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'I worried about making mistakes': Medics tell their stories 'I worried about making mistakes': Your stories
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Senior nurses have spoken out against the increasing number of patients each nurse is expected to look after. Frequently, a nurse now looks after a minimum of eight patients which, according to the Safe Staffing Alliance is too many.Senior nurses have spoken out against the increasing number of patients each nurse is expected to look after. Frequently, a nurse now looks after a minimum of eight patients which, according to the Safe Staffing Alliance is too many.
The Alliance says that the high ratio means that mistakes are made and that nurses are under too much pressure.The Alliance says that the high ratio means that mistakes are made and that nurses are under too much pressure.
Medical professionals have told the BBC News website about their experiences. We have not used their real names. Medical professionals and patients have told the BBC News website about their experiences. In some cases, we have not used real names.
I have worked on wards where there is one nurse to six patients, and wards where there is one nurse to up to 15 patients. There is a big difference in patient care.
When caring for just six patients I was able to give good quality, individualised care. I could remember the name, age and diagnoses of each patient. I knew who their family were and I knew their likes and dislikes.
When I had 10 patients my knowledge of each patient was only superficial. Drug-rounds took longer. I was only able to review the vital signs recorded by the healthcare assistant rather than performing them myself, meaning abnormal readings took longer to be picked up.
There is clear evidence saying more nurses would provide better care. It may be more expensive initially, but more timely intervention and closer monitoring would reduce adverse incidents and shorten length of stay for patients. A less stressed and more fulfilled workforce would reduce staff turnover rates and sickness. This would save money.
I don't think that the nurse to patient ratio is the issue here. I think it's about the nursing culture and about how departments are managed.
When my nine-year-old son recently visited hospital suffering with a broken wrist, we were in the hospital for hours.
I watched the nurses' station whilst I was waiting for my son to be seen. Eight nurses were on shift and four of them stood chatting around a desk. At one point they even showed off each other's nails. They weren't doing paperwork or talking to patients.
When they dealt with us, they were brilliant. They were very professional and attentive but there was a lot of down-time.
We had to go back to the same hospital for surgery as my son's bone needed to be reset. It was a shambles. We were sent from one department to another. Every time we turned up at another area, a nurse had to take the time to help us. If the hospital's departments had better communications, then the nurses' time could be spent looking after patients rather than answering questions from patient's carers, like me.
I came into nursing because I wanted to care for patients, but it's not uncommon for me to have 14 patients to look after. It's impossible to care properly.I came into nursing because I wanted to care for patients, but it's not uncommon for me to have 14 patients to look after. It's impossible to care properly.
Paperwork is seen as the most important thing I must do. I can never do my drug-round without constant interruptions and I could potentially kill someone with a mistake.Paperwork is seen as the most important thing I must do. I can never do my drug-round without constant interruptions and I could potentially kill someone with a mistake.
I have patients in wet beds and patients in pain, who do I go to first?I have patients in wet beds and patients in pain, who do I go to first?
I see patients food put in front of them and taken away because they can't feed themselves. The patients and relatives are unhappy with me and I go home late always and sometimes in tears.I see patients food put in front of them and taken away because they can't feed themselves. The patients and relatives are unhappy with me and I go home late always and sometimes in tears.
It has got worse recently. We have got so much paperwork to do. And the stress of the job has increased since we've had to make savings.It has got worse recently. We have got so much paperwork to do. And the stress of the job has increased since we've had to make savings.
I left my full-time job a year ago because I couldn't cope. I'm now freelance and although I still feel upset by the demands of the job, I can leave a lot of the stress behind.
All nurses I know feel the same but we daren't say anything. We know that if we complain, our card will be marked and it will only be a matter of time before we lose our job.All nurses I know feel the same but we daren't say anything. We know that if we complain, our card will be marked and it will only be a matter of time before we lose our job.
I have worked on wards where there is one nurse to six patients, and wards where there is one nurse to up to 15 patients. There is a big difference in patient care.
When caring for just six patients I was able to give good quality, individualised care. I could remember the name, age and diagnoses of each patient. I knew who their family were and I knew their likes and dislikes. I had time to help each patient wash, and I also had time to record each patient's vital signs frequently.
When I had 10 patients my knowledge of each patient was only superficial. Drug-rounds took longer. So I could only assist with one or two washes and I delegated the rest to healthcare assistants. I was only able to review the vital signs recorded by the healthcare assistant rather than performing them myself, meaning abnormal readings took longer to be picked up.
There is clear evidence saying more nurses would provide better care. It may be more expensive initially, but more timely intervention and closer monitoring would reduce adverse incidents and shorten length of stay for patients. A less stressed and more fulfilled workforce would reduce staff turnover rates and sickness. This would save money.
I left my old ward job where I was caring for over 10 patients. I felt I couldn't do my job properly and I would go home in tears. My patients could see I was really busy but they still needed looking after. And because I was busy, I worried about making mistakes.
I now work as an intensive care nurse where the ratios are fixed. Depending on how seriously ill the patients are, the ratio is either 1:1 or 1:2. Although I'm constantly busy because they need more medical care, I feel I can manage it and I can give them the right care and attention.
I've been working as a hospital doctor for over six years and from what I have experienced I don't think the ratios have changed. But I definitely think the workload for nurses has and that's why they are under more pressure now.I've been working as a hospital doctor for over six years and from what I have experienced I don't think the ratios have changed. But I definitely think the workload for nurses has and that's why they are under more pressure now.
A lot of nurses have been promoted into management. They are then replaced with junior staff and so wards are losing experienced team members which can slow things down.A lot of nurses have been promoted into management. They are then replaced with junior staff and so wards are losing experienced team members which can slow things down.
Nurses are also stretched now because of the amount of paperwork they have to do. I see nurses staying at least an hour after their shift has finished just to catch up on form-filling.Nurses are also stretched now because of the amount of paperwork they have to do. I see nurses staying at least an hour after their shift has finished just to catch up on form-filling.
Also, there have been changes to the nursing role which has impacted on patient care. Nurses now perform basic junior doctor work such as taking blood. More is expected of them and that takes time. They then have less time to devote to patients.Also, there have been changes to the nursing role which has impacted on patient care. Nurses now perform basic junior doctor work such as taking blood. More is expected of them and that takes time. They then have less time to devote to patients.
Believe it or not, the NHS isn't free! To get more nurses, contracts for services and patient care protocols will need to be nationalised, resulting in the need for fewer managers and getting more front line staff. Before I became a Registered Nurse (R. N), I worked in what was essentially a retirement home. During the day, I had 28 patients and at night I had 56. Everybody was over-expended and I could barely do my work. It was always a struggle to reach minimum expectations.
Medication mistakes are more likely to happen with a high number of patients to look after. I was also incredibly stressed. All I did was work. It's just not good for the patients or the nurses.
As soon as I was qualified, I went to work for a company which maintains a 4:1 nursing ratio. This was not because I wanted an easy place to work, but because I wanted to provide full and adequate care.
Now I feel like a have support. I feel good about the care I give. I do a good job but only because I have time to do it.