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'Help nurses make sure they have enough staff '


It is fantastic news that the National Institute for Health and Care Excellence has officially endorsed the Safer Nursing Care Tool.

Produced by nurses for nurses, this tool provides just the evidence nurses need to ensure they have the right number of staff to provide high-quality patient care (see page 4).

It’s interesting that, when talking to us about the tool, one of its creators, Katherine Fenton, chief nurse at University College London Hospitals Foundation Trust, says it will enable nurses to present a clear argument for more staff or a different skill mix because they will be coming from an evidence-based perspective instead of an “emotional” one.

Traditionally, the issue of how many nurses there are on a ward has always been an emotional topic. Arguments that more professionals are needed - when they come from nurses themselves - can tend to be seen as them just having a moan or overplaying their importance. Funnily enough, other professions don’t get quite the same line in any pushback - when radiographers argue for more radiographers, doctors for more doctors or physios for more physios, it is never regarded as an “emotional argument”. I suspect it’s just one more way to keep nurses - and their usually valid claims that they need more resources - at bay.

Of course, nurses are totally conversant with working with an evidence base, proof and outcomes; it’s what they do every day to make sure they are giving patients the best treatment and the best advice. But when it comes to thinking about staffing, everyone from their managers to ministers forgets that nurses are actually very good at approaching problems and challenges with scientific reason and evidence as their starting point.

Nurses are very good at doing more with less - convention dictates that they have always had to. But this tool, used properly, might mean they no longer have to. And it’s a tool that’s pretty hard to argue with - it’s been produced using the evidence from 1,000 top-performing wards, data from thousands of episodes of patient care, and tested and adopted by 10 of the country’s top teaching hospitals - the Shelford Group. So I hope NICE’s official stamp of approval makes more hospitals adopt it so more nurses can refer to it to get the nursing they need - and ultimately make patients safer throughout our hospitals.

Jenni Middleton, editor . Follow me on Twitter @nursingtimesed


Readers' comments (8)

  • Maryam Omitogun

    Nurses can have enough staffs if Nurses respect the profession. I am wondering when Nursing Department are looking for staffs and will be asking the qualified candidates to do calculation and literacy test.The candidates must pass the test before he/she can move to the next stage of the interview.

    Can I asked why this is been used to determine a qualified professional getting a job? I believe the qualified professional completed the form with English language by him/herself and has passed through primary, Secondary and even higher Institution (University or Advanced level). More over this test does not have anything to do with the Job Description for the job.This is one of the reasons why Nursing Department don't have enough staffs.

    This type of Tests applied to other profession as well-Asking job seekers to do tests that does not have anything to do with the job description is a mere wasting of time. This rubbish procedure will continue to let Nursing and other professionals have shortage of staffs and will continue to let the organisations miss competent and Qualified correct staffs to get job.

    Getting correct/enough staffs is very simple if some form of procedure that is been used to deny qualified people of getting suitable jobs are corrected.

    Maryam Dolapo Omitogun
    Nursing/Public Health Professional
    Greater London.

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  • In response to the above comment - I recently talked to a friend who cannot take Paracetamol as she gets an allergic reaction. Some time ago she had to be admitted to hospital and this allergy was recorded in her notes and ward documentation.
    Nevertheless, she was given Paracetamol by a foreign nurse who did not understand what it was about due to language issues.

    In case someone now shouts 'racist', I am a foreigner to this country myself, although I have lived here for many years now - and English was the FIRST foreign language we learnt at school!

    They can have all the qualifications they want, but if they cannot communicate and do calculations in the language of the country they are working in, there is potential for disaster!
    When I was recruited in my home coutry for training in this country, the interview was in English and as far as I can remember, there were an English test and a maths test as part of the interview.

    I believe that in other professions you either have those skills already or are put on a course to acquire those skills before you start your new job.

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  • I totally agree with the Anonymous poster above I'm just starting my BSc at a London University and thought it was ridiculous that they had scrapped the test in Nursing Calculations because the Faculty 'knew we would be tested in Placement.' Sounds more like not enough people are able to pass it to me. Trusts should check that people have the required numeracy and literacy competencies before they hire someone; knowledge can deteriorate over time it's why we do CPD in an attempt to counteract that and improve

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  • I shudder to think about the extra paperwork required to complete yet another 'necessary' set of forms, this time telling us whether there are enough staff to provide adequate care. Surely to tell us that all we need is an experienced nurse to look at the number of staff and the skill mix on any particular day in relation to the requirements of the patients. Taking a set of readings on two days per year (or whatever is finally decided) will not tell us anything about the other 363 days. I know how patient requirements can change dramatically over one hour let alone a whole year. Cutting staff to the bone is a recipe for poor care, whichever way you look at it!

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  • Sorry Maryam, your written English grammar is not good. I suppose you have to keep patient records?
    The literacy and numeracy of foreign born nurses should be rigourous. My close friend is working in elderly care and has noticed many a near miss due to bad literacy, with an inability to construct sentences and ignorance of tenses.
    We don't just need 'bed pan' nurses, we need nurses who can holistically care - including comperehensive written records - and who can understand colloquial English.

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  • Nurses have worked with evidenced based practice for at least 35yrs. I remember the nursing process being introduced and the concept of individual patient care. It does not take a leap of science to understand that if you have 15 out of your 30 patients on the ward who require assistance with basic human needs - feeting toileting and mobility you need more than two trained staff and three HCAs on the ward if you are going to achieve a positive outcome for these patients in a TIMELY manner. Do thye really think this 'tool' will be the magic wand? I doubt it and more of our precious money down the b$&^$y drain!

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  • The number of staff is not the only issue with any clinical sitting but the skill mix seems playing more with outcome of patients care. The entrants whose first langauage is not English should take official English test as we are dealing with people's life. I worked with EEU nurses before and some of them speak very limited English , one of them was put in charge and could not do any medication or completed a form for new admission as the patient's daughter refused to carry on the conversation after one hour struggling with that nurse's English.

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  • Just another tool to act as a magic wand/sticky plaster for the gaping wound, that is under-staffing. Dont need another patronising piece of official legislation to override what nurses already know.

    As for good English speakers on the wards...I couldn't understand a single word of a handover from the nurse giving it. This issue also causes stress for patients who are trying to relay what is wrong with them.

    One instance, a man became frustrated with the two foreign nurses, and in exasperation shouted at them. He was then targeted by the other male patients for shouting at the nurses and we had to move him into a single room because of the bullying. Yes it was nice to see patients stand up for nurses, but it got snidey and we had to step in. This patient was upset at the other patients attitude towards him, and of the lack of basic communication from the nurses.

    All due to very poor levels of spoken English.

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