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News Article
More than 5,000 early career nursing staff quit profession in one year
Patient Safety Learning posted a news article in News
A fifth of the nursing and midwifery professionals who left the register in the last year did so within 10 years of joining, figures show. Nursing leaders described the statistic as “deeply alarming” and called on ministers to “grasp the nettle and make nursing an attractive career”. The latest Nursing and Midwifery Council (NMC) annual report on its register of nurses, midwives and nursing associates in the UK shows 27,168 staff left the profession between April 2023 and March 2024, a slight decrease on the previous 12 months. However, 20.3% of the total - or 5,508 - did so within the first 10 years. This is compared to 18.8% in 2020/2021 and “reflects a rise over the last three years”, according to the report. Professor Nicola Ranger, general secretary and chief executive of the Royal College of Nursing (RCN), said: “It is deeply alarming that over 5,000 young, early-career nursing staff chose to quit the profession last year, most vowing never to return. “When the vacancy rate is high and care standards often poor due to staffing levels, the NHS cannot afford to lose a single individual. “New ministers have to grasp the nettle and make nursing an attractive career.” Read full story Source: The Independent, 19 July 2024 -
Content ArticleThe Nursing & Midwifery Council (NMC) are the independent regulator for nurses and midwives in the UK and nursing associates in England. Their annual report sets out their objectives, describes what they have achieved during the year and explains their governance, financial resources and future plans. 2023-24 was a difficult year for the NMC during which serious concerns were raised about its culture and regulatory decision making. A review was commissioned by Nazir Afzal OBE and Rise Associates, which highlighted safeguarding concerns and found that people working in the organisation have experienced racism, other forms of discrimination and bullying. The NMC also commissioned two independent investigations by Ijeoma Omambala KC into some of their fitness to practise cases and the way the NMC handled whistleblowing concerns being raised. These will be published later in 2024.
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EventuntilJoin Fallon Hughes, DNP, RN, senior director of Nursing Practice, Innovation, Research and EBP for WellSpan Health, and Alisha Wike, RN, bedside nurse at WellSpan Good Samaritan Hospital, in an educational webinar on virtual nursing. They will discuss current evidence on the role of virtual nursing in healthcare and the role of the virtual nurse in an acute care setting, compare virtual nurse operational considerations to those of a traditional nurse staffing model, identify implications for patient safety, and interpret virtual nurse implementation outcomes for application at your own facility. Register for this webinar, hosted by the Pennsylvania Patient Safety Authority.
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News Article
Sexual health nurse failed to disclose test results
Patient Safety Learning posted a news article in News
A sexual health nurse who failed to tell patients and their partners of positive test results for sexually transmitted infections should be struck off, a professional hearing was told. David Allen made incorrect entries and omitted information when updating patient records, the Nursing and Midwifery Council (NMC) heard. Mr Allen, who worked at Wakefield Integrated Sexual Health Services, also posted abusive and inappropriate messages about colleagues online. The NMC found his actions could have resulted in a real risk of harm to patients and had been "a flagrant departure from the standards expected of a registered nurse". The NMC panel, which met earlier in July, heard the discrepancies dated back to 2018 and involved 18 cases. When a person has tested positive for a sexually transmitted disease, guidelines said any current or past sexual partners should be informed, which is called partner notification. The NMC panel found that on 18 occasions, Mr Allen had failed to complete the partner notification and had falsely indicated he had done so. Read full story Source: BBC News, 15 July 2024 -
News ArticleThe UK’s under-fire nursing regulator is being forced to investigate as a third of universities may have released trainee nurses to work in hospitals despite failing to carry out hundreds of hours of mandatory training. The potential training failure comes after the Nursing and Midwifery Council (NMC) allegedly ignored warnings from universities about the problem three years ago, with the regulator only now taking action. The blunder means an unknown number of nurses may have been sent to work in hospitals without the required amount of experience, and hundreds of student nurses have already had their graduation date delayed, leaving some concerned about public safety. Thirty out of 98 universities are now facing reviews by the NMC into how they have monitored the qualifications of student nurses and midwives. Read full story Source: The Independent, 14 July 2024
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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.- Posted
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Content ArticleModern patient safety approaches in healthcare highlight the difference between daily practice (work-as-done) and the written rules and guidelines (work-as-imagined). Research in this area has looked at case study examples, but has lacked insights on how results can be embedded within the studied context. This study used Functional Analysis Resonance Method (FRAM) for aligning work-as-imagined with work-as-done. It aimed to show how FRAM can be effectively applied to identify the gap between work prescriptions and practice. It also aimed to show how these findings can be transferred back to and embedded in the daily ward care process of nurses.
