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'Legislation for safe staffing levels is desperately needed'


When I talk to members of the public about nursing, I know what mental images they have got in their heads - nurses in uniforms, working on wards and helping (usually older) people in and out of bed.

I often wish I could make the public be a fly on the wall at the Royal College of Nursing Congress – and appreciate the full multi-coloured dreamcoat that nursing is.

It’s learning disability nurses, it’s public health nurses, mental health nurses, district nurses, sexual health nurses, prison nurses, armed forces nurses – I could go on but I would end up trying to create an exhaustive list and miss a nurse genre out and end up in trouble with those nurses.

But I also worry that that this huge fabric with its many patterns and colours and textures of nursing is slowly being worn away as certain nurse specialties are not being supported enough.

This week’s RCN Congress at Belfast articulated those concerns beautifully.

“It is a tragedy that some of the most vulnerable people in our society are at risk of not getting the care they desperately need”

An emergency resolution asked the RCN Council to call for urgent action to be taken to preserve the field of learning disability (LD) nursing – it was passed unanimously.

It is a topic Nursing Times has written on often recently – with concerns that half of the LD nursing courses could be shutting their doors and experts calling for action to address the LD nursing shortage. I’ve also written about it personally in the last few weeks.

It is a tragedy that some of the most vulnerable people in our society are at risk of not getting the care they desperately need – and if we don’t have nurses to stand up for them, then many of them will have no one.

But other branches of nursing are at risk too. Prison nursing was discussed at congress, with fears that the low morale we see elsewhere in nursing is particularly prevalent in the penal sector. Alistair Grant, from the RCN Scotland board, introduced the resolution saying nurses in this sector were “firefighting” in “uniquely challenging environments”.

And in sexual health nursing, an RCN report unveiled at congress revealed that nurses in this sector were turning people away for testing, because they do not have the time and resources to test patients.

The report included the findings of more than 600 nurses working in sexual health, who reported that 61% had seen a reduction in the overall sexual health workforce and 57.1% had been a drop in the number of registered nurses.

Over the five years since the government moved public health services to local authorities, the RCN warned a “dangerous recruitment freeze” had prevented staff from delivering vital services including testing for chlamydia and HIV.

The RCN’s report pointed out that during the same period there had been a drop in the number of 18 to 24-year-olds being tested for chlamydia while diagnoses have gone up. Syphillis diagnoses have also risen by 12%.

But let’s not forget that nursing does include nurses working on wards, and yes, helping older people in and out of bed to go the toilet – if they can.

A hard-hitting report published by the RCN this week said that basic nursing care is not getting done, because of staffing shortages.

“I wonder just how much impact that campaign can have in the here and now”

The Nursing on the Brink report expressed some serious concerns from nurses about care being left undone or the quality of care, as there were too few registered nurses in proportion to support staff.

Little wonder that in her keynote speech to congress on Sunday, RCN chief executive and general secretary Janet Davies unveiled plans for an RCN campaign to demand that safe staffing levels and accountability be set in law for every part of the UK. It will launch in the autumn.

Legislation for staffing levels started in Wales, and it’s desperately needed. Though with no nurses to fill vacancies and no plan in place to really reverse this shortage, I wonder just how much impact that campaign can have in the here and now – where it’s definitely needed.

But that campaign – and the ensuing law – is the right thing to keep patients and service users safe.

Congress is a fabulous event because we hear from the different sectors of nursing – the school nurses, the care home nurses, the forensic nurses – they debate, they learn from each other and they enrich the care they provide.

I worry that without legislation it’s going to be an empty hall at future congresses, lacking the loud and diverse gathering of nurse power we’ve seen in Belfast this week.


Readers' comments (5)

  • Good and I hope not too late!

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  • I completely agree, having raised concerns with my union (RCN) regarding staffing levels at the nursing home where I work. I feel constantly uneasy about the numbers caring for clients day and night, and yet the RCN informs me there are no clear guidelines for staff to client ratio. I realise this will then force managers to spend more of their budget on more man power, but the alternative of serious harm occurring due to lack of staff and increased pressure is a reality.

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  • It'll all work out fine eventually. We just need to have a few hundred (or should that be thousand?) unnecessary deaths, then the powers that be might get the idea that a better resourced, managed and motivated workforce is what's needed. Just hope that none of your loved ones is unlucky enough to be in that number.

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  • More qualified nurses is not the whole answer, care staff who have had a decent length of good quality training not simply two shadow shifts where they have been placed with equally inexperienced support staff and on line e learning is not good enough. Neither is registering for the NVQ in care when actual one to one in placement with an assessor or tutor carrying out care is non existent. If the NVQ level 3 is to mean anything when it has a registration element in real life situation tutoring monitoring and assessing must be part of it. Additionally decent literacy and numerously skill should also be included. Bring back SRN and SEN style training where learner nurses had daily contact with patients and learnt from being supervised while doing. Yes it would mean many more qualified nurses being employed in order to be mentors, teachers, supervisors in all settings but the result would be better safer care and a better qualified experienced workforce. Plus point would be that the qualified nurses would be able to spent time doing what they were trained to do observe and care for people not stare at a medicine trolley and computer all day.

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  • 31 May 2018
    I will just tell a story... In a far far far away... distant future. In 2030, the gov admin reduced, downsized all NHS local hospitals. The focus on centralized, regional trauma and emergency care only. Trauma and emergency care are free. Elective surgery are provided by local NHS hospitals. Community and primary care are serve by local GP/ walk in centre/ diagnostic centre. Acute and Social care are contracted to private health care companies. NHS Patient ID are compulsary to be treated in NHS Hospital/ facilities. NHS Patient ID is only given to tax payers. Some treatment are subsidize by NHS. Few diagnostic, lab, xray and pharmacy items and meds are being paid by patients own funds- categorize, label, consolidated package deal/ fees. Over 60 years old are exempt from paying these fees. Tax on income, NI, Pension contributions are increase... and it goes on... until sudden changes happen to the health and social care system... After a major upheaval over the horizon... to be continued... (Intro: theme song from Star Wars)... fading music.

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