The Royal College of Nursing (RCN) in the UK has raised concerns over inadequate nurse staffing levels, with its survey indicating that only a third of hospital shifts had enough registered nurses.

The findings underscore the need for investment in the nursing workforce and the establishment of safety-critical nurse-to-patient ratios in legislation.

The RCN’s Last Shift Survey, which gathered responses from over 11,000 members, revealed that one in three hospital shifts lacked at least a quarter of the necessary registered nurses. In community healthcare settings, the situation was even more dire, with almost four in ten shifts operating with up to half the required number of nurses.

In Accident & Emergency (A&E) departments, the survey highlighted extreme cases where nurses reported being responsible for over 51 patients. The outpatient departments echoed this trend, with similar patient loads. Overall, 80% of nurses surveyed expressed that current staffing levels are insufficient to meet patient needs safely.

RCN acting general secretary and chief executive professor Nicola Ranger commented on the findings, “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.”

Professor Ranger further explained the broader implications of the staffing crisis, “When patients can’t access safe care in the community, conditions worsen, and they end up in hospitals where workforce shortages are just as severe. This vicious cycle fails staff and patients, it can’t go on.”

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The RCN is advocating for urgent action. In its general election manifesto, the college called for the introduction of professionally and legally enforceable nurse-to-patient ratios to ensure a safety-critical maximum number of patients per registered nurse in every healthcare setting.