The vast majority of nurses feel there are simply not enough staff to meet patients’ needs, according to a major survey carried out for the Royal College of Nursing.
The findings – based on responses from 7,720 RCN members – paint a worrying picture of the severe challenges currently facing the profession with increasing workforce pressures affecting patient care.
“The picture painted by the survey is one of demoralised, overworked nursing staff fearful for their patients”
Conducted by the Institute for Employment Studies (IES) on behalf of RCN, the survey found roughly four out of five nurses – 79% – feel that staffing levels where they work are insufficient to meet patients’ needs. That is up from 56% in 2007.
Meanwhile, more than three quarters – 77% – said they felt patient care was compromised several times a month due to short-staffing.
Some findings from the survey were released ahead of the budget in November, showing the financial pressures nurses were under with many struggling to pay bills, missing rent or mortgage payments and lying awake at night due to money worries.
Just over 70% of respondents reported that they felt worse off compared to five years ago, while nearly a quarter said they had been forced to take on an extra job.
The full survey report makes grim reading, with 63% of nurses saying they felt too busy to provide the level of care they would like – up from 40% in 2007 – and the same percentage reporting they felt under too much pressure at work.
It shows that nursing staff working in mental health, nursing homes and community or district nursing are under particular pressure, reporting a worse experience of work than others across many aspects of the survey.
The survey revealed increasing levels of “presenteeism”, with just under half of nurses who took part reporting they had gone to work when feeling unwell at least twice in the past year.
“Any indication that the NHS is becoming less attractive as a place to work for nurses is a cause for concern”
Stress and mental health issues accounted for a significant proportion of health problems. Half of those who had worked while feeling ill said they were suffering from stress, while 22% said they had mental health issues.
More than a quarter – 27% – of nurses have experienced physical abuse from patients, service users or relatives in the last 12 months, while 68% have experienced verbal abuse from the same groups.
Just over 30% said they have experienced bullying or harassment from colleagues in the past year, with Black African/Caribbean and disabled nursing staff more likely to report this than others.
Over half – 54% – of nursing staff feel they do not have opportunities to progress in their current job.
Among registered nurses, those who first qualified outside of the UK were almost twice as likely as UK-qualified nurses to express uncertainty about their opportunities to progress.
This trend suggests “that ongoing uncertainty about the status of EU nationals, post-Brexit, may be having a negative impact”, according to the report.
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Lead author and IES research associate, Rachel Marangozov, said challenges faced by nurses today were likely to be exacerbated by the impact of Brexit on migration and the fact one in three nurses was due to reach retirement age within the next 10 years.
“This survey reveals the personal and financial costs of a career in modern-day nursing,” she said.
“These are costs which many nurses now judge to be too high, not just in terms of inadequate pay, increasing workload pressures, and declining levels of their own health, but also in terms of compromised levels of patient care – the very thing that motivated many of them to take up a career in nursing in the first place,” she said.
Pay rise above 1% ‘needed to ease nurse crisis’
Janet Davies, RCN chief executive and general secretary, described this year’s survey results as “the most worrying yet” from the long-running piece of research, which has been carried out regularly since 1986.
“Working conditions for nursing staff have got steadily worse, with more nursing staff saying there simply aren’t enough of them, and more saying patient care is being compromised,” she said.
“It’s no surprise given that in England alone, there are now 40,000 nursing vacancies,” she said. “The picture painted by the survey is one of demoralised, overworked nursing staff fearful for their patients.”
She added: “If we don’t want to see the same findings repeated in 10 years’ time, the government needs to make nursing a far more attractive career by paying staff fairly, making their promise to increase the number of nurses a reality, and stemming the flow of nursing staff leaving the profession.”
Responding to the survey, Danny Mortimer, chief executive of NHS Employers, said: “Any indication that the NHS is becoming less attractive as a place to work for nurses, from abroad or from the UK, is a cause for concern.
“The suggestion that some staff do not feel they can offer the required level of patient care is of course even more worrying,” she said. “NHS organisations are working hard to address staff concerns and better retain vital nurse skills. However, they also need national support.”
He added: “Expansion of nurse training, revisions to language testing and improving access to affordable housing are welcome interventions to help employers retain staff, but investment is also needed in training budgets.”