lowest cost workforce. Nurses no longer have a voice – the governments drive to claw back millions is having a huge detrimental effect on patient care.”
Another said: “Staff are taken advantage of as they continue to soak up the extra work at their own expense – whether they work extra hours, are increasingly suffering from stress, or the extra workload takes its toll physically.”
In addition, 72% of respondents said they were in favour of mandatory patient to nurse ratios. A similar percentage, 70%, said they were also in favour of introducing mandatory ratios for nursing skillmix between registered nurses and healthcare assistants.
One respondent said registered nurse to HCA ratios were a “minimum move toward greater patient safety at a time of fewer resources”.
Another said: “I have in the past cared for 28 patients alone due to night shift ratio and one other nurse of sick. This is not good enough.”
However, others noted it would be a complex undertaking. One respondent said: “There are so many variables to consider when deciding on a minimum nurse:patient ratio that this could only really be done on a ward by ward basis or by setting the nurse numbers high which would be expensive.”
Another added: “The danger with suggesting mandatory ratios is that it’s not necessarily how many patients you have, but rather it’s their acuity, their level of dependence and need.”
Despite long standing and repeated calls for the introduction of minimum staffing and skillmix ratios from unions and others, the government has so far resisted their introduction.
It is expected to come under further pressure to act on the issue when the report of the Mid Staffordshire Foundation Trust public inquiry is published later this year. Research published by Nursing Times in 2009 showed the more trusts a trust employed per bed the fewer of its patients were likely to die or experience long stays.
The survey also asked respondents which if any workforce issue currently facing the profession would lead them to consider taking some form of industrial action.
Three quarters cited staffing cuts that in their view endangered patient safety – also the most popular reason given by nurses for considering industrial action in a Nursing Times poll in October.
In addition, around half of respondents said they would consider industrial action over attempts by trusts to reband nursing staff to a lower pay level, government proposals to change NHS pension scheme and retirement age, and staffing cuts that significantly increased your workload.
A third also said they would consider taking action over attempts by government or trusts to dismantle Agenda for Change and move to local pay setting, and a quarter over the possibility of being transferred to a social enterprise scheme or other body outside of the NHS.
The poll findings released today are the third instalment of results to come from an online survey of around 400 nurses carried out by Nursing Times over the past week.
The poll has asked nurses about the “big issues” currently facing the profession. As well as workforce, it has looked at other key areas including the health bill and the current review of the Nursing and Midwifery Council.