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News ArticleNHS patients are being left unseen in pain and in some cases to die alone because shifts do not have enough registered nurses, a survey shows. The Royal College of Nursing said analysis of a survey it carried out showed that only a third of shifts had enough registered nurses on duty. The union has also gathered testimonies from nurses who talk of always “rushing” and being asked to do more; working in “completely unsafe” levels of care; and having to make “heartbreaking” decisions on who does or doesn’t get seen. Shortages mean individual nurses are often caring for dozens of patients at a time, the RCN said. It has called for limits on the maximum number of patients for whom a single nurse can be responsible. Nicola Ranger, the RCN’s acting general secretary and chief executive, said the survey showed that patients were being failed. “In every health and care setting, nursing staff are fighting a losing battle to keep patients safe,” she said. “Without safety-critical limits on the maximum number of patients they can care for, nurses are being made responsible for dozens at a time, often with complex needs. “It is dangerous to patients and demoralising for nursing staff.” Read full story Source: The Guardian, 1 July 2024
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News Article
UK nursing regulator’s new chief resigns after four days following racism row
Patient Safety Learning posted a news article in News
The UK nursing regulator’s new interim chief executive has stepped down just four days into the job after facing widespread staff backlash over her links to a high-profile race discrimination case. Multiple staff working at the Nursing and Midwifery Council (NMC) raised concerns to its directors over the appointment of interim CEO Dawn Broderick, who was head of HR at another trust when it was found to have discriminated against a Black employee. The Independent can now reveal Ms Broderick resigned from the NMC on Monday evening. It is the latest in a succession of controversies to hit the nursing regulator, following reports uncovered by The Independent last year. These include allegations from whistleblowers that racism within the NMC was allowing complaints against nurses to go unchecked. Staff have come forward to The Independent, warning they do not have confidence the NMC’s board will take the issue of racism seriously. Read full story Source: The Independent, 2 July 2024 -
News Article
'We desperately need safety-critical nurse-to-patient ratios enshrined in law'
Patient Safety Learning posted a news article in News
The latest release of data from the Royal College of Nursing's Last Shift Survey shows the urgent need for investment in the nursing workforce and safety-critical nurse-to-patient ratios enshrined in law. New analysis finds more than 11,000 members reveals just a third of shifts had enough registered nurses. Chronic staff shortages mean individual nurses are often caring for 10, 12, 15 or more patients at a time. The RCN are now calling for safety-critical limits on the maximum number of patients a single nurse can be responsible for. Our survey found that 1 in 3 hospital shifts were missing at least a quarter of the registered nurses they needed. In A&E settings, significant numbers of nurses reported having more than 51 patients to care for. Across all settings, 80% of respondents said there aren't sufficient nurses to meet the needs of patients safely. RCN Acting General Secretary and Chief Executive Professor Nicola Ranger said: “Without safety-critical limits on the maximum number of patients they can care for, nurses are being made responsible for dozens at a time, often with complex needs. It is dangerous to patients and demoralising for nursing staff. “When patients can’t access safe care in the community, conditions worsen, and they end up in hospital where workforce shortages are just as severe. This vicious cycle fails staff and patients – it can’t go on. “We desperately need urgent investment in the nursing workforce but also to see safety-critical nurse-to-patient ratios enshrined in law. That is how we improve care and stop patients coming to harm.” Read full story Source: RCN, 1 July 2024 -
Content ArticleNurses, midwives and paramedics make up over half of the healthcare workforce in the UK National Health Service and have some of the highest prevalence of mental ill health. This study in BMJ Quality & Safety explored why mental ill health is a growing problem and how we might change this. The authors identified the following key themes:It is difficult to promote staff psychological wellness where there is a blame cultureThe needs of the system often over-ride staff psychological well-being at workThere are unintended personal costs of upholding and implementing values at workInterventions are fragmented, individual-focused and insufficiently recognise cumulative chronic stressorsIt is challenging to design, identify and implement interventions.They suggest that healthcare organisations need to rebalance the working environment to enable healthcare professionals to recover and thrive. This requires:high standards for patient care to be balanced with high standards for staff mental well-being.professional accountability to be balanced with having a listening, learning culture.reactive responsive interventions to be balanced by having proactive preventative interventionsthe individual focus balanced by an organisational focus.
