RCN safety rep Janice explains how she’s helped create a new resource that supports reps to address workplace health and safety issues linked to nursing shortages
As any safety rep knows, risks multiply when nursing teams – hospital or community-based – are understaffed. Care quality is threatened, patients and relatives can become frustrated, staff get stressed and working relationships are strained.
A new RCN publication, shaped and informed by safety reps, highlights the connections between staff numbers and health and safety, and offers safety reps advice on how to tackle the issues that can arise.
Janice Aspinall, a safety rep at University Hospital of Wales, contributed to the publication and describes it as a “fantastic” practical resource. “There’s lots out there about patient safety but not a great deal about staff safety,” says Janice. “This is an excellent tool for signposting – but it makes you think as well.”
About, for example, the link between staffing levels and bullying, says Janice. Workplace interactions and relationships can deteriorate when shortages mean that nursing staff are under excessive stress. Or when managers, feeling pressure from above or to meet targets, make unreasonable demands of staff.
The publication expands on these associations and says that when bullying cultures take hold, staff can find it difficult to report issues relating to safe staffing. The cycle then repeats and intensifies.
But the resource goes on to explain how reps can use the law to bring about change, detailing specific actions they can take to ensure bullying behaviour is tackled.
There's lots out there about patient safety but not a great deal about staff safety
Working together
The idea for the publication grew out of a discussion at the RCN joint reps conference in March last year, Janice says. From the outset, the aim was to develop a toolkit built on the lived experiences of members and reps.
In an introduction to the document, Denise McLaughlin, Chair of the UK Safety Reps Committee, says safety reps are “uniquely placed to hold organisations to account for having unsafe working conditions.”
Denise also acknowledges that safety reps can’t tackle the health and safety problems associated with unsafe staffing on their own. “This resource recognises the role that learning representatives and stewards can take and how we can work together as part of a team of representatives,” says Denise.
Keeping staff safe
One example of how that kind of team approach can prove effective is in issues relating to violence and aggression.
If lack of staff leads to longer waiting times, the risk of anger and violence among patients may rise. But staff shortages can also affect attendance at training related to de-escalating violence and aggression. So, the publication urges safety reps to work with learning rep colleagues on access to mandatory training in that area.
It also suggests teaming up with stewards to review cases where an assault at work has caused injury to see f there are any patterns to these.
Staffing levels came under close scrutiny in the recent general election, with both main parties pledging to increase nurse numbers. But until more are trained, “we have to work with what we’ve got,” Janice says. “We can’t just magic these nurses up.
In acknowledging the issue, managers are taking ownership of it and you’re pushing them to do something about it
“In the meantime, other nurses have to be kept safe and managers have to acknowledge what’s happening.” She adds: “This document helps you to do that. In acknowledging the issue, managers are taking ownership of it and you’re pushing them to do something about it.”
That said, taking steps to achieve a safe working environment is not about “them and us” – staff versus managers – Janice insists. “It’s nice to have something clear that you can show a manager but this isn’t something to beat somebody up with. It’s so we can all work together for the common good, to keep everybody safe.
The recent RCN employment survey demonstrates that this new resource for reps, which is aimed at both the NHS and the private sector, is timely.
The survey showed that 60% of nursing staff are under such pressure that they can’t offer the level of care they want to. It also provided evidence of threats to mandatory training, disturbing levels of abuse from patients and bullying by colleagues, plus a high prevalence of stress – all topics that the new publication seeks to address.
A safety rep for two years and a steward for nine before that, Janice says the appeal of the safety rep role is that “you can be proactive in changing the environment for nursing staff” – and she believes the new resource is another tool to help her do that. “It will be my go-to guide for workplace safety, definitely,” she says.
Words by Daniel Allen. Pictures by Stuart Fisher
More information
Every new RCN safety rep will be given a hard copy of A Safety Representative’s Resource: Staffing for Safe and Effective Care and current safety reps will receive a copy at their supervision meeting.
You can download an electronic copy from our website. Download the resource.
The fight for safe staffing
Safe staffing means having enough nursing staff with the right skills and knowledge, in the right place, at the right time. Without safe staffing levels in place, nursing staff are struggling to provide patients with the safe and effective care they would like to, and which patients deserve.
Last year, RCN members in Scotland secured new legislation on safe staffing levels after a similar law was introduced in Wales in 2016. The RCN is continuing to campaign for staffing for safe and effective care to be enshrined in law in all health care settings across all four countries of the UK. Read more about our safe staffing campaign.
