EU directive puts nurses in charge of continuity

As reported by Nursing Times earlier this month, nurses are already being given work previously carried out by doctors in hospitals compliant with the European Working Time Directive, which is due to become a legal requirement for all NHS organisations on 1 August.

Chris Jones, nephrology nurse consultant at King’s College Hospital in London and chair of the RCN nephrology nursing forum, said that with doctors spending less time on the wards, nurses would become the clinicians most responsible for making sure patient care remained consistent and spotting when patients’ conditions deteriorated.

Mr Jones was speaking to Nursing Times after the publication of a report into the care of people with acute kidney injury by the National Confidential Enquiry into Patient Outcome and Death.

‘The changes soon to be made to junior doctors’ hours mean it is likely it will fall to nurses to ensure continuity of care, making it extremely important that they are able to recognise and act upon the signs of deteriorating kidney function,’ said Mr Jones.

‘We have to deal with this the best we can. We are not saying nurses should take over the whole of the patient’s care, but they may have to take more onboard and have more of a role and increased awareness,’ he said.

The NCEPOD report – which looked at 564 patients who died from AKI in hospitals in England and Wales between January and March 2007 – found kidney care in some areas was already lacking, regardless of any future impact of the working time directive. Acute kidney injury was often recognised late when complications were already evident, and complications were also missed or inadequately managed, the report authors said.

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