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Responding to some of the current challenges facing nursing

Dr Denise Chaffer 1 Apr 2022 RCN President

Dr Denise Chaffer, RCN President, highlights the need to address inequalities in mental health services and the importance of working together to improve nursing retention

This month I met with the RCN Professional Lead for Mental Health, Stephen Jones, and some members of the RCN Mental Health forum. They raised some very important issues in relation to racial disparities in mental health, and the role of the nurse in promoting the rights of all within their care. A section in the RCN’s response to the Department of Health and Social Care's consultation on Reforming the Mental Health Act was dedicated to this very issue. In a follow-up article, Stephen Jones and Dr Ann Mitchell, a Mental Health forum Committee member, affirmed how important it is for mental health services to avoid the “one size fits all” approach and develop a system that shows respect for different cultures. Members can contact the forum for more information.


Today I presented at the RCN UK Joint Representatives Conference focusing on the importance of supporting and retaining staff in the health service. The presentation will focus on both the global and national shortage of nurses, and the importance of focusing on staff wellbeing - the need to reduce bullying, incivility, stress and assaults on staff, and how we can work together to drive improvements in fair and learning cultures in the workplace. You can read more about how this is key to patient safety in my recent update. We also launched a new publication at the conference to support reps to work with employers to support colleagues to gain access to flexible working – one of the main issues facing nursing staff’s work-life balance today.


We know the nursing workforce crisis causes issues for nursing staff and the potential safety of our patients. A recent report from the International Council of Nurses suggested up to 13 million more nurses will be required over the next decade - the equivalent of almost half of the world’s current 28 million workforce. And the Nursing and Midwifery Council’s Leavers’ Survey 2020 reported that 21,800 nurses, midwives and nursing associates left the register between July 2019 – June 2020.  Some of the reasons leavers gave included: retirement (51.896%); staffing levels (10.9%); too much pressure, stress and poor mental health (22%); and negative workplace culture, bullying, poor management and difficulty raising concerns (18.1%).  In addition to this a report in 2018 (The price of fear: Estimating the financial cost of bullying and harassment to the NHS in England, Kline & Lewis) estimated the cost of bullying and harassment to be around £2.281 billion per annum to the NHS in England. These costs included sickness absence, employee turnover, sickness presentism, litigation and industrial relations costs.


The RCN Employment Survey last year reported on the percentage if nurses thinking about leaving the profession. 57% of respondents said they were either thinking about leaving their job or actively planning to leave. And of those thinking of leaving, 47% gave not being able to give patients the level of care they would like to as one of the reasons for leaving.  This all points to a rising crisis in our nursing workforce and one that calls for urgent action. 


Highlighting these issues, and lobbying for safe staffing and fair pay, has never been more important. But we must do this alongside exploring what we can all do – in all workplaces and settings - to work together to improve the health and wellbeing of staff. This is essential, as well as driving improvements in safety, quality and reduction in the cost of harm.


The RCN holds a unique position as both a professional organisation and a trade union, in our ability to bring together all our accredited reps, forums, boards and various committees in our  shared purpose in addressing this. And exploring how we can best work together as the RCN with employers and other stakeholders in addressing issues facing nursing staff has never been more important. These issues include areas such as: ensuring equity; inclusion; reduction of discrimination (in particular for our overseas nursing workforce) as well as promotion of consistent fair and learning cultures in the workplace; significant reduction of bullying and incivility; staff well-being and learning organisation principles; and being kinder and more supportive to each other. It is important to build up and share areas of best practice and explore what it is that will help employers to retain nursing staff. For example, asking nursing staff what are the positive things that would help them to stay in their roles and building on this feedback to make meaningful changes.   


I had the greatest pleasure this month in attending an in-person event in London with Carol Webley-Brown (RCN Council member for London region) where we heard poems created by health care workers across the health service. The poems have been brought together in a book titled These are the Hands which is being sold to raise money for NHS charities. The book includes a poem from Molly Case (nurse and author) whom many of you may know from RCN Congress.  This collection of poems was so moving and captured so much of the heart, compassion and essence of nursing, and there were many very moving accounts via the medium of poetry that were shared.


Finally, I end this month’s update with the news that yesterday, the RCN rejoined the International Council of Nurses – a federation of more than 130 nursing organisations that represent 28 million nurses worldwide. Through our membership of the ICN, we will work together with nursing organisations from around the world on issues such as humanitarian support, ethical international recruitment, addressing the global shortage of nursing staff, and recovery from the pandemic. 

Dr Denise Chaffer

Dr Denise Chaffer


Denise has been President of the RCN since July 2021 and is currently the Director of Safety and Learning for the NHS Resolution (formally known as NHSLA).

Page last updated - 01/04/2022