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News Article
‘Dysfunctional’ culture at UK nursing regulator is safety threat, review warns
Patient Safety Learning posted a news article in News
A “dysfunctional” culture at the UK nursing regulator is threatening public safety, according to a damning report that found the Nursing and Midwifery Council (NMC) took seven years to strike off a nurse who had been accused of rape and sexual assault. Staff at the regulator broke down in tears “as they recounted their frustrations over safeguarding decisions that put the public at risk”, according to the authors of an independent review of the regulator. The review team highlighted a “toxic culture” at the NMC, with one former employee describing their section of the organisation as a “hotbed of bullying, racism and toxic behaviour”. The report also shone a spotlight on suicides by nurses caught up in long drawn-out fitness to practise investigations, highlighting how some nurses had been under investigation for nearly 10 years. The authors commented on the NMC’s backlog of 6,000 cases, which meant some nurses were forced to wait four or five years for their investigation to be completed, even though some cases were “baseless complaints where no further action is required”. Read more Source: The Guardian, 9 July 2024 -
Content ArticleAn independent review of the Nursing and Midwifery Council (NMC)'s culture has highlighted safeguarding concerns, and found that people working in the organisation have experienced racism, discrimination and bullying. We take this extremely seriously and will deliver a culture change programme rooted in the review’s recommendations. The NMC commissioned Nazir Afzal OBE and Rise Associates to carry out the review after concerns were raised about the organisation’s culture, including racism and fear of speaking up. Over 1,000 current and former NMC colleagues, plus more than 200 panel members who sit on fitness to practise hearings, shared their lived experiences as part of the review. The NMC accepts the report’s recommendations.
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News Article
Lucy Letby sentenced to 15th whole life term
Patient Safety Learning posted a news article in News
Former nurse Lucy Letby has been sentenced to another whole life term for trying to kill a premature baby girl. The 34-year-old is already in jail for murdering seven babies and attempting to murder six others at the Countess of Chester Hospital between June 2015 and June 2016. On Tuesday, she was found guilty of trying to murder another girl, known as Baby K, following a retrial. Letby had refused to go up to the dock to be sentenced to 14 whole life terms last August, but was in the dock earlier to be handed her 15th. Her original murder trial jury acquitted her of two counts of attempted murder, and there were six further charges on which jurors could not decide, including that concerning Baby K. Read full story Source: BBC News, 5 July 2024 -
News ArticleA damning report into the UK’s nursing and midwifery regulator will find the body is endangering the public due to its toxic culture and failing to address widespread racism within its ranks, The Independent can reveal. An explosive review into allegations that the Nursing and Midwifery Council (NMC) has a “deep-seated toxic culture” is set to be published next week and concerns over public safety will be one of many shocking revelations it will deliver, The Independent understands. Staff who have given evidence to the report and also spoken to The Independent, have reported being “gaslighted” and intimidated or bullied when trying to report concerns about public safety to leaders. The review, carried out by Nazir Afzal, a former chief crown prosecutor, and Rise Associates, was commissioned following reports by The Independent revealing whistleblower allegations that racism and sexism within the NMC are leading to complaints against nurses going “unchecked”. The review covers responses from around 1,000 staff and former staff, who were asked about the organisation’s culture in a survey, and hundreds of staff interviews. The Independent understands the review has found evidence supporting the whistleblowers’ accusations. Read full story Source: The Independent, 7 July 2024
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News Article
Departing chief spells out ongoing NMC challenges
Patient Safety Learning posted a news article in News
