Urgent patient safety review urged after nurses blow the whistle on staffing shortages

The RCN is calling for an urgent review of nurse staffing levels across the UK after a 30,000-strong survey nurses were being left sick, burned out and ‘sobbing’ at staff shortages.
RCN survey

The RCN is calling for an urgent review of UK nurse staffing levels after a 30,000-strong survey found nurses were being left sick, burned out and ‘sobbing’ due to staff shortages.

Seven in ten nurses in England said their last daytime shift exceeded National
Institute for Health and Care Excellence guidelines. Picture: StockDisc

More than half (55%) of those who took part in the RCN survey said shifts did not have the level of nurses planned, while 53% warned staff shortages is compromising care.

Some warned that shortages meant some patients are no longer afforded enough dignity, even dying alone.

Patient safety

The RCN is calling on health and social care providers across the UK to urgently review nurse staffing levels, give public assurances on patient safety and take action where standards are not met.

The UK-wide survey of nursing staff asked about staffing levels on their most recent shift and the quality of care provided. More than a third (36%) report having to leave elements of patient care undone due to a lack of time, while two-thirds (65%) work an unpaid extra hour on average.

Seven in ten nurses (71%) in England said their last daytime shift exceeded National Institute for Health and Care Excellence guidelines, which state that more than eight patients to one nurse should act as a ‘red flag’. A quarter (26%) reported shifts with 14 or more patients per nurse.

Nursing staff working in hospitals rated the quality of care lower than those in community services such as district nursing. Emergency departments had the lowest quality ratings of all hospital services, with one in seven (14%) emergency nurses rating care as poor or very poor.

Raised concerns

Almost half of all respondents (44%) said no action was taken when they raised concerns about staffing levels.

Nursing staff rated the quality of care more highly when there are fewer patients for every one registered nurse, which supports recent research by nurse researcher Jane Ball, which found a link between the number of registered nurses, patient care duties left undone and mortality levels.

The survey was carried out in May and suggests that pressures previously associated with the winter months have become common throughout the year.

The respondents also reported that:

  • Patients are no longer afforded enough dignity, even dying alone.
  • Colleagues have burned out and have become sick themselves, unable to come to work.
  • Staff leave work “sobbing” at the impact of shortages on patient care.
  • Many question their future in nursing and contemplate leaving the profession.
  • They struggle to give their children and families enough support after shifts that can exceed 12 hours.

Provide assurances

The RCN is calling on providers to urgently assure their boards that they are providing safe services. In addition, the college is calling for UK-wide legislation to guarantee safe and effective nurse staffing. 

The college repeated its call for increased funding for health and care services to meet the patient demand.

RCN general secretary Janet Davies said: ‘When this many professionals blow the whistle, they cannot be overlooked.

‘The nursing shortage is biting hard and needs the attention of ministers – this warning comes from the very people they cannot afford to lose.

‘Nursing staff are revealing desperately sad experiences and their honesty must drive forward the policy debate.

‘We urgently need assurances from every health and care provider that services are safe for patients – and new laws on staffing should follow swiftly.’

 RCN survey: voices from the front line

‘I was supposed to finish at 7.15pm to collect my son. I did not finish until 7.55pm so I was late. I was mentally and physically exhausted and unable to engage with my family when I got home. Relationships were strained again because my family believe that I always put work first, which I do. I could not sleep due to the worry of not meeting all the care demands and feeling that I’ve failed my patients, colleagues and now my family. I cried all the way home’

Adult acute nurse

‘I feel like I’m spinning plates, except the plates are patients – that to me is the worst feeling. A feeling of having no control. Going from crisis to crisis continuously is so incredibly stressful. Front line staff feel like they are working on a battlefield; we don’t know who to go to first. We can start a shift with an acceptable amount of staff but we are always moved to other wards. So we go from having eight patients to working on a ward we are unfamiliar with, often with 12 or more patients’

Adult acute nurse 

‘I drove home from work sobbing today, knowing that the patients that I cared for did not get even a fraction of the level of care that I would consider “acceptable”’

Registered nurse

‘When I told my manager I was the only nurse on a shift with 44 residents I was just told that’s how it’s going to be. We should not be reduced to one nurse just because it’s supposed to be quieter at night according to managers.’

Nurse in a care home


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