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Content Article
Should hospital nurses be working 12-hour shifts? (12 May 2022)
Patient-Safety-Learning posted an article in Nurses
Increasingly, some nursing leaders say it’s time to move away from the 12-hour nursing shifts used by many hospitals. They say that health systems must develop other scheduling options to accommodate the changing needs of nurses as they progress in their careers. This article by Ron Southwick looks at the arguments for moving away from the 12-hour shift, including the risks that the current system poses to patient safety. -
News Article
'I don't ever trust Epic to be correct'. Nurses in the US raise more AI concerns
Patient Safety Learning posted a news article in News
Nurses in the United States continue to voice concerns about artificial intelligence and its integration into electronic health records (EHR), saying the technology is ineffective and interferes with patient care. Nurses from health systems around the country spoke to National Nurses United, their largest labor union, about issues with such programmes as automated nurse handoffs, patient classification systems and sepsis alerts. Multiple nurses cited problems with EHR-based programs from Epic and Oracle Health that use algorithms to determine patient acuity and nurse staffing levels. "I don't ever trust Epic to be correct," Craig Cedotal, RN, a paediatric oncology nurse at Kaiser Permanente Oakland (Calif.) Medical Center, told the nurses' union. "It's never a reflection of what we need, but more a snapshot of what we've done." He said the technology does not account for the hours of preparing and double-checking the accuracy of chemotherapy treatments before a pediatric patient even arrives at the hospital. Read full story Source: Becker's Health IT, 14 June 2024 -
Content Article
I am one of many staff that undertake additional shifts as bank staff or agency staff. The reasons are varied and personal. This is a reflection on a shift that I undertook a few weeks ago. I have taken the decision to remain anonymous in this account. -
Content ArticleThis study explored the beliefs and organisational contexts of nursing aide (caregivers henceforth) assaults and their subsequent reporting of these events. Although this data is a pretty specific cohort and setting (rural nursing homes), the social and systems lenses that the authors take, and the silence resulting from blame attributions have broader applications.
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Content ArticleElectronic health record (EHR) nursing summaries have the potential to support nurses in locating and synthesising patient information. However, nurses’ role-specific perspectives are often excluded in the design of the EHR system. The purpose of this study was to describe nurses’ current use of nursing summaries and vital sign information within them and glean their ideas for design improvements. en clinical inpatient nurses participated in interviews and co-design activities. Nurses hardly use the nursing summary to overview a comprehensive patient's health status. The current design of a nursing summary lacks comprehensive patient information and contains much irrelevant data. Nurses prefer vital signs to be prominently displayed on the summary screen for easy visibility. Involving nurses in the design process can lead to a nursing summary that better meets their needs.
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Content ArticleEvidence shows that nurse staffing affects patient safety events (PSEs), but the role of an appropriate nursing care delivery system remains unclear. This Japanese study aimed to investigate whether nursing care delivery systems could prevent PSEs. The findings suggest that in an emergency intensive care unit, a collaborative nursing care delivery system was associated with a decrease in PSEs.
