• There’s now a ‘high risk’ of harm on shift, say nursing staff in hospital and community settings
• The RCN says nursing professionals continue to bear the brunt of funding restrictions and budget cuts, making an already challenging job even harder

A ‘deadly mix’ of collapsing growth in the registered nurse workforce and increasingly complex patient needs are leaving staff struggling to keep people safe, as a quarter say registered nurse numbers are so far below what is required that there is now a ‘high risk’ of harm on shift.

In a speech to over 3,000 frontline nursing staff gathered in Liverpool [Today], Professor Nicola Ranger will call for new and sustained investment to grow the nursing workforce to a level that meets the needs of an ageing, more sick population.

The findings are from the Royal College of Nursing’s (RCN) latest ‘Last Shift’ survey, which asked more than 13,000 nursing staff across the UK about their experiences on their most recent shift.

As the College begins its annual Congress in Liverpool, General Secretary and Chief Executive Professor Nicola Ranger said governments they are failing in their duties to keep patients safe.

Professor Ranger said: “Widespread vacancies of registered nurses are always unsafe, but the risk is being compounded by the demands of delivering ever more complex care to an ageing, sicker population, with multiple conditions. It is a deadly mix.
Four fifths (79%) say that clinical complexity has increased over the last two years alone, while just one in ten say staffing was at the right level for all patient needs to be met. More than two thirds (69%) say the situation is now forcing them to make difficult decisions about prioritising care.

Nursing staff across all NHS settings report care demands increasing, while registered nurse staffing remains unchanged or in some cases has fallen. They say adults, children and those with mental ill health are all presenting with more clinical complexity which is placing unsustainable pressure on staff.

A nurse working on an older people’s ward in the NHS in Wales, said: “[We] need to increase the agreed establishment; nurse to patient ratio due to increasing acuity, dependency and complexity of patients’ condition and presentation. More and more patients are now presenting with worsening cognitive function and often display challenging behaviour.”
A health care support worker from an inpatient mental health unit in Wales said: “Our ward has been bombarded with high acuity for around a year now and staffing levels have barely seen an increase.”
The findings of the RCN’s survey also show the extent to which having too few registered nurses to meet growing demand is impacting staff wellbeing. More than three in four (76%) felt emotionally exhausted on their last shift. Reports of exhaustion were highest among those who said their shift was understaffed.

RCN Wales Executive Director Nicola Williams said:

“Nursing staff across Wales are telling us clearly that staffing levels are not matching the complexity and intensity of care patients now need. Too many shifts are operating without enough registered nurses to deliver safe and effective care.”

“When more than a quarter of nursing staff describe staffing levels as unsafe and nearly half report compromised care, we need to listen and take action to address it.

“Our members are going above and beyond every day for their patients, are demoralised, going without breaks and having their much needed training time cancelled, they cannot continue carrying the burden of workforce shortages indefinitely. Emotional exhaustion is becoming normalised across the profession and that is dangerous for staff, patients and the future sustainability of services.”

“The newly elected Welsh government must urgently invest in growing and retaining the nursing workforce, ensure they have the training they require, alongside delivering safe staffing levels that are properly planned and enforced. Without action, patient safety risks will continue to grow.”

“The RCN says the findings demonstrate the urgent need for workforce investment and robust nurse staffing plans based on patient need, alongside action to improve recruitment and retention across Wales.”

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