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NHS nurses are too busy to care for patients properly, research shows

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By:  Health policy editor

Survey of 30,000 nurses finds 53% fear quality of care is suffering, and some patients are being left to die alone

One in three hospital nurses are too busy to relieve patients’ pain, give them their medication on time or talk to them and their families, research reveals.

Fifty-three percent of nurses fear the quality of care patients receive is suffering because they cannot do everything they need to do during their shift, according to a survey of 30,000 nurses.

And nurses are being left responsible for the care of as many as 25 hospital patients at a time, even though official guidelines say that to ensure patient safety it should not be more than eight.

The findings, compiled by the Royal College of Nursing (RCN), paint a picture of nurses so busy in often understaffed wards that many are having to leave some patients’ care needs unattended to.

Staff shortages are so acute that some patients are even being left to die alone, with no nurse present in their final moments, the survey found.

Thirty-six percent of respondents said a lack of time meant they had to leave necessary tasks undone. They included changing the patient’s position often enough for their safety and comfort, helping them with their dental health and completing records of patients’ care.

Such lapses in care matter because they heighten the risk of someone experiencing complications of their condition or suffering harm, the RCN says.

Fifty-three percent of nurses said patient care had been compromised during their last shift. Those most likely to say that were those working in A&E and other urgent and emergency care settings (67%) and prisons (64%). However, far fewer nurses in GP surgeries (31%), hospices (35%) and operating theatres (35%) said the same.

A further 53% said they felt sad or upset that they could not provide the right standard of care. “I feel like I’m spinning plates, except the plates are patients – that to me is the worst feeling. A feeling of no control. Going from crisis to crisis continuously is so incredibly stressful,” one nurse said.

Another said: “I drove home from work sobbing today, knowing that the patients I cared for didn’t get even a fraction of the level of care I would consider acceptable. I would be devastated if my family or friends were in the hospital I work in, as there are just not enough staff to go around.”

Even more respondents – 55% – said there were fewer registered nurses on duty than planned during their last shift. That finding adds to the evidence that the NHS is running so short of nurses that wards are routinely understaffed. The health service in England alone has vacancies for 40,000 nurses, the RCN claims.

Sixty-five percent of nurses said they worked just under an hour’s overtime – often unpaid – while 44% said no action was taken when they raised concerns about poor staffing levels. Nurses voiced anxiety about patient safety and their lack of job satisfaction, and some said they might quit the NHS.

The RCN is urging ministers to legislate to guarantee the minimum number of nurses that need to be on duty in different areas of medical care, depending on the number of patients at the time.

A Department of Health spokesman said it was funding an extra 10,000 training places for nurses, midwives and allied health professionals by 2020 “to ensure the NHS has the staff it needs both now and in the future”.

He added: “We are helping the NHS to make sure it has the right staff, in the right place, at the right time to provide safe care. That’s why there are over 29,600 more professionally qualified clinical staff including over 11,300 more nurses on our wards since May 2010 [in England].”

Meanwhile, hospitals are already so overcrowded that cutting any more beds would be unwise, the influential King’s Fund thinktank warns on Friday.

A 30-year decline in the number of beds means that the UK has fewer beds per head of population than any of the other 14 richest EU countries, it says. Beds in England have fallen from 299,000 in 1987-88 to 142,000 now, despite a rising demand for care, it has found.

Dangerously high levels of hospital bed occupancy mean that proposals to cut the NHS’s supply of beds in England even further, as envisaged in many of the controversial sustainability and transformation plans, are unrealistic, it says.

The King’s Fund adds: “With hospitals under real strain from rising demand and a prolonged slowdown in funding, further significant reductions are both unachievable and undesirable.”

Hospitals in England are already planning to open up several thousand temporary beds this winter to help them cope with an expected surge in patients, especially if predictions of a flu crisis are borne out.