A new study by BMJ Quality & Safety suggests that hospital nurses are being forced to ration care because they do not have enough time to properly look after patients.
Researchers also found that the most important aspects of care are regularly being left undone.
Registered nurses (RNs) working in English NHS hospitals also complained that:
“Care is needed but is often not done because of insufficient time.
There is a strong relationship between RN staffing levels and the prevalence of care being left undone – and, the better the practice environment the smaller the volume of care that is left undone.”
Almost 3,000 nurses who work in 46 English hospitals were examined and about nine in 10 nurses said that they were too busy on their previous shifts and were unable to perform at least one care activity such as:
- “Proper patient surveillance,
- Documenting care,
- Administering medication properly,
- Comforting patients,
- Preparing them for discharge and/or
- Changing a patient’s position in bed to prevent bed sores.”
Following this discovery, the authors from the Florence Nightingale School of Nursing and Midwifery and the University of Southampton, found that:
- “86% of nurses were unable to perform at least one of 13 care elements because they were busy,
- 66% could not comfort and talk with patients because they didn’t have time to do this on their last shift,
- Just over half of nurses said they were forced to skip “educating patients” and
- 47% said they didn’t have time to develop or update nursing care plans.
- Conclusively, the average nurse cared for 7.8 patients on a day shift and 10.9 at night,
- And the fewer patients a nurse looked after, the less likely that care would be missed or rationed.”
The authors also found that 78% of nurses in the best staffed environments reported some care was missed on their last shift, compared with 90% of those with lower staffing levels.
According to the Guardian, Gail Adams, head of nursing at Unison, said:
“This report adds to the growing evidence that there is safety in numbers when it comes to caring for patients.”
Dr Peter Carter, general secretary of the Royal College of Nursing also said:
“These are depressing findings and unfortunately not surprising.
When nurses are overloaded with tasks, and have extremely limited time to complete them, something has to give.
Without enough staff on the ground, it’s vital care such as having the time to talk with and reassure patients that suffers.
Cutting nursing posts to save money is a false economy – it leads to poor care which in turn creates more strain on the system, particularly in accident and emergency departments. We need to prevent poor care by making sure wards are well staffed, not just use poor care as an early warning sign.
We urge all employers to make use of this research.”
A Department of Health spokesperson also said:
“Hospitals themselves must decide how many and which staff they employ.
But we have been absolutely clear that these decisions must be based on providing the best patient care, and hospitals should publish details and evidence to show that staffing numbers are right for the care needs of the patients that they look after.
The new chief inspector of hospitals will be able to take action if hospitals are found to be compromising patient care by not having the right number of staff on wards. We are also working with the National Institute for Health and Care Excellence, the Care Quality Commission and NHS England to develop better tools to help hospitals decide their staffing numbers.”