Mike Bird

There are many bad things about the work situation you describe. The worst thing about this (to my eyes) is that this describes the norm, not the exception. And the attritional effect of constantly having to scramble to meet the minimum needs of your patients, comply with regulatory demands and trying to keep your patients comfortable, cared for and treated well must eventually wear you down. It raises a number of questions. First, it's clearly not safe. Lack of of cover means you can't give patients the attention they may need. If a patient's condition deteriorates suddenly, nurses busy elsewhere may not be available to notice, let alone act. Second, it's exhausting trying to keep all the plates spinning without a break. And exhausted care staff will get emotionally drained, they make mistakes, and their reserves of patience and goodwill will get exhausted. Then they, quite sensibly, leave. Making the problem worse. Third, if this, or something like this, is happening on every ward in every trust (and we don't hear much about trusts being fully staffed these days) then, on the numbers you describe here, 2 nurses are doing the work of 3. In effect, you are subsidising the NHS with your extra effort. And if this is the norm, then the Trust will begin not to treat this situation as an aberration, but as the new standard operating model. This is wrong. Simply put, this is an economic problem. Demand outstrips supply. As Alison Leary said at the Patient Safety Learning Conference yesterday, the NHS, unlike businesses, determines how much it chooses to afford then tries to meet demand. Your blog demonstrates that this isn't working. In economic terms, a chronic shortage of nurses is prima facie evidence that nurses are, in hard cash terms, undervalued. If the NHS made nursing more economically attractive for people to do (by paying nurses more, by paying for more nurses and by subsidising training) more people would become nurses, the job would become easier, and this problem would go away. This won't happen, of course, unless enough people understand the problem and push for a solution. And pieces like this one that you have posted can only help. Thanks for sharing it.

Excellent Danielle - I look forward to hearing the ideas! Thanks for keeping us up to date.

World Patient Safety Day is a great idea to engage people to think about and act on patient safety. Many people will be doing things on the ground to mark the day, making people aware of patient safety and perhaps, taking actions to make things better. Danielle's idea is a great example. Patient Safety Learning's recent report, A Blueprint for Action (www.patientsafetylearning.org/resources/blueprint), identified six foundations of patient safety and the action we will take or instigate to address them. We propose to mark World Patient Safety Day by building on this work. We will launch the first of a programme of short videos to introduce people to the foundations of patient safety and the action we propose to address them. We will add to these videos through the coming months until we have addressed all the foundations of patient safety. In addition to generating interest on the day, we hope these videos will be of use to anyone trying to talk to colleagues or others about patient safety as a systemic issue that requires action. We hope you enjoy them and - more importantly - that you find them useful in helping move the patient safety conversation forward.