The fall in nursing numbers is a complete disaster

Without swift work to rectify this problem, patient care will suffer.

Following recent reports regarding a significant rise in emergency hospital admissions and higher patient mortality rates over the weekend due to a lack of senior doctors, we are now faced with the abysmal fact of fewer training nurses. Research by Nursing Times (NT) earlier this month revealed that nurse training places have been cut by more than 2,500 in the past three years. Professor David Green, Vice Chancellor and Chief Executive of the University of Worcester commented: "We are heading straight for a national disaster in two to three years’ time." Worse still, Strategic Health Authority figures obtained by NT showed that there were over two thousand more nurses opting to work in a community based setting as opposed to acute care.   

During my time in the NHS I have worked in primary and secondary care with the latter including time spent in acute medical, high dependency and intensive care environments. And I have witnessed first-hand the considerable strain placed on the nursing profession. In an acute medical setting for example, a nurse would be typically responsible for at least four to six patients, sometimes even more. And in the acute setting, a patient’s clinical state can change at any moment. As doctors, following initial patient assessment, we put plans in place from a management perspective to ensure recovery. But due to large patient numbers and demands from outpatient clinics it is difficult to be on the shop floor monitoring each patient around the clock - a sad fact but unfortunately true.

In a high dependency or intensive care setting, the situation however is very different. Doctors are always present and patients benefit from one to one nursing allowing for effective patient assessment. You may argue that these types of patients obviously need a more advanced and rigid monitoring regime and you are probably right. But ward patients also rely heavily on nurses to be their eyes and ears, alerting doctors to any concern they or of course the nurse may have.

An afternoon ward based scenario to help illustrate my point; a four patient bay being manned by one nurse.

Patient A has been admitted with chest pain which initially settled but has now recurred and is more severe in nature. The nurse must do a new set of observations, namely blood pressure, heart rate and oxygen saturations, as well as an electrocardiogram (ECG), give pain relief which has been previously prescribed and alert the doctor responsible for that patient about the change in clinical state.

Patient B, a chronic alcoholic admitted following an alcohol binge, starts to vomit large amounts of blood. He feels faint, his blood pressure is falling and he is at risk of cardio respiratory arrest. The nurse, in addition to recording new observations, will need to insert a cannula and start intravenous fluids if the doctor responsible for this patient is busy and unable to reach the patient straight away.

Patient C has been admitted with renal failure due to not eating and drinking. He has a history of severe depression and is refusing to take his medication. He has been referred to the on call psychiatrist but while waiting for a review is threatening to kill himself and other patients on the ward.

And Patient D, who has been admitted following a fall at home but is now suitable for discharge. He is becoming frustrated by the time it has taken to receive his discharge paperwork and medications. It has been two hours now and he wants to make an urgent complaint about the care he has received, or lack of, to the Patient Advice and Liaison Service (PALS).

You may find it hard to believe but the above ward scenario is certainly not far from the truth.

Not only are nurses expected to respond to changing patient conditions they are also responsible for patients’ personal needs, administering appropriate medication, referring patients to other multidisciplinary staff such as a physiotherapist or occupational therapist and for facilitating discharge to name but a few.

With falling nursing numbers, the government should take heed and put concrete plans in place to ensure this situation is rectified and done so quickly. The workforce is already stretched and I for one fail to see how patient care will not be grossly affected.

Neel Sharma is a Medical Doctor and Honorary Clinical Lecturer at the Centre for Medical Education, Barts and the London School of Medicine and Dentistry

Great Ormond Street Hospital nurses perform during the Olympic opening ceremony. Photograph: Getty Images
@Simon_Cullen via Twitter
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All 27 things wrong with today’s Daily Mail front cover

Where do I even start?

Hello. Have you seen today’s Daily Mail cover? It is wrong. Very wrong. So wrong that if you have seen today’s Daily Mail cover, you no doubt immediately turned to the person nearest to you to ask: “Have you seen today’s Daily Mail cover? It is wrong.”

But just how wrong is the wrong Mail cover? Let me count the ways.

  1. Why does it say “web” and not “the web”?
  2. Perhaps they were looking on a spider’s web and to be honest that makes more sense because
  3. How does it take TWO MINUTES to use a search engine to find out that cars can kill people?
  4. Are the Mail team like your Year 8 Geography teacher, stuck in an infinite loop of typing G o o g l e . c o m into the Google search bar, the search bar that they could’ve just used to search for the thing they want?
  5. And then when they finally typed G o o g l e . c o m, did they laboriously fill in their search term and drag the cursor to click “Search” instead of just pressing Enter?
  6. The Daily Mail just won Newspaper of the Year at the Press Awards
  7. Are the Daily Mail – Newspaper of the Year – saying that Google should be banned?
  8. If so, do they think we should ban libraries, primary education, and the written word?
  9. Sadly, we know the answer to this
  10. Google – the greatest source of information in the history of human civilisation – is not a friend to terrorists; it is a friend to teachers, doctors, students, journalists, and teenage girls who aren’t quite sure how to put a tampon in for the first time
  11. Upon first look, this cover seemed so obviously, very clearly fake
  12. Yet it’s not fake
  13. It’s real
  14. More than Google, the Mail are aiding terrorists by pointing out how to find “manuals” online
  15. While subsets of Google (most notably AdSense) can be legitimately criticised for profiting from terrorism, the Mail is specifically going at Google dot com
  16. Again, do they want to ban Google dot com?
  17. Do they want to ban cars?
  18. Do they want to ban search results about cars?
  19. Because if so, where will that one guy from primary school get his latest profile picture from?
  20. Are they suggesting we use Bing?
  21. Why are they, once again, focusing on the perpetrator instead of the victims?
  22. The Mail is 65p
  23. It is hard to believe that there is a single person alive, Mail reader or not, that can agree with this headline
  24. Three people wrote this article
  25. Three people took two minutes to find out cars can drive into people
  26. Trees had to die for this to be printed
  27. It is the front cover of the Mail

Amelia Tait is a technology and digital culture writer at the New Statesman.