Public Release: 

Nursing shortage might not exist

Letter: Retaining nurses in the NHS BMJ Volume 325, p1362

BMJ

The true extent of the NHS nursing shortage - if it exists at all - will be known only when nurses spend all their time nursing, argues Professor Steven Lewis in this week's BMJ.

Evidence from the United States, Canada, and Germany has found that nurses spend time performing functions not related to their professional skills, such as cleaning rooms or moving food trays. Nurses also reported more pressure to take up management responsibility, taking them away from the direct care of patients.

This means that, although a shortage of professional nursing may exist, a shortage of nurses might not. Nurses spend much of their time doing things that should be delegated to others and not enough of their time doing what they are educated to do. This is inefficient and demoralising and accounts for at least some of the widespread job dissatisfaction in the profession, says the author.

Increasing the supply of new nurses may turn out to be perversely ineffective, he adds. If overall numbers grow, nurses perform even more non-nursing tasks, and system costs rise because highly trained people are used inefficiently.

"Only when nurses are allowed to withdraw from areas of non-nursing activity and do what they should be doing will we know the true extent of the nursing shortage - if it exists at all.

Achieving a proper division of labour that respects and maximises professionals' competencies will make the healthcare system more effective and efficient. It will also create a better motivated and contented workforce," he concludes.

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