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News ArticleThe United State's largest nurses union is demanding that artificial intelligence tools used in healthcare be proven safe and equitable before deployment. Those that aren’t should be immediately discontinued, the union says. Few algorithms, if any, currently meet their standard. “These arguments that these AI tools will result in improved safety are not grounded in any type of evidence whatsoever,” Michelle Mahon, assistant director of nursing practice at National Nurses United, told Fierce Healthcare. NNU represents 225,000 nurses in the US and has a presence in nearly every state through affiliated organisations, like the California Nurses Association, which protested the use of AI in healthcare in late April. NNU nurses also represent nearly every major hospital and health system in the nation. Most AI nurses interact with is integrated into electronic health records and is often used to predict sepsis or determine patient acuity, union nurses said at an NNU media briefing last month. EHRs cause an estimated 30,000 deaths per year, which is the third leading cause of death in the nation, Mahon said. Adding what they call “unproven” algorithms to EHRs is not how the health system should be spending dollars, NNU says. The union is demanding that all AI used in healthcare meet the precautionary principle, a philosophical approach that requires the highest level of protection for innovations without significant scientific backing. Any AI solution that does not meet this principle, which NNU claims is most of the AI currently on the market and deployed in hospitals, should be immediately discontinued, they say. Read full story Source: Fierce Healthcare, 3 June 2024
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News ArticleMore hospital patients with learning disabilities will die if politicians do not tackle the “devastating collapse” in specialist nurse numbers, a leading charity and a union have warned. The number of specialist learning disability nurses working in the NHS has dropped by 44 per cent over the course of the Conservative party’s time in government, a new analysis by the Royal College of Nursing (RCN) has revealed. The nursing union found a 36 per cent drop in applicants for specialist nursing degrees, while applicants are so low some universities have stopped funding courses altogether, according to a report shared exclusively with The Independent. The RCN and the charity Mencap have warned specialist nurses are vital in keeping patients with learning disabilities in hospital safe, as they are trained to spot life-threatening illnesses, such as sepsis, which can present differently. Dan Scorer, head of policy at Mencap, said: “Learning disability nurses have that in-depth training and understanding about the complexity of how people with a learning disability can present, and about how they will show they are experiencing pain. They’ve got vital expertise and insights to make sure that we don’t miss things.” He said the government must increase the number of training places available, and warned some universities have stopped courses altogether. He added: “I think the government removing bursaries for nurse training was pretty devastating. The impact of that was really significant, and whilst that’s been partially reversed, it significantly impacted the undergraduate training capacity that was available.” Read full story Source: The Independent, 4 June 2024
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Content ArticleIn a new Royal College of Nursing report, survey findings and member testimonies show the full grave picture of corridor care across the UK. Of those forced to deliver care in inappropriate settings, over half (53%) say it left them without access to life-saving equipment including oxygen and suction. More than two-thirds (67%) said the care they delivered in public compromised patient privacy and dignity. Thousands of nursing staff report how corridor care has become the norm in almost every corner of a typical hospital setting. Heavy patient flow and lack of capacity sees nursing staff left with no space to place patients. What would have been an emergency measure is now routine. The report says corridor care is “a symptom of a system in crisis”, with patient demand in all settings, from primary to community and social care, outstripping workforce supply. The result is patients left unable to access care near their homes and instead being forced to turn to hospitals. Poor population health and a lack of investment in prevention is exacerbating the problem, the report says. The RCN are asking for mandatory national reporting of patients being cared for in corridors, to reveal the extent of hospital overcrowding, as part of a plan to eradicate the practice. They also need members to raise concerns when care in inappropriate settings takes place. Related reading on the hub: A silent safety scandal: A nurse’s first-hand account of a corridor nursing shift
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Content ArticleOne of the enduring lessons of the pandemic has been the pivotal role that nursing plays in health care--vital work that isn't widely understood or, sadly, appreciated. Sara Fung and Amie Archibald-Varley started the wildly popular The Gritty Nurse podcast to give voice to nurses all over the world, including more than 400,000 nurses in Canada. The authors have quickly become sought-after speakers and advocates for nurses and are called on regularly by the media to talk about a wide range of issues around the profession. In their first book, they take you to the front line of nursing to show the compassion, selflessness and dedication of professionals who not only give it all for their patients, but get up and do it over and over again.
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Content Article
The Gritty Nurse Nursing Podcast
Patient_Safety_Learning posted an article in Nursing
The Gritty Nurse Nursing Podcast examines hot topics related to health and healthcare. We shy away from nothing, discussing topics such as mental health, social justice, women's health and women's rights. Hosts Amie Archibald-Varley and Sara Fung are story-tellers and love hearing how healthcare has impacted individuals' lives. They want to discuss the good, bad and ugly . They also provide a platform for empowerment and shared experiences, where they represent voices that have been silenced, underrepresented and marginalized --so they can share their stories of hope, change and inspiration. -
Content ArticleThe Thirlwall Inquiry is examining events at the Countess of Chester Hospital and their implications following the trial, and subsequent convictions, of former neonatal nurse Lucy Letby of murder and attempted murder of babies at the hospital. As part of this Inquiry, its Terms of Reference asks: “Whether recommendations to address culture and governance issues made by previous inquiries into the NHS have been implemented into wider NHS practice? To what effect?”. To help inform its work in this area, the Inquiry Legal Team has produced this Table of Inquiries and reviews which have been conducted in England and Wales over the last thirty years. Recommendations from each Inquiry have been set out in a comprehensive table, alongside details of whether or not those recommendations have been implemented.
