Comment

Nurse staffing is too important to leave to wishful thinking – we need detailed plans for achieving it

New workforce standards will help healthcare decision-makers see nurses as an asset, not just a cost

The pandemic has shown how central nurses are to patient safety, so its time decision-makers told us what they intend to do to meet fundamental workforce standards

This past year has shown us all the critical importance of skilled nursing care to the safety of patients.

The biggest challenge during the pandemic was not making sure we had enough beds or enough ventilators, but that we had enough nurses with the right skills to care for acutely ill patients.

Quite simply, workforce is the make or break issue in care delivery.

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The pandemic has shown how central nurses are to patient safety, so it’s time decision-makers told us what they intend to do to meet fundamental workforce standards

The results of having too few nurses are potentially catastrophic Picture: iStock

This past year has shown us all the critical importance of skilled nursing care to the safety of patients.

The biggest challenge during the pandemic was not making sure we had enough beds or enough ventilators, but that we had enough nurses with the right skills to care for acutely ill patients.

Quite simply, workforce is the make or break issue in care delivery.

A lack of registered nurses can lead to patients dying

The pandemic has made clear that having sufficient nurse staffing isn’t a nursing issue, it’s a health service issue.

The impact of having too few nurses is potentially fatal: when there are too few registered nurses on duty patients are more likely to suffer compromised care and potentially die.

‘Application of these universal workforce standards could be game-changing’

Staffing decisions are too important, the effects of getting it wrong too great, for us simply to hope that healthcare providers have everything in place to ensure services are staffed safely.

Principles set out in RCN workforce standards are obvious, but routinely neglected

The new RCN workforce standards set out the basics that all healthcare services need to achieve, to provide nursing care safely, in any context.

They recognise the critical importance of nursing workforce and make explicit the responsibilities that decision-makers have to ensure enough nursing staff are in place with the right skills to deliver care safely and effectively.

Many of these principles seem obvious: the need to base staffing decisions on an assessment of patient need and levels of demand for nursing care; the expectation that boards take responsibility for staffing decisions – taking account of the risks to patients of understaffing; that nurse leaders’ expertise is used to inform decision-making. Or that there are enough staff employed to accommodate leave and that each shift has adequate staff on duty for mandatory breaks to be taken.

Yet these basic tenets are routinely neglected, which is why having these fundamental standards, and the detail of what they look like in practice fully specified, is so vital.

One of the great challenges of the pandemic was not bed numbers, but nurse numbers Picture: Daniel Mitchell

Nurse staffing is a patient-safety issue

Application of these universal workforce standards could be game-changing and could create a fundamental shift where the full potential of the nursing workforce as an asset, not simply a cost, is recognised and harnessed.

Getting nursing workforce right isn’t a nursing issue, it’s a patient-safety issue.

Decision-makers at every level need to think about what’s needed to achieve these standards in the short, medium and long term.

As we celebrate International Nurses’ Day, we need to see that a general appreciation of nurses and their work is translated into a specific and ongoing commitment to the adoption of nursing workforce standards.

Because nursing workforce isn’t just the icing on the cake, it is the cake.


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