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Is there a need for a minimum nurse-to-patient ratio across all areas of healthcare?

  • Comments (7)

Last week, we hosted a twitter discussion on NICE’s ground-breaking new guidelines on safe staffing levels in the NHS. The draft recommendation states that if nurses are looking after more than eight patients on adult, hospital wards, the risk of harm to patients is increased.

On individual wards, the draft guideline highlights the importance of the nursing team’s awareness of patient needs and “red flag events”, which signal that an immediate response is needed, such as an urgent need for additional nurses.

 

What do you think of this announcement?

  • Should NICE have gone further and formally recommended a minimum staffing level?
  • Are there enough nurses working in the UK to fulfil a one nurse to eight patients ratio?
  • Could trusts use this guidance as an excuse to not bring in additional nurses when needed if they are already below 1:8?
  • Comments (7)

Readers' comments (7)

  • To determine an ideal nurse patient ratio on a hospital ward/dept there are several factors to be considered;
    Not just the number of patients on the ward but their level of dependency as individuals. You may have several who need assistance with eating, mobility, toileting and washing.
    Also, are we in danger of accepting that the word 'nurse' covers every person working on the ward or are we stipulating that there should be an agreed number of RGN's on duty at all times to supervise/administer patients' care/medication/treatments and also supervise student nurses?
    The levels of patient dependency will fluctuate at least on a daily basis and Nurse Managers should be aware of each ward's workload every day so that staff can be mobilised to cover shortfalls.
    This is not a 'one size fits all' situation!

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  • Anonymous

    having the minimum brought down to 8 is a great idea, however other factors need to be considered also! the dependancy level of the patients and the degree of intervention required. while its possible to manage 8 individual patients on a regular basis, there are frequent occasions when the interventions required are more intense and you can find yourself bogged down with one individual who has become acutely unwell. why do our hospitals have to run on the bare minimum? i know of few staff who will idle the day away, having a coupe of people to float to ensure the iv's etc are kept to time. someone to check out controlled drugs. a qualified member to assist in the assessment of skin when turning patients.someone to step in when a patient really needs an ear! surely we can do better for our patients! the amount of time required to document which is constantly increased to cover situations where you may find yourself in litigation. the job has changed so much in 30 years! more and more we take on extended roles, covering more and more of what was done by doctors. we seem to find extra specialists for this and that but yet the nurse on the ground……..her role continues to expand ad infinitum. genuine nurses just want to do their job safe in the knowledge that her efforts are appreciated and with the confidence management is there to support in difficult situations rather than to find a fall guy for the apportioning of blame!

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  • Anonymous

    This is a great idea as long as it is done carefully. I work on the community as a staff nurse and it is normal practice in the east kent communitytrust for nurses to be seeing up to 15patients in an 6hour shift. and the managers are not in control, there have been so many serious incidents recently , I am sure that they don't see there are simply not enough staff, and they still continue to overload us with work , patient care is a priority , but how can it be if you are seeing this many patients, seeing a certain amount of patients ie no more than eight is good but some nurses trivualise a patient by saying oh that's only a quick one , she wont take long , what has happened to holistic care, as befors nursing has changed for the worse, there is so much bullying , and whistleblowing does not excist.

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  • I am proudly an Australian Nurse. We have fought very hard to have patient ratios as a mandatory part of our Enterprise Bargaining Agreement (EBA). This means that in the public secto on a morning shift it is one nurse per four patients, evening shift is one nurse to five patients, and night shift one nurse to 10. Still not great figures but better than the private sector where the almighty dollar dictates : Mornings: One nurse to 5 patients, Evenenings One nurse to 6 patients and Nights One nurse to 10-12. We have given up many other benefits to ensure the ratios are kept as part of our EBA. Patient safety relies on it! And on a busy day in a busy med/surg ward, these ratios are still unsatisfactory, and leave many nurses feeling as if they have failed their patients in their duty of care!

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  • Anonymous

    A nurse to patient ratio is only meaningful if it is tailored to each nursing environment and is flexible enough to meet increased needs. As another contributor has said 'one size does not fit all'!

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  • Anonymous

    As a experienced nurse my belief is that NICE should have gone further and it should have been extended to community as well . We have had many discussions within our small team regarding staffing, evidence based practice identifies that many incidents would be reduced if we had a better nurse patient ratio this leads to better communication , improve patient care/delivery and reduce incidents

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  • 55HCA

    I work as a HCA in the community - why did NICE not apply safe staffing ratio's to the community setting. Unlike a ward where once all the beds are full that's it, we are expected to keep taking patients no matter how many Staff are available, In my team we are so busy handovers seldom happen communication breaks down, incidents happen, care plan are not updated & patients suffer. We aspire to give holistic care but due to the workload care degenerates to a long list of tasks to be done & just ensuring safety - this is a poor service for our lonely, frail vulnerable mostly elderly clients. who also put with rushed care given by hard pressed poorly trained & paid carers - no wonder such a lot of our patints don't feel valued and are depressed. And the Govt wants to move more care out of Hospital they need to fund & organise it properly first !!!

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