Collapsing growth in the registered nurse workforce and increasingly complex patient needs are leaving nursing staff exhausted and struggling to keep people safe, according to the findings of the RCN’s latest Last Shift Survey. 

These findings come as we begin our annual Congress in Liverpool. In her speech to delegates, Professor Nicola Ranger, RCN General Secretary and Chief Executive, will call for new and sustained investment to grow the nursing workforce to a level that meets the needs of an ageing, sicker population. 

The Last Shift Survey asks respondents what the staffing levels were like the last time they were at work, how those staffing levels have an impact on them, the care they were able to provide, and the impact of this on patients, service users and clients they care for.   

Of the 13,000 nursing staff who completed our survey, almost a quarter (22%) say registered nurse numbers are “so far below” what is required, there’s now a “high risk” of harm on shift. 

Overall, almost two in three reported that registered nurse staffing levels were “below” or “well below” what was needed. 

Around eight in ten respondents report that clinical complexity, for example, an ageing population and more people living with long-term conditions, has increased in the two years since our previous Last Shift Survey. 

Just one in 10 say staffing was at the right level to meet all of a patient’s needs on their last shift, and more than two-thirds (69%) say the situation is now forcing them to make difficult decisions about prioritising care.  

In response to the survey findings, Nicola 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.” 

Our analysis also shows growth in the registered nurse workforce has fallen behind that of doctors across the UK. In England, registered nurse growth has fallen to an eight-year low. Meanwhile, studies show patient need is only going to increase. 

Nicola said: “It is a government’s first priority to keep its citizens safe, but our analysis and the testimony of nursing staff show ministers are too often failing in this most basic task. We need a new approach, away from the flawed ‘finger in the wind’ workforce planning, which led us here.   

“It must be centred on new, sustained investment in the nursing workforce to the level that allows our profession to meet all patients’ needs - now and in the future. Anything else lays the ground for another patient safety disaster.” 

The RCN is here to support its members through challenging times. 

Our managing stress resource gives advice on managing stress and excessive workloads. We also have a work-related stress guide specifically for managers covering all aspects of HSE guidance. 

The RCN Nursing Workforce Standards can be used to challenge issues in the workplace and has guidance on safe and effective care. These are the first national blueprint for tackling the nursing staff shortage in your workplace and across the UK. 

The RCN believes everyone should feel safe and supported when raising concerns about patient care. You can find advice and guidance on this in our Raising Concerns toolkit.  

For more support around dealing with stress, members can contact RCN member support services.