Today, student members at RCN Congress organised a demonstration to express their disappointment and frustration that it is so hard for them to find their first registered nurse posts. Few NHS Trusts are recruiting new graduate nurses, particularly in England and Wales. But at a time when we have a shortage of nurses in many clinical environments, why is recruitment not happening? 

Students and new nursing graduates are bearing the brunt of the broader failure to plan the nursing workforce and invest in nursing. The reason they face difficulties finding permanent nursing roles is not because we don't need more registered nurses. And it's not because we've educated too many nurses. In fact, if anything we have educated too few nursing graduates compared to what the NHS itself said it needs – and have had to rely heavily on international recruitment as a result. Recent RCN data shows we're running with dangerously low staffing levels in many parts of the NHS. 

Investing in nursing is one of the most powerful interventions that can be made in health care - without good nursing care everything else is wasted effort. If a patient has a straightforward operation with an excellent surgeon but doesn’t have good nursing care with vigilance and continual assessment, then that puts that patient’s care and outcomes at risk.

Multiple studies show that people die of avoidable causes when they have not had sufficient high-quality nursing care – when permanent staffing levels are lower than needed in a setting. Care gets missed, complications happen and nurses cannot deliver the quality of care they know is needed.

Yet the nursing workforce continues to see disinvestment. Vacant posts are not recruited to. Roles with additional requirements, which should be Band 6, are advertised as Band 5. Case loads and patient to staff ratios creep up and up. Roles in acute settings are inundated with applications, because the vast majority of students do not have opportunities for practice learning in community and primary care settings. Unfunded requests from governments to NHS Trusts, to finance enough graduate roles to ensure future nurses are not lost, come to nothing.

For those students and recent graduates - who have spent three years getting a degree to become a registered nurse - to then be unable to find a job, reflects a fundamental failure in health care planning and policy. Behind this, lies a deep-rooted tendency to undervalue nursing; to see it as ‘women’s work’, underestimating the benefits of nursing to health care economies. 

Investing in nursing is a political choice. It is not enough for governments to hope that individual universities and trusts will be able to plan and deliver a national health care workforce. By not ensuring there are enough registered nurse posts and people to fill them; by failing to have effective policies that shape the workforce –employers, universities, and ultimately governments, are responsible for today’s crisis, that will have a ripple effect for years to come. 

We currently await the imminent publication of the Ten-Year NHS Workforce Plan in England. We expect the NHS and HEI sectors to be working together regionally to plan workforce requirements across fields of nursing, and ensure that everything between them is being done to attract nursing students who want to join and stay in UK public sector services. This joint accountability must be required and enabled by NHSE and the government (DHSC) as part of a robust national workforce plan, and we expect to see measures reflecting this in the forthcoming 10 Year Workforce Plan:

• Job availability for nursing graduates – ensuring that there are enough suitable band 5 or equivalent jobs are available across health and care settings for nursing graduates so that investment in education is not lost, as part of this the Government must commit to regular data collection and reporting on role availability and access.
• Relocation packages – financial support held at a national level for relocation costs for nurses who choose to relocate for their role to broaden access to early career opportunities and help to address geographic imbalances in workforce supply.

The time for sticking plasters is gone – we need real solutions to these important problems. They are solvable – it just requires political will. 

We need governments to use evidence to take appropriate action and ensure that patients have sufficient access to registered nurses, so they are kept safe, receive the most effective care possible, have a good experience of health care and move quickly through the system. 

Investment in nursing is investment in patient care, and is money well spent.