Andrea Sutcliffe revealed in May that she would be resigning as chief executive and registrar of the Nursing and Midwifery Council (NMC) due to ill health. Marking the end of her tenure at the NMC, Ms Sutcliffe spoke to Nursing Times about some of her key achievements while leading the organisation over the last five years, and the challenges that lie ahead for her successor and the important work that must be prioritised in the coming months. Ms Sutcliffe’s departure comes at a tricky time for the regulator, which has come under fire for alleged failures in its regulatory processes and concerns about its internal culture. A series of articles were published by The Independent last year, which raised serious concerns about the inner workings of the NMC, the way it treats staff and how it handles whistleblowing. The newspaper reported that there was a “culture of fear” at the NMC that meant staff were afraid to speak out, while also claiming that there were issues of racial discrimination and sexism within the organisation. Ms Sutcliffe said the articles raised “really serious concerns” about the internal workings of the NMC and stressed the necessity of the independent reviews to “thoroughly scrutinise” what has been going wrong. “We’re trying to do things, but we’re clearly not doing enough and it’s not making the difference it needs to,” explained Ms Sutcliffe. “Some people’s experience within the organisation is not acceptable, and we’ve got to get that right.” Read full story (paywalled) Source: Nursing Times, 28 June 2024 -
News ArticleThe NHS will face scrutiny over alleged failures to listen to whistleblowers’ warnings about baby killer Lucy Letby after the nurse was convicted of another attempted murder. Letby was convicted of trying to murder a “very premature” infant by dislodging her breathing tube in the early hours of 17 February 2016, following a retrial at Manchester Crown Court. The 34 year-old’s latest conviction comes after she was found guilty of the murders of seven babies and the attempted murders of six others at the Countess of Chester Hospital’s neo-natal unit between June 2015 and June 2016, following her original trial last August. The former nurse was given a rare whole-life order, making her one of Britain’s most prolific child serial killers. She is due to be sentenced for the further offence on Friday. Detective superintendent Simon Blackwell, who is strategic lead for Operation Hummingbird, said: “The investigation, which is ongoing, focuses on the indictment period of the charges for Lucy Letby, from June 2015 to June 2016, and is considering areas including senior leadership and decision making to determine whether any criminality has taken place. The investigation is complex and sensitive and specific updates regarding progress will be issued at the appropriate time. At this stage we are not investigating any individuals in relation to gross negligence manslaughter. “We recognise that this investigation has a significant impact on a number of different stakeholders including the families in this case and we want to reassure that we are committed to carrying out a thorough investigation. Since Letby’s original convictions in August 2023 it has been a very busy period for the investigation team. This has included a subsequent appeal, the re-trial for one count of attempted murder and the launch of the statutory public inquiry that Cheshire Constabulary is assisting with.” Read full story Source: The Independent, 2 July 2024
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News Article
Half of nursing students in England have considered quitting, survey finds
Patient Safety Learning posted a news article in News
Almost half of nursing students in England have considered quitting before they graduate amid the worst workforce crisis in NHS history, according to the largest survey of its kind. Applicant numbers have fallen significantly since the end of a grant to support nursing students in 2017. Now a report by the Royal College of Nursing (RCN), seen by the Guardian, suggests that as many as 46% of those enrolled – about 32,000 students – could walk away. The cost of living was the top reason for students considering an early exit, with seven in 10 (70%) citing “financial difficulties” as a factor. Nursing students have to pay university fees of more than £9,000 a year. “I wasted so much time and put my sweat, blood and tears into something that is burning me out before I start and isn’t even paying enough. It makes me sad for myself that this is the profession I chose.” Nearly six in 10 respondents (58%) said witnessing low morale and burnout among qualified nurses had also prompted them to consider ditching their nursing degree. Read full story Source: The Guardian, 3 July 2024 -
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 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
