London School of Hygiene & Tropical Medicine

Results of the international RN4CAST study into links between nursing workforce issues and patient outcomes have been published in the British Medical Journal.

The study in England, which was delivered collaboratively by researchers from institutions including the London School of Hygiene & Tropical Medicine and the National Nursing Research Unit at King’s College London, reveals that the levels of burnout and job dissatisfaction experienced by English nurses are some of the worst in Europe.

Researchers surveyed over 2,900 nurses based at over 40 trusts in England and results have been compared with similar samples from 11 other European countries and from the USA. 42% of English nurses regarded themselves as burnt out, second only to Greece, while 44% stated that they intended to leave their job in the next year. 

One of the authors, Martin McKee, Professor of European Health at the London School of Hygiene & Tropical Medicine, said: "These alarming findings must be a major cause of concern for the government as it embarks on a radical change to how we provide health care that is so dependent on the commitment, goodwill and professionalism of those who deliver front line care."

The study reveals huge variation, both between hospitals and within hospitals, on core workforce issues such as nurse to patient ratio. Researchers have called for analysis of this variation in greater depth to assess whether staffing levels are managed deliberately to reflect differences in patient needs or if in fact staff shortages are leading to greater pressure on nursing staff and worse outcomes for patients.

The RN4CAST survey asked nurses across Europe and the USA to rate their satisfaction with different aspects of their job, including levels of support, working environment, and whether or not they would recommend their hospital to friends and family.

The authors said: "There is a clear link between nurse staffing levels and job satisfaction and their views on overall outcomes for patients. We are now analysing hospital data on death rates and rates of complications to see if high patient to staff ratios impact on these outcomes."