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Who should be involved in setting minimum staffing levels?

  • Comments (7)

Key points

  • Defining minimum nurse staffing levels could help to stabilise the nursing workforce, ensure safe levels of staffing and deliver care to an agreed standard.
  • However, careful consideration needs to be paid to variations in patient needs and local clinical contexts, as well as the potential impact on patients.
  • Setting a mandated minimum has major consequences not just in terms of investment required to set up and establish (and periodically recalibrate) levels, but also in terms of mechanisms needed to monitor compliance and deal with non-compliance.
  • Ratios currently in use focus on numbers of nurses to patients. There is a need to look at overall staffing levels, and the skill mix of the nursing team.
  • Ratios do not obviate the need for robust mechanisms for workforce planning locally, to ensure that the right staff with the right skills are in place to meet patient needs.

Let’s discuss

  • Why is there a call of minimum staffing levels in the UK?
  • Who should be involved in setting minimum staffing levels?
  • What are the advantages and disadvantages of set minimum staffing levels?
  • Think about patients in your ward or unit. Is nurse-to-patient ratios the best way of defining staffing levels?
  • Comments (7)

Readers' comments (7)

  • Anonymous

    How about the Red Cross (IRC), or perhaps human rights lawyers. We could ask a neutral country like Sweden, or Switzerland to oversee the process. If its done in house it will be dead in the water otherwise. It needs to be legally binding, not just the amount, but also the mix. Don't forget, it has to be stated that there should be a minimum skill mix. With our leaders, unless they fear the law, they will do what they like.

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  • Anonymous

    Just reminding people that different patient groups would need different ratios based on needs, eg:acutely ill (ITU) (HDU) and also those with a high level of physical, cognitive or emotional needs-eg stroke, rehab, dementia or palliative. need a far higher ratio than a minor surgical, or more general medical ward.-Whilst as nurses we are aware of this there is a danger that by pushing for a minimum ratio we find we have a 'one size fits all' standard forced on us to the detriment of our patients. (I remember in the past on one ward having to calculate something called patient care hours-it was stopped when we back calculated we were running on 50% of the staff we should have had-but the theory behind it is valid)

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  • Anonymous

    anon 11.04

    just wondered if you have ever worked on a 'general medical ward' - busy, busy, busy. We have 'acutely ill patients with a high level of physical, cognitive and emotional needs.' General medical wards care for those with dementia, stroke, and those needing palliative care as well as those with acute illnesses.

    We don't expect to have the same staffing ratio as ITU/HDU but we do expect more than 1 nurse to 12 patients. All it takes is for one patient to become acutely unwell and that is your trained nurse taken up for the entire shift.

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  • Anonymous

    I think one qualified nurse to 5-6 patients is the maximum on general medical wards. 10-15 patients is an impossible task.

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  • Anonymous

    anon 11.46 - in your dreams. I wish I could look after 5-6 patients, I might actually be able to do the job I love and go home feeling I've had a good day.

    When they do introduce minimum staffing levels, which they will have to do, I hope managers also look at skill mix.

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  • Anonymous

    "Who should be involved in setting minimum staffing levels?"

    RNs by consensus for their own wards!

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  • Anonymous

    Not just the Staff Nurses but also your HCAs and Support Workers. This potential change won't just affect the Staff Nurse role but also the role of the Healthcare Assistants too whose value on a ward is too often overlooked. Is it a case of looking at job descriptions and duties?

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