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'Overwhelming' pressure on A&E 'causing nurses to leave'

  • 3 Comments

Accident and emergency nurses are leaving their jobs at a rate never seen before, as “overwhelming” pressure on A&E departments is becoming “normal” year-round, it has been warned.

Those that leave are often newly-qualified staff who depart within a couple of years due to burnout and a lack of ongoing training to deal with increasing numbers of complex patients which has left them “unconsciously incompetent”, nurses added.

“Overwhelming pressure and major incidents have sadly become the new normal in our hospitals”

Janet Davies

They also said that despite using agency nurses to plug gaps, staffing shortages remained due to fewer applications for permanent positions.

Emergency nurses from across regions in England, Northern Ireland and Wales issued the warning at a briefing at the Royal College of Nursing’s annual congress in Glasgow.

They pointed to a series of emergency departments that had been downgraded or had reported staffing issues in 2016 so far.

They said more people using the service, as well as problems with delayed discharge, meant nurses were increasingly being forced to look after patients in corridors or ambulances due to a lack of beds year-round.

Janet Youd, chair of the RCN’s emergency care association, said nurses were leaving due to the “day in day out pressure” of not being to provide the kind of care they wanted to.

She noted that cuts to budgets for continuing professional development training, which meant there was less money to backfill shifts while nurses train, were also a “massive threat”.

“The big problem with training is that when shifts are short, training gets pulled. We’ve got a spiral of deskilled nurses and people leaving. It’s a positive feedback loop in overdrive,” she told Nursing Times.

“Nurses can’t be release for training and then we have a dangerous situation with people who are unconsciously incompetent”

Janet Youd

“So with the untrained staff, you can’t pull them because there is nobody to backfill them and then they leave. So we recruit a whole new batch of often newly qualified nurses. And we don’t give them training and then we’re surprised that they leave, because they’re burnt out?,” she added.

“Because there isn’t the funding for the backfill, nurses can’t be release for training and then we have a dangerous situation with people who are unconsciously incompetent,” said Ms Youd.

Ms Youd called for investment in recruitment and nurse development in addition to wider issues around bed availability being addressed.

The RCN’s director for the east of England, Karen Webb, said that in her region cuts to social care and a focus by trusts on NHS finances, plus reductions to public health spending, was leading to more older patients accessing A&E.

“We’ve seen Addenbrookes Hospital in Cambridgeshire had to declare a major incident in March because of internal bed flows. In King’s Lynn in Norfolk in April we were advised of patients being triaged in their ambulances. In Southend in Hospital in May they declared a critical incident because they simply ran out of spaces to put people,” she said.

Meanwhile, the RCN’s director in the north west, Estephanie Dunn, said: “In our region we have an A&E that has struggled to maintain services and they closed on the basis it was unsafe – Chorley A&E department.”

Janet Davies, chief executive and general secretary of the RCN, said: “Overwhelming pressure and major incidents have sadly become the new normal in our hospitals.

“Units are having to be closed and operations cancelled due to the level of demand when there is no extreme weather, and no major outbreaks of infectious diseases,” she said.

“It is time we had a serious look at how long hospitals can continue to function when they are consistently under-funded and under-staffed,” she added.

  • 3 Comments

Readers' comments (3)

  • michael stone

    There is probably 'something technical' going on here, which I don't understand, as opposed to one of my usual gripes about the NHS 'inventing weird terminology'.

    'So with the untrained staff, you can’t pull them because there is nobody to backfill them and then they leave'

    Aside from - at least for me - the following being more 'obvious', does it mean something different or not ?:

    'So with the untrained staff, you can’t pull them because there is nobody to cover for them [while they do some training] and then they leave'

    I'll probably get told that 'cover' is for unplanned situations, and 'backfill' is for planned ones - it is still covering for the absent nurse, however.

    This one, isn't anywhere near the top of my list of 'NHS terms' I have a strong dislike for.

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  • “So with the untrained staff, you can’t pull them because there is nobody to backfill them and then they leave. So we recruit a whole new batch of often newly qualified nurses. And we don’t give them training and then we’re surprised that they leave, because they’re burnt out?,” she added.

    I understand the point she is making but surely the much bigger issue is the care and well being of the nurses themselves. Its almost like accepting that they will get burn out and quit and then they recruit some more - like noone cares about the nurses themselves...They are just there to be recruited and when they can't cope they get some more! How sad is that for our 'caring' profession.

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  • michael stone

    Re the previous comment - I didn't take that, from the comment inside the article. I thought she was just saying 'we can't train our 'new' nurses because we don't have the resources to allow it' - I don't necessarily think she was suggesting that the situation isn't a bad one for those nurses.

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