Nurses have always been an integral part of healthcare and medicine, because not only are they involved in regular monitoring of the patient – they are also an important source of comfort and support for the patients. Recently, in the Gorakhpur hospital in India, 30 children died as a result of critical oxygen deprivation and shortage of qualified staff. When the case was investigated, the root causes of this tragedy were found to be understaffing—resulting in an incapacity to effectively manage the large numbers of ill children.

Up to 40% more patient deaths on understaffed wards

Recently, a study conducted has revealed that wards which are poorly staffed are likely to register more deaths as compared to wards which are adequately staffed. A greater number of patients for any one nurse is more likely to result in negligence in delivering medication, less attention to individual patient health and poorer knowledge about the patient’s improvement or deterioration. According to some unions, approximately “40,000 nursing posts” are vacant, which represents a dire paucity of qualified healthcare professionals.

In the UK, the ratio of patients to nurses is approximately eight to one. However, if the number of patients goes up even slightly, mortality risks are considerably elevated. This is particularly concerning in the context of epidemics or seasonal illnesses, where hospitals are likely to encounter a greater number of patient cases—and therefore, may be unable to clinically manage all of them optimally.

Janet Davies, chief executive of the Royal College of Nursing, comments on the way hospitals cope with nurse understaffing. “As the nurse shortage bites, hospitals are filling wards with unregistered healthcare assistants in a bid to cope, especially at night. Ministers cannot ignore further evidence that the lack of registered nurses leads to people left in pain for longer and a higher risk of not recovering at all,” she expresses.

Data collection from 31 NHS trusts

The study published in the International Journal of Nursing Studies closely monitored the rate of recovery of 420,000 patients who had underwent routine surgeries such as joint replacement surgery. The optimal patient to nurse ratio was found to be five to one, and the hospitals that fared the worst clocked up to “11 patients per nurse”. Dr Jane Ball, the principal researcher of the study from the University of Southampton, commented on these findings stating that, “These results give the clearest indication yet that registered nurse staffing levels are not just associated with patient mortality, but that the relationship may be causal.”

The lower levels of registered nurses result in less provision of essential care for patients; approximately 10% of essential work left incomplete is associated with an additional 16% mortality risk for patients post-surgery. Tasks left incomplete are primarily a consequence of reduced time available due to a greater number of patients.

Education also plays a key role in determining the overall mortality risk of patients as hospitals with greater numbers of registered nurses document less patient deaths. It is essential to ensure that nurses have completed the appropriate education as their competence impacts patient safety. “The government must redouble its efforts to train and recruit more nurses and stop haemorrhaging experienced professionals who feel burnt out and undervalued,” comments Davies.

The total number of EU nurse registrants in the UK has been declining tremendously, since Brexit vote. Source: Nursing and Midwifery Council/The Telegraph
The total number of EU nurse registrants in the UK has been declining tremendously, since Brexit vote. Source: Nursing and Midwifery Council/The Telegraph

Dire crisis of nurse shortage in the NHS workforce

Reduced numbers of registered nurses indirectly leads to a scenario whereby patients may be compelled to receive care that is inefficient, expensive and substandard. Patients may have slower recovery from surgery and may also spend a longer time in discomfort as a result of such level of care. A spokesperson for the Department of Health states that, “We expect all parts of the NHS to make sure they have the right staff, in the right place, at the right time in order to provide safe care.” Provisions are now currently in place to train more nurses in order to ensure effective care is available at all times for patients. MIMS

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