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Tens of thousands of coronavirus survivors needing long-term care are heaping pressure on Britain’s stretched community services, threatening a crisis that experts warn could dwarf that seen in hospitals over the past 12 months. As many as 100,000 intensive care patients, including up to 15,000 Covid-19 survivors, will need long-term community nursing care after being discharged from hospitals during the past 12 months, The Independent has been told. This will be on top of an as yet unknown number of Covid patients from the 350,000 treated on general wards since the pandemic began, as well as tens of thousands of people who were sick without going to hospital but have been left with debilitating symptoms of long Covid. Labour’s shadow health minister Liz Kendall warned: “There will be huge pressures on community services as people who need long-term support are discharged back into their own homes. “Ministers have got to put in place a proper workforce strategy for the NHS and community care otherwise we will see people struggling to recover and the burden of care could also fall on their families." “This is one of the long-term consequences of Covid that we haven’t begun to even think through yet.” Read full story Source: The Independent, 14 February 2021

Tens of thousands of nurses across the UK have not had their first coronavirus vaccine, sparking fears that they could contract COVID-19 or infect patients. A Royal College of Nursing (RCN) survey of 24,370 nurses found that 85% had had at least one dose, with the remaining 15% unvaccinated. The findings show that the government is in danger of failing to deliver one of the main elements of its pledge that all 15 million Britons in the top four priority groups for immunisation – which includes all health and social care staff – should have been offered a first shot by next Monday, 15 February. “It is extremely worrying that, as our survey suggests, many thousands of nursing staff have yet to be given their COVID-19 vaccine less than a week before the government’s deadline,” said Dame Donna Kinnair, the RCN’s chief executive and general secretary. “With only days to go, every effort must be made to reach all nursing staff to ensure their protection and that of the patients and vulnerable people they care for.” Read full story Source: The Guardian, 9 February 2021

Nearly 500 women had to have their cervical smear tests redone after it emerged the nurse who carried them out was not qualified. 'Dishonest' Alison Watts failed to tell her bosses at an NHS surgery that she failed her course and continued screening women for almost two and a half years. When it was discovered Watts had not passed the qualification, 461 women had to be recalled to have the cervix test again so they could have 'quality assured' tests. Now Watts has been struck off for the shocking breach of trust, with a tribunal ruling that she put patients at 'significant risk of harm'. A Nursing and Midwifery Council [NMC] report said: 'This was not a single instance of misconduct but involved 461 patients over a two year period. There is evidence of sustained dishonesty and deep-seated attitudinal issues.' Read full story Source: Daily Mail, 26 January 2021

Emergency legislation is needed to protect doctors and nurses from “inappropriate” legal action over critical Covid treatment decisions made amid the pressures of the pandemic, health organisations have argued. A coalition of health bodies has written to Matt Hancock, the health secretary, calling for the law to be updated so medical workers do not feel “vulnerable to the risk of prosecution for unlawful killing” when treating coronavirus patients “in circumstances beyond their control”. The letter, coordinated by the Medical Protection Society (MPS), states there are no legal safeguards for coronavirus-related issues such as when there are “surges in demand for resources that temporarily exceed supply”. The coalition, which includes the British Medical Association and Doctors’ Association UK, wrote: “With the chief medical officers now determining that there is a material risk of the NHS being overwhelmed within weeks, our members are worried that not only do they face being put in this position but also that they could subsequently be vulnerable to a criminal investigation by the police. “There is no national guidance, backed up by a clear statement of law, on when life-sustaining treatment can be lawfully withheld or withdrawn from a patient in order for it to benefit a different patient, and if so under what conditions. The first concern of a doctor is their patients and providing the highest standard of care at all times.” Read full story Source: The Guardian, 16 January 2021

More than one in 10 hospital nurses are now off work in areas hard-hit by covid, according to internal data leaked to HSJ. The data shows the toal absence rate among acute trust nurses has risen steadily over the last month. Nationally the total absence rate among acute trust nurses was 9.7% as of Monday, up from around 7% at the start of December, pushed up by rapidly rising absences due to covid. These make up more than half of total absences, and have now hit rates last seen in early May. Senior NHS sources said staff absences are severely compounding operational pressures in the hardest hit regions, limiting hospitals’ capacity to operate more than is suggested in official bed capacity figures. The highest rate was in the East of England where 11.4% of nurses off work, with coronavirus accounting for 7.5%. This is likely to mask even higher rates in particular hospitals, services and wards. Read full story Source: HSJ, 14 January 2021

