Nursing workforce pressures put patient care at risk

Led by researchers at the National Nursing Research Unit (NNRU) at King’s College London and the University of Southampton, the RN4CAST survey of nurses in over 400 general medical and surgical wards at 31 Trusts, was part of an international research programme looking at links between nursing workforce issues and patient outcomes across 15 countries.

Jane Ball, Deputy Director of the National Nursing Research Unit at King’s College London, said: “The results provide clear evidence of the links between nurse staffing and the quality of care patients receive. On wards with poorer Registered Nurse staffing levels, nurses were more likely to say that care had been left undone due to lack of time. Working with inadequate staffing not only puts patients at risk, but places immense pressure on staff, and this has a knock effect on morale. Nearly half of the nurses we surveyed would leave their current job if they could. At a time when the number of nurses being trained is being cut, the service can ill-afford to lose this valuable expertise.

“We have now given the results to all the participating trusts and urge them to look at what their staff have said about staffing issues at ward level, and the effect this has on their working environments and patient care.”

Results published earlier in the year showed that over 40& of nurses who responded to the survey were suffering from emotional exhaustion, or ‘burnout’. In addition, just one in four nurses agreed that there were enough staff to get the work done.

Professor Peter Griffiths, Chair of Health Services Research at the University of Southampton, said: “Our results support what we already suspected. If there aren’t enough staff, especially qualified nursing staff, then patient care suffers and certain tasks have to be abandoned due to lack of time and resources. This will obviously impact on staff satisfaction levels, with nurses feeling more stressed and less able to complete their job to the level they’d like. However, there were also other key issues which impact on nurses’ job satisfaction, such as less than half feeling that they receive praise and recognition for good work and just over a quarter stating that they receive verbal abuse from patients or their families a few times a month.

“There is no denying that the NHS faces tough times ahead but this highlights both the importance and potential benefits of both managers and the public supporting nurses to ensure that they can deliver excellent care in the face of these challenges.”

There were, however, many positive findings from the survey. 94% of respondents agreed that high standards of care are expected by management and 84% would recommend their hospital to friends and family if they needed care. Nearly 90% stated that doctors and nurses have good working relationships, collaborating on patient care and working well as a team.

Anne Marie Rafferty, Professor of Nursing Policy at King’s College London, said: “This survey reveals serious issues affecting the nursing workforce in England, with significant variation in staffing levels both between trusts and within trusts. This affects care quality and nurses’ confidence in hospitals.”

The next stage of the study will compare these results with measures of patient outcome, such as mortality rates.