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Wards dangerously understaffed, warns Nursing Times survey
3 February 2013

Wards dangerously understaffed, warn nurses

More than half of nurses believe their ward or unit is dangerously understaffed, according to latest survey results revealed ahead of an influential report on care failings in the NHS. 

In a Nursing Times survey of around 600 nurses, 57% described their ward or unit as sometimes or always “dangerously understaffed”.

In addition, 76% said they had witnessed what they considered to be “poor” care in their ward or unit over the past 12 months – of which nearly 30% said they seen it happen regularly.

One survey respondent commented: “It is becoming more and more stressful for a nurse to nurse. Safety is always at the forefront of my mind but it is becoming increasingly difficult to ensure that all patients are kept safe whilst in my care due to numerous constraints and expectations of the service.

“There needs to be more beds and more nurses to ensure patients receive the best care, not less nurses and less beds.”

Another said: “Nurses are constantly put under pressure. Our job role is constantly expanding, however, the staffing levels do not.”

Ahead of the imminent publication of the Mid Staffordshire Foundation Trust public inquiry report, Nursing Times conducted an online poll of its readers across a range of issues including staffing, patient safety and NHS culture. 

The average ratio of patients per registered nurse on a ward was eight or more, according to 85% of survey respondents who said they worked on general medical wards in an acute hospital – of these 44% said the ratio was 10 or more patients per nurse.

A ratio of eight or more patients per registered nurse is associated with patient care on a ward regularly being compromised by short staffing, according to the Royal College of Nursing (1).

In addition, 43% of those who worked on general medical wards said the ratio of registered nurses to unqualified healthcare assistants was either 50:50 or worse.

A previous report into the care failings at Mid Staffordshire Foundation Trust by the well-respected clinician Professor Sir George Alberti highlighted the 50:50 ratio between registered nurses and HCAs on a ward at Stafford Hospital (2). The RCN recommend a ratio of 65% registered nurses to 35% non-registered nursing staff.

Asked whether they thought there were more “Mid Staffs” out there, 46% of survey respondents said they thought there were many trusts failing like Mid Staffs and 38% that there were a small number of trusts failing like Mid Staffs.

Meanwhile, around a third were not confident they could rule out a similar situation to that which occurred at Mid Staffs happening at their trust.

More specifically, 23% said they were “at risk” of a similar situation occurring at their trust and 12% that it was already happening at their trust – either in isolated parts of the organisation or across it. 

One survey respondents said: “Cutting staff number will mean poor care as simple as that. Most hospitals are heading the Mid Staffs way due to these cuts, and that will put patients safety at risk.”

Another added: “Acute care in the NHS is in crisis. There are examples of poor care in every trust. Changing the culture within nursing is the only way to secure and reverse the deteriorating situation.”

The idea of “hourly rounding” – where nurses proactively visit patients every hour to check on them rather than waiting to be called for assistance – was promoted by David Cameron among a package of nursing focused measures announced in January.

However, 31% of survey respondents who worked on general medical wards said they were not aware of hourly ward rounds having been introduced at their trust. 

-Ends-

For further information contact Sarah Kemp at sarah.kemp@topright-group.com or on 07738 740831

Editor’s notes:

The Nursing Times survey “How will the Francis report affect nursing?” was conducted online from 24-31 January. A total of 595 nurses took part in the survey.

The Mid Staffordshire Foundation Trust public inquiry report – the “Francis report” – is due to be published on Wednesday 6 February 2013.

If you use the story, please credit Nursing Times as your source. In online articles, please provide a link to www.nursingtimes.net.

For further information or to arrange interviews contact please Editor Jenni Middleton via  +4420 3033 2707 or jenni.middletone@emap.com or News Editor Steve Ford on +442030332709, 07941338601 or steve.ford@emap.com

(1) Guidance on safe nurse staffing levels in the UK; RCN Publishing (2010) http://www.rcn.org.uk/__data/assets/pdf_file/0005/353237/003860.pdf

(2) Mid Staffordshire Foundation Trust: A review of the procedures for emergency admissions and treatment, and progress against the recommendation of the March Healthcare Commission report (2009) http://www.nursingtimes.net/Journals/1/Files/2009/4/30/Albertireport.pdf

Jenni Middleton, Editor, Nursing Times

Jenni was appointed editor of Nursing Times in September 2010 and can talk about the profession, nursing issues and standards of care within the healthcare sector. She is particularly interested in nurse education – both continuing professional development and student nurse training, having set up the UK's first digital magazine and community hub for student nurses just over a year ago, and launched the Student Nursing Times Awards. Nursing Times also runs Nursing Times Learning, the Nursing Times Awards, Patient Safety Awards and Care Integration Awards. She has worked as an editor in various sectors for nearly 20 years. 

Steve Ford, News Editor, Nursing Times

Steve is a journalist with more than a decade specialising in writing about the health sector. He is currently the news editor of Nursing Times, which he joined in February 2007. He has written extensively on current standards of nursing, its governance and regulation, including the past and present reports into events at Mid Staffordshire Foundation Trust. Steve started out in 1999 at www.health-news.co.uk, which was one of the UK pioneers of online news for health professionals. Between 2003 and 2007, he worked for the primary care weekly newspaper Doctor, where he was senior clinical reporter and then news editor.

About Nursing Times

Nursing Times is the leading weekly magazine for nurses in the United Kingdom. The magazine and its website nursingtimes.net publish original nursing research and a host of clinical articles for nurses at all stages in their career. Nursing Times also provides a professional and clinical news service; an extensive Opinion section with in-depth features on nursing issues and topics.

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