Many hospital staff treating the sickest patients during the first wave of the pandemic were left traumatised by the experience, a study suggests. Researchers at King's College London asked 709 workers at nine intensive care units in England about how they were coping as the first wave eased. Nearly half reported symptoms of severe anxiety, depression, post-traumatic stress disorder or problem drinking. One in seven had thoughts of self-harming or being "better off dead". Nursing staff were more likely to report feelings of distress than doctors or other clinical staff in the anonymous web-based survey, which was carried out in June and July last year. Just over half reported good well-being. Victoria Sullivan, an intensive care nurse at Queen's Hospital in Romford, said she often can't sleep because she's thinking about what is happening at the hospital. Her worst moment was breaking the news of a death on the phone, she said, adding that the screams from the patient's relatives "will honestly stay with me forever". "Telling someone over the phone and all you can say is 'I'm really sorry', whilst they're crying their heart out, is quite traumatising," she said. "Although you're saying how sorry you are, in the back of your mind, you're also thinking: 'I've got three other patients I've got to go and see, the infusions need drawing up, and meds need to be given and a nurse needs support'. "The guilt is just too much." Lead researcher Prof Neil Greenberg said the findings should be a "wake-up call" for NHS managers. He said: "The severity of symptoms we identified are highly likely to impair some ICU staff's ability to provide high-quality care as well as negatively impacting on their quality of life." Read full story Source: BBC News, 13 January 2021

Guy’s and St Thomas’ NHS Foundation Trust will work with Omnicell to develop a European technology-enabled inventory optimisation and intelligence service which will be initially implemented across South East London Integrated Care System (ICS). This partnership will encompass all six acute hospital sites within the South East London ICS, including Guy’s & St Thomas’, Kings College Hospital NHS Foundation Trust and Lewisham & Greenwich NHS Trust. The project will have the following goals: Develop analytics and reporting tools with a goal of improving patient safety, achieving increased operational efficiency and cost efficiencies Utilize the analytics and reporting tools with a goal of achieving agreed efficiencies and cost reductions Demonstrate the impact of managing clinical supplies and medicine spend together at scale Build a service model for the ICS which can be scaled up and adopted by other hospital groups in the UK Read the full article here

The UK’s most senior nurses and the nursing regulator are encouraging the profession to “speak up” if they feel unsafe at work amid the latest surge of COVID-19. The four chief nursing officers and the Nursing and Midwifery Council has today issued an open letter. Source: Nursing Times, 8 January 2021

Ministers are being warned of a mounting workforce crisis in England’s hospitals as they struggle to recruit staff for tens of thousands of nursing vacancies, with one in five nursing posts on some wards now unfilled. Hospital leaders say the nursing shortfall has been worsened by a collapse in the numbers of recruits from Europe, including Spain and Italy. The most recent NHS figures reveal there are about 39,000 vacancies for registered nurses in England, with one in 10 nursing posts unfilled on acute wards in London and one in five nursing posts empty on mental health wards in the south-east. Thousands of nursing shifts each week cannot be filled because of staff shortages, according to hospital safe staffing reports seen by the Observer. Patricia Marquis, England director for the Royal College of Nursing (RCN), said: “There just aren’t enough staff to deliver the care that is needed, and we now have a nursing workforce crisis. We should never have got into a position where we were so dependent on international nurses. We are on a knife-edge.” Read full story Source: The Guardian, 9 October 2021

The US Institute for Safe Medication Practices (ISMP) has expressed its shock that the Tennessee (TN) Board of Nursing has recently revoked RaDonda Vaught’s professional nursing license indefinitely, fining her $3,000, and stipulating that she pay up to $60,000 in prosecution costs. RaDonda was involved in a fatal medication error after entering “ve” in an automated dispensing cabinet (ADC) search field, accidentally removing a vial of vecuronium instead of VERSED (midazolam) from the cabinet via override, and unknowingly administering the neuromuscular blocking agent to the patient. While the Board accepted the state prosecutor’s recommendation to revoke RaDonda’s nursing license, ISMP doubts that the Board’s action was just, and believe that it has set patient safety back by 25 years. On September 27, 2019, in a stark reversal of a 2018 decision to take no licensing action against the nurse, the TN Board of Nursing filed disciplinary action against RaDonda that focused on three violations: Unprofessional conduct related to nursing practice and the five rights of medication administration Abandoning or neglecting a patient requiring nursing care Failure to maintain a record of interventions. During the hearing, RaDonda was given an opportunity to testify and defend herself; however, she never shrank from admitting her mistake. According to her defense attorney, her acceptance of responsibility for the error was immediate, extraordinary, and continuing. However, RaDonda also testified that the error was made because of flawed procedures at the hospital, particularly the lack of timely communication between the pharmacy computer system and the ADC, which led to significant delays in accessing medications and the hospital’s permission to temporarily override the ADC to obtain prescribed medications that were not yet linked to the patient’s profile in the ADC. Although many questions regarding RaDonda’s alleged failures and the event remain unanswered, the Board still voted unanimously to strip RaDonda of her nursing license and levy the full monetary penalties allowed, noting that there were just too many red flags that RaDonda “ignored” when administering the medication. The ISMP has asked whether the Board’s action was fair and just in this situation? Read full story Source: ISMP, 12 August 2021

