Nurses made to 'choose between paperwork and patient care' because of staff shortages, RCN warns

'I am not sure if I want to stay in nursing, I feel the care I give is compromised by trying to complete specific tasks which are more concerned with audit and performance rather than care of the patient'

Shortages create cycle where inexperienced staff forced into high pressured roles and then quit (Getty)

Nursing staff are being forced to choose between finishing paperwork and treating patients, as the chronic staff shortages in the NHS continue to hamper the care staff can give, the Royal College of Nursing (RCN) has warned.

In a major report on nurse morale the RCN says the profession is “on the brink”, with the 43,000 vacant full-time nursing posts across the UK hampering their ability to do the job to the best of their ability.

The shortage is a major source of public concern as well, with a YouGov poll of the public revealing 74 per cent of people think there are not enough nurses to run the health service safely – and addressing this was their top priority for the NHS.

“We warned this would happen, but were called scaremongers,” chief executive Janet Davies is expected to say of the damage caused by Conservative government pay restraint policies.

In her speech to open the RCN’s annual congress in Belfast today she is calling for safe nurse staffing levels to be enforced by law in every part of the UK.

Wales, in 2016, became the first country in Europe to have a legal duty for health boards to employ enough nurses, record staffing levels and take action against breaches.

The Scottish government has pledged similar measures but there are no such moves in England and Northern Ireland.

For its report the RCN surveyed 30,000 nursing staff, many of who explained how the current shortages were affecting them.

Some of the main concerns identified were that a lack of time means fundamentals of personal and patient care are not carried out, with nurses unable to find time to wash patients or get them back in to bed.

The burden of paperwork and auditing, a major part of this government’s drive to make the NHS the safest and most transparent health service in the world through data monitoring, is another burden.

“Respondents described having to make difficult choices when there are shortages of registered nurses, between completing paperwork and providing care and treatment,” the report says.

On anonymous respondent added: “I am not sure if I want to stay in nursing, I feel the care I give is compromised by trying to complete specific tasks which are more concerned with audit and performance rather than care of the patient.

“The paperwork is onerous, repetitive and does not facilitate care planning.”

This issue was compounded by problems with IT systems which can make the process more onerous.

Nurses also raised concerns about the lack of time to discuss patients' care needs and next steps with love ones and relatives, and the shifting make up of the workforce.

There are many more healthcare assistants and junior nurses being recruited to plug an exodus of experienced staff, but this has meant many step straight into a high-pressure environment without adequate support and is contributing to high rates of staff turnover.

When these concerns are raised managers have no solutions or are too preoccupied with their own roles, the research found.

“I constantly raise concerns each morning about staffing levels, risks to the clients,” another nurse told the RCN. “It falls on deaf ears”

Professor Davies said this was a “vicious circle” as the number one reason for nurses leaving – cited by 54 per cent of their respondents – was staff shortages.

“This situation could have been avoided. It was no accident – it was sadly inevitable.

"The reason we have so many vacancies is because of short-sighted cost-cutting in past years, and ineffective workforce planning driven by finance and not the needs of patients.

“This autumn, the College will launch a new campaign to demand, for every part of the UK, safe staffing levels and accountability set in law."

The Department of Health and Social Care has said it will train an extra 5,000 nurses a year from 2018 after scrapping training bursaries.

A spokesperson said: “The NHS would collapse without our wonderful nurses – the fact that the NHS is ranked as the safest healthcare system in the world is a testament to them.

"From this year we will train 25 per cent more nurses, are committed to helping them work more flexibly to improve their work/life balance, and have awarded a pay rise of between 6.5 per cent and 29 per cent in a deal backed by the Royal College of Nursing themselves.”