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News Article
Nurse wins staff shortages whistleblowing case
Patient-Safety-Learning posted a news article in News
An NHS trust has lost an employment tribunal case against a nurse who had his shifts cancelled after whistleblowing when a patient was put in seclusion because of staff shortages. A judgment published last week found that Mark Temperton, a mental health nurse, was “subjected to detriment” after having made a “protected disclosure” during his agency shift at Greater Manchester Mental Health Foundation Trust’s (GMMH) Atherleigh Park Hospital. Mr Temperton, who is also employed by the Priory Group as a regulatory inspector as well as doing ad-hoc work for the Care Quality Commission, worked as an agency mental health nurse for Blackstone Recruitment and was booked to work a night shift in a psychiatric intensive care unit (Priestners Unit) at Atherleigh Park on 14 October 2022. He raised concerns after a patient, brought in by the police, was put “immediately” into seclusion because of staff shortages. Mr Temperton subsequently raised it with the nurse in charge and with a locum consultant psychiatrist but the patient was kept in seclusion. According to the Mental Health Act’s Code of Practice, seclusion “should not be used as a punishment or a threat, or because of a shortage of staff”. Serious concerns were also raised about the trust’s Edenfield Centre in September 2022 by BBC Panorama, one of them being use of inappropriate seclusion. Paul Lewis-Grundy, associate director of corporate governance at GMMH, said: “It is absolutely vital that staff feel confident and safe to speak up, with no detrimental impact to themselves or their career and prospects. Over the past two years, we have invested significantly, and taken a number of steps, to support this across GMMH.” Read full story (paywalled) Source: HSJ, 15 May 2024 -
Content ArticleThe Royal College of Nursing (RCN) is developing a professional framework for nursing which will encompass the whole nursing workforce, from the nursing support worker through to the consultant nurse. Beyond the point of registration, the work of the registered nurse increases in its complexity, and as part of this framework, the RCN has developed definitions of the levels of nursing practice beyond registration. This webpage provides definitions and standards for enhanced, advanced and consultant levels of nursing. These definitions will help those who aspire to practice at these levels, as well as giving greater clarity to employers and higher education institutions. They can be applied across all fields of nursing and in all settings.
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News Article
Agency charging hospitals nearly £2,000 for specialist nurse shift
Patient-Safety-Learning posted a news article in News
An agency providing last-minute freelance nurses to NHS hospitals is routinely charging up to £2,000 a shift, BBC News has discovered. Glen Burley, chief executive of an NHS trust, said that Thornbury Nursing Services is targeting areas in England where nurses are in short supply. He says it is "profiteering" from an overstretched NHS, but Thornbury says it offers a valuable, flexible service. The government says new measures will end the use of expensive agencies. However, Labour has said the high costs are a result of the "Conservatives' failure to train enough nurses over the past 14 years". Under NHS rules, hospital managers are obliged to use staffing agencies that work within an agreed framework, with a limit or cap on how much should be paid. But when last-minute essential cover is needed, trusts may use off-framework agencies, such as Thornbury. These are not legally obliged to abide by pre-agreed pay scales. Workload pressures in the NHS and a desire for more flexibility over shifts are thought to be driving more nurses to work for such agencies, which tend to pay the people on their books more while also taking a payment for themselves. BBC News has discovered Thornbury charges almost £2,000 for a 12-hour bank holiday shift by a specialist paediatric nurse - an area of expertise where there are known staff shortages. Of that, BBC News calculates the nurse receives about £1,050 - meaning nearly £800 goes to the agency. Read full story Source: BBC News, 8 May 2024 -
Community Post
Improving patient safety in the implementation of EPRs - a call for support from clinicians
Clive Flashman posted a topic in Health records and plans
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Hi, we at patient Safety Learning are looking to hold a virtual round table in the last week of June to look at how to improve patient safety related to the implementation of EPRs. If you are a clinician who has been directly involved with the roll out of an EPR, then you could be part of the event. All notes taken at the event will follow Chatham House rules and your participation will not be disclosed outside the round table group if that is your preference. If you'd like to be involved, please contact me (Clive Flashman) directly at support@pslhub.org Many thanks, Clive -