NHS trusts in London are looking to dilute their intensive care nurse-to-patient ratios due to workforce shortages, according to a leading critical care nurse. Nicki Credland, chair of the British Association of Critical Care Nurses, told HSJ’s Patient Safety Congress that trust leaders in London have discussed relaxing the ratios from one nurse per patient, to one nurse per 1.75 patients. ICU staffing ratios have been intermittently diluted throughout the covid pandemic, but this has previously been used as a temporary measure. Ms Credland, a keynote speaker at the event on Tuesday, suggested some trusts are now looking at a permanent shift away from one-to-one care. She added: “What we are seeing now is that certain trusts in the country are doing exactly what we were worried about." “Starting to move away from those [guidelines for the provision of intensive care services] standards that we have, that protect both us as nurses but also protect the patient’s safety as well." Read full story (paywalled) Source: HSJ, 24 September 2021

More than 600,000 cancer patients in the UK are facing treatment delays or missing out on vital support because of a shortage of specialist nurses, a new report from Macmillan Cancer Support reveals. One in five of all those living with cancer (21%) are lacking dedicated support. The NHS is suffering from a “shocking” shortfall of 3,000 specialist nurses in England alone, according to the analysis by Macmillan Cancer Support. As a result, cancer patients are struggling with medication, having hospital appointments cancelled because there are not enough staff or experiencing devastating delays to chemotherapy. In some cases, patients are ending up in A&E. Patricia Marquis, England director of the Royal College of Nursing, warned the workforce crisis was having a “devastating impact” on people living with cancer. “Expertise built up over many years is lost very quickly and it is patients who pay the price, as this report shows,” she added. Read full story Source: The Guardian, 8 September 2021

New data from NHS Digital on the latest vacancy statistics shows as of June 2021 there were 38,952 registered nurse vacancies across the health service, with the Royal College of Nursing saying news of worsening nurse shortages should “stun” ministers into taking action. RCN England director, Patricia Marquis, has said: “As health and care services head into what will be a very difficult winter, this should stun ministers to address the rising number of nursing vacancies and prevent further risk to patient care. After the pressures from the last 18 months we also know that many experienced nurses are considering leaving the profession. These are skills that cannot be replaced quickly. Unless there is an urgent investment in the nursing workforce, starting with an increase in pay that reflects their skill and professionalism, and there is accountability for workforce planning at ministerial level, we will be dealing with the fallout for years to come.” Read full story. Source: Nursing Times, 26 August 2021

Selena Brash, a clinical team lead with the East Hampshire school nursing team, has spoken out about the controversial plans to cut back public health nursing services in Hampshire. Ms Brash, in response to the Hampshire County Council plans to save £6.8m from its public health budget, started a petition earlier in the summer calling for increased funding “to protect the provision of school nurses”, warning that cuts to to public health school nursing services would “result in a detrimental effect on children and young people’s health and wellbeing, with lifelong consequences”. “If the cuts go ahead, then this could set a precedent for other local authorities to follow suit, meaning there would be a massive impact on the health and wellbeing of our young people and future generations,” Ms Brash told Nursing Times. Read full story. Source: Nursing Times

This interview with April Kapu, DNP, APRN, ACNP-BC, FAANP, FCCM, FAAN, a critical care nurse, discusses how Nurse Practitioners are changing healthcare, the likelihood of all states granting full practice authority to NPs, and what the American Association of Nurse Practitioner members can expect from her for the next two years. Read full story. Source: American Medical Association, 16 August 2021

Vaccinated nurses will now be expected to return to work instead of isolating as new rules are set to relax. In a letter on the latest rule change from NHS England chief nursing officer Ruth May, chief people officer Prerana Issar, and medical director for primary care Dr Nikita Kanani said “Fully vaccinated staff and students who are identified as a contact of a positive Covid-19 case will no longer be expected to isolate and will be expected to return to work.” Staff returning to work are required to have been double jabbed, have no Covid-19 symptoms and receive a negative PCR test. This latest change in rules go in line with changes for the wider population. Read full story. Source: Nursing Times, 16 August 2021

New data has revealed as many as 14 million people could be on NHS waiting lists in England by the autumn of 2022 unless action is taken now to avoid this outcome. The Royal College of Nursing has confirmed these latest figures confirmed the “immense task that lies ahead” for the profession saying that more investment is needed to help tackle the waiting list crisis. In response to the analysis, Patricia Marquis, RCN England director, said: “These figures confirm the immense task that lies ahead for health and care services in recovering from the pandemic.” Read full story. Source: Nursing Times, 9 August 2021

