Wards dangerously understaffed, warn more than half of nurses

Nursing Times conducted an online poll ahead of the publication of the report of the Mid Staffordshire Foundation Trust public inquiry on Wednesday.

Chairman Robert Francis QC’s report will consider why chronic failures of care at the trust were not picked up by regulators for so long.

A decision to slash nursing posts in a bid to save money and achieve foundation trust status has previously been blamed for many of the failures.

Of about 600 nurses who responded to the poll last week, 57 per cent described their ward or unit as sometimes or always “dangerously understaffed”.

In addition, 76 per cent said they had witnessed what they considered to be “poor” care in their ward or unit over the past 12 months – of which nearly 30 per cent said they seen it happen regularly.

One respondent said: “It is becoming more and more stressful for a nurse to nurse. Safety is always at the forefront of my mind but it is becoming increasingly difficult to ensure that all patients are kept safe while in my care.”

More than 80 per cent of respondents believed there were more “Mid Staffs” out there while, around a third were not confident they could rule out similar failings happening at their trust.

More specifically, 23 per cent said they were “at risk” of a similar situation occurring at their trust and 12 per cent said that it was already happening at their trust – either in isolated parts of the organisation or right across it. 

More than half of repondents - 55 per cent - thought nursing was facing unfair criticism over standards as a result of previous well publicised failings at Mid Staffordshire. But most thought that while the Francis report would have a negative effect initially, generating more criticism, it would lead to positive changes in the long run – leading to better staffing and regulation.

Nursing Times asked about a number of issues raised during the inquiry such as staffing, patient safety and culture.

Overall, 73 per cent of respondents said they had completed an incident form over the past 12 months because an adverse incident, or risk of one, had occurred. Worryingly, 76 per cent said they had not received feedback or a response after submitting the form. This reflects evidence heard by the inquiry that incident forms filled out by nurses at Mid Staffordshire concerned about staffing levels ended up in the bin.

Of nurses working on general medical wards, 85 per cent said the average ratio of patients per registered nurse was eight or more – of these just under half said the ratio was 10 or more patients per nurse.

The Royal College of Nursing has said a ratio of eight or more patients per registered nurse is associated with patient care regularly being compromised.

In addition, 43 per cent of those who worked on general medical wards said the ratio of registered nurses to healthcare assistants was either 50:50 or worse. The RCN recommends a ratio of 65:35 in favour of registered staff.

One survey respondent said: “Cutting staff numbers will mean poor care as simple as that. Most hospitals are heading the Mid Staffs way due to these cuts.”

Another added: “Acute care in the NHS is in crisis. There are examples of poor care in every trust. Changing the culture within nursing is the only way to secure and reverse the deteriorating situation.”

Unison head of nursing Gail Adams said: “Sadly the Nursing Times survey chimes with Unison’s own findings last year. At the time less than 10 per cent of nurses said they could deliver safe, dignified, compassionate care all of the time.

“It is time for the government to listen to staff and reverse its dangerous cuts to nursing staff.”

A spokesman for the NHS Commissioning Board was unable to comment on the survey findings, but highlighted that the importance of locally determined safe staffing levels was included in the new national nursing strategy, Compassion in Practice.