We're struggling to keep patients safe – what our survey of nurses reveals

Nursing Standard-Sunday Mirror survey shows how nurse understaffing is blighting patient care

There's an exodus of excellent nurses because of workplace pressures – and those who are left are at 'breaking point'

Most respondents told us they do not have enough time for safe care. Picture: Alamy

Standards of patient care have deteriorated in the past five years ago, two-thirds (66%) of nurses in a major survey by Nursing Standard and the Sunday Mirror said.

The same proportion said they would be prepared to pay more in tax to support the NHS.

More than 3,000 nurses, almost half of whom are in senior or managerial roles, gave their views in our online survey about the state of the nursing profession and the health service. Most respondents said they worked in the NHS.

The survey’s results on care standards echo nurses’ views in the most recent NHS staff survey, which revealed falling levels of satisfaction with the quality of work and care nurses are able to give. Time and resources were cited as the main barriers.

Three-quarters of nurses (76%) told the Nursing Standard-Sunday Mirror survey their workplace does not have adequate staff to give patients safe care.

Almost half (49%) of respondents said they were under pressure to save money every day in their workplace, and in answer to a question about quitting the NHS, 43% of respondents said they would consider doing so.

RCN general secretary Janet Davies said the feedback represents ‘a tragic situation’ that could have been avoided, but added that the college was working to improve staffing levels.

Ms Davies said: ‘These findings are the result of many years of short-sighted cost-cutting and ineffective workforce planning. Too many politicians and policymakers are unable to recognise the value of nursing.

‘Extra NHS funding in England must begin to turn this around by investing in nursing staff – both with new recruits and by valuing experienced staff to stop the haemorrhaging we’ve seen.’

Ms Davies added the college could begin a campaign this autumn to demand safe staffing levels and accountability in the NHS be enshrined in law throughout the UK. Minimum safe staffing is already mandatory in Wales in adult acute medical and surgical wards, and the legislative process in underway in Scotland. There are no plans for mandated safe staffing levels in England or Northern Ireland.

‘It will go some way to ending the current situation where patient care is compromised by short staffing.

‘It cannot be repeated enough. Mortality increases when the level of registered nurses falls, patients can pay the heaviest possible price,’ Ms Davies added.

Other survey findings included:

  • Most nurses (69%) said they don’t have time to deliver safe patient care, with 64% saying they infrequently have time for safe care and 5% saying they never have time to give safe care.
  • More than 60% described morale as ‘at rock bottom’ (19%) or ‘poor’ (42%).
  • Almost half (47%) of nurses said they had seen patients suffer needlessly as a result of cuts to services.
  • Workplaces are not safely staffed according to 61% of respondents.
  • Yet 69% were proud to work in the NHS and a similar proportion (67%) would agree to pay more tax to support it.

Other issues nurses highlighted were high stress levels, feeling unfairly paid, and seeing services that were readily available five years ago being rationed today.

One acute trust staff nurse said: ‘I have seen excellent nurses leave the NHS in droves – the ones that are left are near breaking point.’

Another nurse told us: 'I am proud of the free-for-all ethos and the standards of care that nurses wish to deliver. However, there are not enough staff or resources to deliver high standards of patient-centred care in the NHS.'

University of Southampton principal research fellow Jane Ball said: ‘Not being able to “do a good job” and deliver care to a high standard is a major reason nurses give for wanting to leave.

‘We have a national shortage of nurses. More are leaving the profession than entering it and we cannot afford to lose them at the current rate.’

Dr Ball added there was a critical need to find ways of breaking the cycle of low staffing levels creating unsustainable working conditions, which in turn drive more staff away from the NHS.

A Department of Health and Social Care (DH) spokesperson told Nursing Standard there were ‘near-record numbers of nurses’ working on wards since 2010.

He said the DH had increased nurse training places by 25%, introduced flexible working arrangements and given NHS staff a ‘well-deserved’ pay rise to address recruitment and retention issues.

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The 2017 NHS staff survey results

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