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Exclusive: Specialist nurses fear impact of ever increasing workloads

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Specialist nurses who work with pancreatic cancer patients are under increasing pressure due to greater workloads, with half reporting they do not have enough time with patients.

These are some of the worrying findings from a survey of 70 clinical nurse specialists, shared exclusively with Nursing Times, and which are likely to chime with specialists in other disease areas.

The survey by the charity Pancreatic Cancer UK found 97% of nurses thought their workload had increased in the past year and 91% expected it to increase again over the next 12 months.

“We’re concerned about the amount of extra, unpaid time nurses are spending in order to fulfil their roles”

Anna Jewell

Half of the survey respondents said they were unable to spend the necessary amount of time with their patients and 53% also revealed they were struggling to manage their workload without feeling stressed.

Many reported they did not have the all support or resources needed to provide a quality service to patients. The survey updates a similar exercise in 2011 and appears to show the situation has got worse, with a greater proportion reporting a lack of time with patients and heavier workloads.

This year nearly half – 47% – of the nurses who responded to the survey said they were the only nurse specialist working locally in a role that covered pancreatic cancer, compared to a third in 2011.

Pancreatic Cancer UK

Anna Jewell, acting director of operations at Pancreatic Cancer UK

“When we did the survey two years ago nurses already felt they had high workloads and we’re very concerned to see workloads are continuing to increase and people expect it to be more,” said Anna Jewell, acting director of operations at Pancreatic Cancer UK.

“We’re also concerned about the amount of extra, unpaid time nurses are spending in order to fulfil their roles,” she said. “It shows more support is needed for this nursing group, which we consider to be a crucial part of the care pathway for people with pancreatic cancer.”

More than 40% of specialist nurses reported doing two to three hours unpaid work each week, while 28% said they worked more than six. Nearly 60% said they did not get any administrative support to help them do their job and 37% reported spending 10-20% of their time on paperwork.

In addition, many nurses said their role had been reviewed by their trust at least once in the last five years, which increased stress. Nurses said the process made them “feel like they constantly have to justify their role or that clinical nurse specialists were seen as expensive luxuries by managers rather than integral parts of a service”, said the charity.

“If you feel you are unable to provide high quality patient care for whatever reason it is incredibly stressful”

Sophie Noble

Ms Jewell said trust’s seemed to find it harder to measure the benefits of specialist nursing, even though they were often obvious to staff, patients and families.

She urged trusts to review their specialist nursing provision and the support they were able to give it.

Sophie Noble, one of three hepatobiliary nurse specialists based at Leicester General Hospital, said she had seen an increase in workload, with more referrals and new ways of working such as enhanced recovery services.

“The fact there is three of us does make a difference, but for those nurse specialists who are on their own, providing a good service is obviously a lot harder because it all falls on you,” she told Nursing Times.  “You are trying to be there for your patients, get your workload done – the telephone calls as well as the clinics – and that is a very stressful situation to be in.

“People who go into these nurse specialist jobs are people who are very keen to provide high quality patient care and if you feel you are unable to do that for whatever reason it is incredibly stressful,” she said.

While her team does not have admin support, one thing that has made a difference has been working with a Macmillan pancreatic dietician who helps “free up nursing time”, said Ms Noble.

Another has been the creation of a local pancreatic support group for patients and relatives, she said. More than three quarters of specialist nurses who took part in the survey said a local support group would boost their ability to help patients and families.

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Readers' comments (1)

  • As a manager of specialist nurses and know just what excellent nursing support they provide & are also filling the gap of junior doctors I would say that these findings will mirror every speciality related to long term conditions, and any acute surgical pathway. The shame is that many of the bean counters do not see this and view their roles as expensive & a luxury. Mmmmm, well a band 5 nurse earns more than a band 6 specialist nurse does. No weekends,unsocial etc & it is very hard to get the job matched financially because AFC has made that really difficult.

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