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No nurse wants to leave patients in need of care

  • Comments (11)

Nurse staffing numbers are in the news again following publication of a study suggesting that the worse patient outcomes associated with lower nurse staffing levels result from the omission of necessary nursing care. Put simply, short-staffed nursing teams don’t have the time to do everything their patients need them to do.

So no surprise there – but at last there seems to be a head of steam building to ensure decisions on nurse staffing are based on more than the fact that nurses are the biggest staff group and can therefore take a bit of trimming in hard times. The Prime Minister’s Forum on Nursing and Care Quality has called for the Care Quality Commission to monitor nurse staffing levels as an early warning of where poor care is likely to happen.

We had a lively #NTTwitchat about the issue, in which some people suggested that nurses should never allow instances of missed care. They felt it was breaching both their code of conduct and the spirit of the role.

No nurse wants to leave patients in need of care – unfortunately too many employers rely on this. But if missed care results from low staff numbers, should nurses plug the gaps by undertaking yet more free overtime – on top of what most already seem to do? That’s a perverse incentive for trusts to maintain the low-staffed status quo – or cut even further. It’s also a safety risk for patients and a health risk for overworked nurses.

One of the arguments against minimum staffing ratios is that they are blunt tools that take no account of local needs and patient acuity. That’s a fair point, but the NHS needs a method of assessing how many nursing staff it needs, and the appropriate skill mix. And nurse managers need a formula they can use to demonstrate they need more staff or cannot afford to lose existing staff.

So news that the Shelford Group of leading trusts in England have not only adopted a tool enabling them to determine their staffing needs is welcome. It’s even more welcome that the tool was developed by nurses. Here’s hoping the tool will prove what we already know – more nurses not only mean safer and better care, but also lower costs.

  • Comments (11)

Readers' comments (11)

  • Private Care needs the same (or more) safeguards as NHS

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  • Anonymous

    staff need to be looked after and supported adequately to enable them to provide that care.

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  • Anonymous

    Many nurses will stay on beyond their shift hours, (unpaid and unrecorded) to cover gaps in the service and to ensure there are no care omissions. When you talk to management about this you are told it comes with the job. Patients will never know how many staff do this or how many hours staff work unpaid - but by doing this it just continues to paper over the cracks in a nursing system buckling under the increasing pressures piled on it.

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  • Anonymous

    Anonymous | 8-Aug-2013 8:11 am

    shame some of the hypercritical and ungrateful public don't understand this. see some of the venemous comments in the national press such as the Telegraph.

    I think we all acknowledge that this practice 'just continues to paper over the cracks' but no caring nurse wishes to leave a patient in the lurch.

    maybe some of the mental health nurses have better approach as far as management is concerned. many will down tools exactly on the dot regardless of whether the patient wants their attention or is in the middle of a crisis or not. as one once said to me if you don't look after yourself first, how can you look after your patients? Perhaps a question for each nurse to ask themselves as it depends on where one one works, individual values and judgements, and something where there is no general consensus of opinion. However, maybe everybody needs to be more discerning about the circumstances under which they will stay and those they will not. Make a distinction between genuine need and those who manipulate by playing on your sense of duty and guilt and especially managers who tell you there is nobody else to do the work or stay on for that extra shift, after you have already done a full one plus, and you don't know how hard they have tried to find a replacement!

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  • Anonymous

    interesting comment about finding out how hard management have been trying to look for a replacement.
    We have an in house Bank -since they changed to paying a month in hand we have no Band 5 staff;we now have no Band 2 staff. We daily resort to Agency for Band 5; they don't bother covering any Band 2.
    We have to wing it.
    Further more to apply for Agency you need get authorization from Senior Management, who ask if you have tried the Bank, changed staff rotas to cover etc -this done by email to staff on the ward dealing with the shortage - it takes for ever and the shift is almost due to start by the time they say OK!

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  • Anonymous | 8-Aug-2013 8:27 am

    I always understand how hard nurses are working and I always appreciate them.

    Having a nurse look after you is a privilege and I always thank them.

    LOVE
    PDaveANGEL

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  • Anonymous

    PDave Angel | 11-Aug-2013 7:48 am

    from Anonymous | 8-Aug-2013 8:27 am

    "Having a nurse look after you is a privilege..."

    I agree and looking after patients or gaining the trust and being permitted to look after any other being right down to the smallest on our planet is also a priviledge which we should never allow ourselves to forget.

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  • Anonymous

    Anonymous | 8-Aug-2013 8:27 am
    and
    Anonymous | 10-Aug-2013 7:50 am

    As long as you do not take your breaks and do not work within your assigned hours, there is absolutely no need for your managers to make any effort to find adequate staff. Why would they when the overworked, guilt ridden staff will work for free? It all adds to the problem and makes it worse. Poor staffing levels and overworked nurses have become the norm and management have got away with it. We have done nothing to stop it. Very misguided and dangerous for our patients. That is where the problems that led to Mid Staffs began.

    Anonymous | 11-Aug-2013 8:22 am

    Nurses are very much aware of the privilege. Unfortunately, that is abused by managers and that is something we should never allow ourselves to forget. Neither should we permit it to continue.

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  • Anonymous

    Anonymous | 11-Aug-2013 10:26 am

    "Nurses are very much aware of the privilege..."

    after well over 30 years in the profession I have never forgotten it, and as you say have never seen any of my colleagues not aware of this. we are indeed a very special breed and as a manager and very much a hands on basic and advanced care nurse I have never let any manager walk over me!

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  • Anonymous

    Anonymous | 11-Aug-2013 11:07 am

    ".......I have never let any manager walk over me!"

    Unfortunately, the vast majority of your colleagues cannot say the same. It would also be interesting to further explore how well you think the profession has stood up for its patients and itself in those 30 years? I have similar tenure and my conclusion is that it hasn't. We are the lowest paid and have the lowest status amongst the other UK professions. Be assured, the vast majority of your colleagues have big footprints stamped all over their backs.

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