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 at RCN's annual congress in Liverpool, General Secretary and Chief Executive, Professor Nicola Ranger, called 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.
Professor Nicola Ranger commented that governments are failing in their duties to keep patients safe: “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."
She added that nursing staff across all NHS settings report care demands increasing, while registered nurse staffing remains unchanged or in some cases has fallen. 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.”
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.
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.
