Safer staff and safer patients

The Nurse Staffing Levels (Wales) Act became law in March 2016 after almost 10 years of RCN campaigning. Safe staffing champion Rhian Wright explains how it is having an impact on the frontline

What does your safe staffing champion role involve? 

I raise awareness of the act when talking to members and ward managers. As I walk through the hospital I check the safe staffing figures are displayed on the wards.  

I had one manager tell me they had taken theirs down and they were planning to replace them. This is not good enough, I explained to the manager that it’s a requirement under the act to display this information at all times. 

I also sit on the RCN Wales safe staffing champions group. We meet regularly to discuss any problems or issues that have arisen in the health boards.  

How does the legislation work?

In adult acute medical and surgical wards an appropriate nurse safe staffing level must be calculated and maintained. 

The Welsh government has issued guidance on how to determine this using an acuity tool. Health boards have a duty to report on compliance and take action if there are vast failings. 

What’s the acuity tool?  

Managers use it to score the intensity of care needed for each patient on a ward. The triangulated approach used for calculation also includes an element of professional judgement.

How’s it working?

In my experience it usually comes out at a reasonable and safe level.  It’s easily understood and provides the evidence you need to support a discussion to make sure wards have enough staff to care for patients effectively.

I have a supportive, rather than confrontational role, and recognise that we have a national shortage of nursing staff

What do you think when the safe staffing numbers aren’t right? 

I have a supportive, rather than confrontational role, and recognise that we have a national shortage of nursing staff.

I know we can’t just make staff magically appear but I insist we take reasonable steps if there aren’t enough staff on a ward.

What does 'reasonable steps' mean?

For example, if a ward is short of staff and they’re only recruiting bank staff from their ward, they could do much more. The act has given the RCN much more leverage to request action.

Why did you take on the role?

I’m passionate about providing the best care for patients and I want us all to be able to focus on patient care. If staffing isn’t right, you’re more likely to make mistakes and patients will suffer. 

Nursing staff are more likely to be absent from work with anxiety and work-related stress if they constantly feel they don’t have the time to carry out their role to the best of their ability and not give patients the care they deserve.

What do you do if a member tells you safe staffing isn’t in place?

I speak to managers and try to establish the reasons for lower staffing levels. I then follow this up with the RCN Wales office if needed.

Rhian is a voluntary safe staffing champion in Cardiff and Vale University Health Board. The RCN has safe staffing champions in each health board.

‘We’re ahead of the game, but there's still a lot to do’

Moira says members' support is crucial to our continued campaigning

We’re thrilled that we have legislation in place but we’re not resting on our laurels. We’re now monitoring how the act is being implemented and we’re ready to take action where necessary.

But that’s not all. We want to see the act extended into other health care areas including mental health, children’s care, and in the community. Please get involved. There’s plenty of lobbying and influencing work on the horizon and you can make a difference. 

Even if you can only spare a few minutes to send a postcard to your local AM or feedback your experiences to the RCN, remember the impact we’ve already made and think about what you can do for your patients and colleagues in the future. 

Every small action helps build a stronger and safer workforce.

Moira Davies, RCN Welsh Board Member

Want to get involved?

Is there an RCN safe staffing poster in your workplace? If not, get one up straight away. Download the poster and find out more about the campaign.

Illustration by Jenny Robins

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