In the wake of headlines about large numbers of NHS nurses leaving within short periods of time, Senior Lecturer in Mental Nursing and former NHS Nurse, Kim Moore provides her insight into the latest NHS staffing crisis news.

Should we be surprised by yesterday’s report of more nurses leaving the profession than those that are joining or that newly qualified nurses are leaving the profession entirely after less than 5 years after gaining their registration? (BBC, 2018) I would argue not.

For many years nurses have been calling out about staffing shortages (RCN, 2002; Bucan et al, 2017), while Brexit has undoubtedly had an impact on staffing numbers; many nurses cite difficult working practices and unsafe conditions (BBC, 2018) as reasons for leaving.  For more than a decade many authors have highlighted nursing shortages and safe staffing issues in the NHS; more recently within the ‘against the odds’ report (RCN, 2017) . Nurses clearly stated that they not only work unpaid hours on top of their shifts, they often do not have time to eat or take a toilet break.

For over a decade (KingsFund, 2000) we have known that morale in nursing was poor; issues with workload, pay and conditions (including NHS funding) were identified as critical factors influencing this despondency.  So over the years to combat this, nurses have been re-designed, demoted, given increased workloads and their pay has been frozen.  It is hard to admit that many nurses today cannot feed their families, pay accommodation or travel costs to get to work (Tiplady, 2017;, 2016).  So have any of the issues outlined twenty years ago changed?  The simple answer is no – it has gotten worse for nurses and leaving the profession is a consequence of constant change and increasing demands.

There is one contradiction that stands out for me.  The current government’s commitment to improving mental health at work and healthy workplaces (Stevenson & Farmer, 2017) is exciting as a mental health nurse.  It is commendable to expect all employers to embed mental wellbeing strategies within their organisations and workplaces.  It is ambitious, but not unachievable to develop mentally healthy work cultures and environments.  Strangely, this program does not it seem apply to the NHS or the many nurses struggling to provide quality patient centred care (RCN, 2017) in NHS settings.  Nurses have consistently spoken out about growing patient safety risks, expressed their frustrations and demonstrated their emotional exhaustion – leaving work in tears (Hirst, 2017) and these are all clear signs of mental distress and poor mental health.  If the Government truly believes its own rhetoric, then lead by example.

This time last year Theresa May announced the government intention to make sweeping reforms to improve the mental health of the nation: “I want us to employ the power of government as a force for good to transform the way we deal with mental health problems right across society”  (May, 2017)  If this is not delivered within its own organisation (including the NHS) then don’t be surprised that new and experienced nurses are leaving the profession when they cannot financially, physically or emotionally afford to stay. Nurses are struggling to survive at work; many employed in an organisation that expects them to provide safe care for their patients at the expense of their own physical and mental health. Too often nurses are saying that they can no longer afford to be a nurse. Not only are more nurses needing to use food banks to survive (ref), few can afford to have a mortgage in large cities where they are needed to work.

Caring, compassion and guilt can only take us so far, if it is a driving philosophy for the care delivered to our patients why is it not applied to the staff who struggle to keep these vital services running.


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