Nurses Need Greater Support To Prevent Poor Patient Care

November 19, 1998

The "professional cleansing" of nurses. The systematic downgrading of nurses damages patient care

An editorial linked to a personal view in this week's BMJ examines claims of poor quality of care by nurses within the UK. The author, Professor Hugh McKenna from the University of Ulster, writes that the "finger of blame for poor care should not be pointed at hard pressed staff, but at the system that frustrates their desire to do what they are educated to do - care".

Professor McKenna notes that the number of qualified nurses in England and Wales fell by 21 per cent from 1991 to 1992 and that this decrease corresponded with an equivalent rise in the number of untrained care assistants over the same period. He says that subsequent recruitment initiatives (that have cost millions of pounds) have not taken away from the fact that nurses face high levels of stress in the modern NHS and that they undertake what are perceived by many as unsavoury tasks. He also believes that recruitment has not been helped by the Government's decision to stage nurses' recent, inadequate, pay award.

McKenna suggests that poor quality of care is being perpetuated by a vicious circle: low numbers of registered nurses lead to poor quality of care, which leads to high stress and low morale; this in turn leads to high sickness rates, a shortage of nurses and poor quality of care...

The author concludes that the solution is for nurses to ensure that the reasons why care is not always as good as it should be are tackled politically, strategically and operationally.


Professor Hugh McKenna, Professor of Nursing, School of Health Sciences, University of Ulster, Jordanstown, Co Antrim, Northern Ireland


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