A report by Birmingham University’s Health Services Management Centre has urged for senior nurses to be given greater leadership responsibility in order to improve acute nursing care standards.

Aside from making leadership recommendations, Time to Care? responding to concerns about poor nursing care also suggests that nurses be given better support to cope with the emotional strain of their work and that a recognised training programme for healthcare support workers be implemented.

The HSMC’s recommendations come after a number of reports have highlighted problems with nursing care within the NHS, including the Francis Inquiry (2010) and the Care Quality Commission 2011 report.

Directors of nursing, who are responsible for overseeing good nursing care in the NHS, and other senior nurses were consulted and the issues and solutions they offered were compiled and included in the report.

The seven core recommendations are:

Environment of care

  • Ward sisters/Charge Nurses need to have a clearly defined role as the clinical leader of their ward/department. They need to be recruited based on their attitudes and competencies; developed and supported as leaders, and their role recognised at all levels of the organisation.
  • Senior Nurse leaders need to be freed from the competing demands placed upon their time to enable them to fulfil the prime role of leading clinical nursing.
  • Where new ward designs limit the visibility of nurses, systems of ‘intentional rounding’ should be introduced to ensure organisational processes enable nurse patient contact to be maintained.
  • Clinical dashboards that measure nursing care indicators, which can then be reported to the Board, are an important tool which should be introduced into every acute hospital trust.

Education and development

  • Student nurses need to feel a greater sense of belonging to the nursing profession rather than being identified primarily as a university student.
  • Healthcare support workers would benefit from a recognised training programme in every organisation, underpinned by a probationary period for all new starters.

Emotional Labour of Nursing

  • Boards should recognise the emotional labour of nursing and establish a systematic approach to supporting nurses. This should be evaluated to assess its impact on nurses as carers and the subsequent outcome for patients.

Lead author and senior research fellow at HSMC Yvonne Sawbridge said: “Whilst many would acknowledge that nursing is an emotionally difficult job, this rarely features in current debates, and organisations rarely discuss nursing in these terms.

“Giving nurses systematic support would enhance the experience for all nurses and their patients on acute wards and send a clear message that the role nurses play in acute care is genuinely valued.”