News Article
Letby to seek permission for conviction appeal
Patient Safety Learning posted a news article in News
Lucy Letby is to apply for permission to appeal against her convictions for the murder and attempted murder of babies in her care. A panel of three judges at the Court of Appeal in London is due to consider the former nurse’s case later. The 34-year-old was handed 14 whole life terms last year. She was found guilty of murdering seven babies and attempting to murder a further six at the Countess of Chester Hospital between 2015 and 2016. Second stage Shortly after her trial ended in August, Letby applied for leave to appeal against her convictions. She lost the first stage of the process, in which a single judge reviewed her arguments as a paper exercise. Letby, originally of Hereford, now has the right to a second stage, which involves renewing her application before a panel of judges at a hearing at the Court of Appeal. Separately to the appeal, Letby is due to be re-tried on one charge of attempted murder, which the jury at her trial was unable to decide on. Read full story Source: BBC News, 2 April 2024 -
Content ArticleThe Nursing & Midwifery Council (NMC) is commissioning independent research into nursing and midwifery students’ practice learning to ensure members of the public can shape this work from the start and throughout. One way people can get involved is by being part of a new Public Advisory Group on practice learning.
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Event
Nursing Live
Patient Safety Learning posted an event in Community Calendar
untilThe only nursing event of its kind in the UK, Nursing Live brings thousands of nurses together to enjoy two days of high-quality professional development, peer-to-peer collaboration, well-being activities and more. As well as bringing senior nursing leaders together to debate key issues and policy, Nursing Live featured some of the sector’s most respected frontline practitioners, such as Nicola Bailey OBE (RCN Nurse of the Year 2021), and Ana Waddington (RCN Nurse of the Year 2020). With dedicated workshops offering guidance on personal mental and physical health, the well-being of nurses was a core theme running throughout Nursing Live. This was complemented by an extensive range of accredited CPD masterclasses covering topics as diverse as equality and inclusion, safeguarding, leadership, medicine management, and innovation. Recruitment opportunities, and exploring different nursing career pathways, were also highlighted, with many exhibitors using Nursing Live to meet prospective employees, and promote live vacancies. Further information -
Event
RCM conference 2024
Patient Safety Learning posted an event in Community Calendar
untilEnergising excellence. Bringing research, education, practice and leadership to life The RCM conference is back for 2024. Professional and educational standards of proficiencies have made clear the importance of midwives working across the professional pillars of the profession: research, education, clinical practice and leadership. Safe and effective care needs an evidence base from research, which is then disseminated and supported through education and strategically implemented into clinical practice and sustained through effective leadership. Furthermore, understanding midwifery professional pillars is relevant for promoting career pathways and ensuring professional recognition alongside our multi-disciplinary colleagues. Register -
News ArticleA senior mental health nurse suffered “degrading and humiliating” treatment while she languished for 10 days on an unsuitable NHS ward during a mental health crisis, The Independent has been told. Rachel Luby, 36, was admitted to Basildon Hospital A&E in Essex on 5 January this year after attempting to take an overdose of over-the-counter medicine following a traumatic assault. This, she claimed, was the start of weeks of horrific care she endured while waiting for a mental health bed. It culminated in her being restrained and forced into a caged van “like an animal”. She revealed her story after The Independent reported on a warning from top emergency doctors that self-harming and suicidal patients who go to A&E are not being treated with compassion because staff are overwhelmed. Ms Luby, an award-winning nurse, said she waited more than a week and a half in a general hospital before she was moved to a bed on a mental health ward. Ms Luby was able to leave the ward and find medication to overdose again, despite staff allegedly assessing her as a risk. In a second incident, she went to the bathroom and attempted to take her own life. She told The Independent: “I feel that this is something I will not recover from. I will not ever reach out for help in the future. “If this is the treatment that I’m getting as a nurse, then what the heck is happening to those that don’t have the voice or education that I have? It horrifies me to think what is happening to people that are far more vulnerable than me.” Read full story Source: The Independent, 27 March 2024
