Checking there are enough nursing staff available on the day or night

Checking there are enough nursing staff available on the day or night

Sometimes there may not be enough nursing staff available on a ward to provide the care needed by the patients. This could be because the ward has more patients who need more nursing than usual, or for reasons such as staff being off sick.

NICE says that the registered nurse in charge of the ward or the shift should check that there are enough nursing staff available to provide the care patients need at any time of the day or night. One sign that there may not be enough staff is that there is a shortage of more than 8 hours or at least a quarter of the registered nursing time needed compared with the registered nurse time that is available. But the nurse in charge should also look out for things that may indicate that there are not enough nursing staff to give patients the care they need, including those in the box below.

Signs that there may not be enough nursing staff available on the ward

Patients are not given their medicines at the times they should be.

Patients have to wait more than 30 minutes to get the pain relief they are due to be given.

Temperature, blood pressure, pulse and other 'vital signs' are not taken when they should be (as set out in the patient's notes).

Other regular checks are not done, such as:

  • asking patients about any pain

  • helping patients go to the toilet or bathroom

  • making sure patients can reach what they need

  • making sure patients are comfortable

  • checking if patients are at risk of pressure ulcers and taking steps to stop the pressure ulcers developing.

There are fewer than 2 registered nurses present on the ward during a shift.

Each hospital should have a policy for what the nurse in charge of the ward should do if there are not enough nursing staff to give the patients the care they need. The nurse in charge needs to be able to get quick action to solve the problem. The action might include bringing more nursing staff to the ward straightaway.

See What you can do for information about what patients, relatives or carers can do if they think there is a problem.