Health leaders have warned the public may be at more risk amid plans to simplify nursing training across the UK. Nursing leaders have also come out in opposition of the proposals by the Nursing and Midwifery Council (NMC) saying bosses could not be sure that the nurses they hired would have the skills required to care patients' safely. Matthew Winn, chief executive of Cambridgeshire Community Services Trust, said "The changes being proposed by the Nursing and Midwifery Council will lead to a watering down of the educational and training standards of these specialist professionals. If courses are developed unilaterally by universities, as an employer I will have no idea if the district nurse is competent to undertake the role I am recruiting them to do.” Read full story. Source: The Independent, 08 August 2021

A trial, which took place at the start of 2020 but had to be cut short due to the coronavirus pandemic, has found having learning disability nurses involved in the delivery of annual health checks at GP practices can help improve uptake. Despite the trial being cut short, it was still considered a success with a second trial being launched. “This project highlighted that the specialist expertise, knowledge and skills of the learning disability nurses working with the GPs, can help improve the assessment process of the annual health checks and overall positive health outcomes for people with a learning disability.” said Lisa Harrington, specialist community matron in learning disabilities, a nurse on the project. Read full story. Source: Nursing Times, 3 August 2021

In April of last year, many people in America came out and cheered for the healthcare workers fighting to save lives during the height of the coronavirus pandemic, but now, nurses across the US are holding strikes due to staff shortages and inadequate equipment amid the pandemic. “Most of us felt like we went from heroes to zeroes quickly,” says Dominique Muldoon, a nurse for more than 20 years at Saint Vincent’s hospital in Worcester, Massachusetts. Muldoon, co-chair of the local bargaining unit has also said nurses are going home crying in their cars, working through breaks and staying up late just to get the work done as demand for patient care has increased. “You’ll end up staying late or working through your break trying to fit the workload all in, but ultimately become so frustrated, because eventually you keep trying to overcompensate and cannot keep up with it." Muldoon has said. Read full story. Source: The Guardian, 30 July 2021

Nurses are being drafted in to an NHS hospital to help support the maternity unit due to dozens of midwife vacancies. According to the Royal College of Midwives, they were worried the staff shortages were becoming more widespread as the NHS are becoming more desperate to fill the vacancies, however, the College has warned against using registered nurses instead of midwives as it could have an impact on the care of women and babies. Amid staff shortages at Basildon Hospital, there is now an active consideration to move planned caesarean sections to Southend Hospital, part of the Mid and South Essex NHS Foundation Trust. One worker has said “Basildon doesn't feel like a centre of excellence at the moment. I worry that flooding a department with newly qualified midwives and agency workies is a recipe for patient harm.” Read full story. Source: The Independent, 28 July 2021

The Royal College of Nursing has demanded the health secretary is made fully accountable for the planning and supply of nursing staff in England. As the Health and Care Bill passes through parliament, the RCN insists key changes need to be made to Bill to enable the workforce crisis to be appropriately addressed, including ensuring that the commissioning of services is done in partnership with local communities and ensuring that the voices of experts such as royal colleges are part of the regulation of the profession. Read full story. Source: RCN, 17 July 2021

A new study has found nursing shortages may have negatively impacted patient safety, including unsafe practice management workarounds and cognitive failures. Research has found cutting corners when understaffed may have been the only way to get the work done quicker due to the added strain and heavier workload and in another study, it was discovered nurse staffing demand increased to 245 percent between September and December 2020. It was also reported that nurses who had little or no experience of working in the ICU environment were assigned to work there which may have led to higher stress levels and cognitive failures such as memory and attention lapses. Read full story. Source: Recycle Intelligence, 13 July 2021

The RCN council has agreed to support the principles behind a petition, started by RCN Professional Nursing Committee member Alison Leary, calling for the title of 'nurse' to be protected and reserved for those who are registered. Whilst the term 'registered nurse' is protected in law, the term 'nurse' is not, meaning anyone can call themselves a nurse, regardless of whether they have the appropriate qualifications or not. The RCN believes the title should be protected in order to help protect the public and ensure accountability. Read full story. Source: RCN, 12 July 2021

Over 60 demonstrations took place on 3 July 2021 to protest over pay. Figures have suggested that a band 5 nurse takes home around £5,000 less per year than they did a couple years ago due to austerity measures and a public sector pay cap. The protest as arranged by groups Keep Our NHS Public, Health Campaigns Together, NHS Workers Say No and NHS Staff Voices with a separate demonstration by Nurses United UK have raised concerns for patient safety, arguing that the pay issue has a direct impact on recruitment and retention of nurses. Read full story. Source: Nursing Notes, 3 July 2021