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We don’t have enough time to care for patients, say nurses

UNISON survey indicates that permanent staffing:patient ratios still too low

Caroline White

Monday, 14 April 2014

Two thirds of nursing staff say they don’t have enough time to care properly for patients, while over half say that care was left undone as a result, reveals a survey* of almost 3,000 nurses issued by the health sector union UNISON today.

These time pressures existed despite the fact that half of the respondents said they worked through their breaks or beyond their shift, says the union.

The survey, which was undertaken on one day in early March, shows that three quarters of all midwives and 71% of all nurses (general and mental health) said they did not have adequate time with each patient, and 59% of all nurses on a night shift said there were elements of care they were unable to provide.

Over half of respondents (60%) felt that the number of staff working on that day resulted in a lower standard of care, with 45% of nurses saying they were caring for 8 or more patients, rising to 53% for night shifts.

Almost half (48%) of respondents described their organisation as either being at risk of a similar situation to Mid-Staffs, or stated that it was already happening in parts, or across, their hospital.

Independent evidence shows that there is a clear link between lower nursing staff to patient ratios and a heightened risk of dying while in hospital, says the union.

Gail Adams, UNISON head of nursing, said: “One of the most damaging findings of this survey is how little has changed since last year. Despite all the government rhetoric, despite the Francis, Keogh and Cavendish reports, the spectre of another Mid-Staffs still looms large over the NHS. Progress on safe staffing levels has been glacial and that means poorer care and patients still at risk.”

She added: “It’s clear that despite nurses working through breaks and beyond their hours, they simply do not have enough time to give patients the care and attention they need. That is distressing for patients and for the staff trying to care for them.”

One survey respondent said: “I did not feel able to provide the type of care I would have liked to the patients. It felt more like a conveyor belt. No compassion, little dignity, I left at the end of my shift feeling distraught and that perhaps I have made a huge mistake training as a registered nurse.”

The government needed to take swift action and impose legally enforceable nurse to patient ratios, said Ms Adams, a move supported by two thirds of survey respondents.

The survey responses also indicate a continuing over reliance on bank and agency staff, with 45% of respondents saying that they worked alongside one or more agency/bank workers.

The regular use of these staff is not cost effective or in the best interests of patients, says the union, which points to anecdotal evidence suggesting that some hospitals draft in bank or agency staff when they are expecting a Care Quality Commission inspection.

“Relying on bank or agency nurses because of understaffing is a false economy. It is frustrating for existing staff because they are often unfamiliar with the ward and it is unfair on patients who experience a lack of continuity of care. The answer is to ensure that there are sufficient established nursing posts to provide safe dignified and compassionate care,” said Ms Adams.


* Running on empty: NHS staff stretched to the limit. UNISON’s staffing levels survey 2014.

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