The Nursing Initiative to Improve Patient Safety

In the United Kingdom, there is currently a mass exodus of veteran nurses dropping out from their lifelong career devoted to the health and longevity of others to pursue safer, stable, and more rewarding goals. For the first time in history, the National Health Service has recorded a higher number of nurses abandoning their trade than nursing graduates joining to lend their aid to the cause.

In the past four years, the NHS has registered a 51 percent dropout rate in experienced nurses, which encompasses at least 20 percent more professionals leaving the Nursing and Midwifery Council in 2016/17, compared to previous periods of time. Specifically, the number of nurses that abandoned their trade in 2016/17 were 34,941 professionals, while the same parameter in the 2012/13 period was of only 23,087 individuals.

This schism in the nursing society is due to several factors, which have accumulated into a metaphorical boiling point, leading to the mass exodus mentioned above. Said factors frequently revolve around the government-mandated cap in nursing wages, as well as the retirement of government-awarded bursaries specifically intended for professionals in the field. These factors have sparked protest among the nursing population and, adjoined to the UK’s retirement from the EU, have only helped to increase the instability perceived by professionals of the trade.

In lieu of this situation, the Health Secretary Jeremy Hunt went on record and stated that, as a first step towards addressing the dire circumstances in which nurses in the EU are laboring, the government-mandated pay caps have been lifted, but with the condition that there would be a noticeable improvement in the quality of their service and productivity, or else the measure is forfeit and things would go back to how they were in the past. To this prognosis, Siva Anandaciva, a chief analyst at The King’s Fund think-tank, expressed her concern, stating that the number of nurses abandoning their trade is deeply worrying and must be addressed as soon as possible before it is too late, and a public health crisis sparks due to insufficient personnel.

On the other end of the spectrum, the Director of policy and strategy at NHS Providers, Saffron Cordery responded to this situation that, in the midst of a deep health crisis, where there is a rising struggle to make the supply of healthcare services meet the seemingly-insurmountable demand, “we are seeing more nurses and midwives leaving the register than joining it,” expressing his concern for the current predicament. Similarly, a spokesperson for the Department of Health, in an attempt to defuse the situation, claimed that the number of nurses and midwives that abandoned their trade were only a mere 0.2 percent of the total amount of professionals, which consists of about 700,000 registered nurses. Unfortunately, this did little to improve the situation, and Cordery called for urgent measures to be developed in order to address the upcoming nursing crisis after the UK’s separation from the European Union.

Nursing Turnover in the United States

Meanwhile, on our side of the Atlantic, a similar situation is unfolding. However, in stark contrast to the ongoing nursing crisis in the UK, the problems with nurses in the United States revolves around their turnaround rates, which only serve to increase instability in the workplace and jeopardize the health and safety of patients interred within the facility.

According to a study featured in the Policy, Politics & Nursing Practice journal have revealed that, in 2014, at least 1 in 5 nurses abandoned their very first job in a year or less. Furthermore, it was also found that 1 in 3 registered nurses also abandoned their position in their second year, a number that varied slightly (for the better) in hospital settings. The study took existing turnover data, along with reported data from a nationally representative sample of registered nurses, and became the first longitudinal study of its kind in the United States, at the time. The data used in the study was obtained from surveys of three cohorts of registered nurses, which were performed since 2006.

This predicament comes off as a serious issue, considering that the nurse turnover is a very costly problem for hospitals, which also happens to affect the quality of care received by patients. As of 2014, it was estimated that the organizational costs created by nurse turnovers were of around $6.4 million for a single, large hospital. Furthermore, excessive turnover within a single facility has been associated with the use physical restraints on patients, pressure ulcers in the personnel due to stress, and accidental patient injuries.

Fortunately, the US government has started taking measures to address this issue by releasing a bill to limit the number of mandatory overtime hours single nurses can perform a single shift. Considering that, in the past year, around 250,000 patient deaths happened due to medical errors (in no small part due to excessive exhaustion in nursing personnel), this measure comes as an important first step to remedy the precarious circumstances in which nurses were currently working.

In the past, nurses that just came out of a 12-hour shift could be forced to work an additional mandatory period of 4, 6, or even 12 extra hours due to staff shortages. Due to the excessive fatigue created by hours upon hours of working, nurses became unable to provide the quality of service required by most patients and, shortly after, their safety also became an issue. With this new bill, nurses are no longer required to work these mandatory shifts, which is a positive step towards improving their work situation.

Nevertheless, finding the right balance to improve the conditions in which nurses must perform their labors is a process of give and take, and often requires close cooperation between government institutions, hospitals, and the union which represent the nursing workforce. For this reason, it is expected that, while this step will definitely lay the foundations for future improvements, the situation is still critical, and there is still much to do in order to provide safe, fair conditions for nurses to labor in.