A quarter of respiratory nursing teams across the NHS claim they are unable to spend enough time with patients, with a majority reporting working extra unpaid hours - according to a major new study by the British Thoracic Society (BTS).
Critically, over half of the current respiratory nurse workforce are also planning, or are eligible, to retire within the next decade which the authors say must be urgently addressed through effective recruitment, retention and succession-planning initiatives.
The study, published in BMJ Open Respiratory Research (http://bmjopenrespres.bmj.com/content/4/1/e000210), analysed over 600 responses to two different online surveys – one for individual respiratory nurses and the other for NHS employers.
It was commissioned to map out the current state of the respiratory nurse specialty in the NHS, to help inform future workforce plans and ensure the long-term provision of quality patient care.
Key findings include:
• Only 5 in 10 nurses (53.6%) reported they were able to spend as much time with their patients as needed – and over a quarter (25.3%) felt they were unable to have sufficient patient contact.
• More than 9 in 10 nurses (91%) reported working additional hours each week above what was contracted, with nearly three quarters (72%) stating they worked an extra six hours a week.
• Within the next decade, 48.1% of nurses surveyed plan to, or will be eligible for, retirement – and a further 1.8% plan to leave nursing in the next five years. Retiring nurses are often working at a senior level and leading services, which raises a significant need to identify suitably qualified staff to replace them.
• A good proportion of nurses felt supported by clinical colleagues (77.6%) and line managers (62.2%) – the vast majority (93.1%) felt able to attend meetings and study days, with 78% agreeing that training and education opportunities were available to access.
Respiratory nurses work with patients with respiratory conditions across acute, integrated and community services. They most frequently reported providing care for patients with asthma (including severe or difficult asthma), chronic obstructive pulmonary disease (COPD), bronchiectasis and interstitial lung disease.
The study suggests that the role of respiratory nurse can be ‘poorly understood’ in the NHS and under threat - despite a range of evidence that shows that the work of respiratory nursing can lead to savings and efficiencies, better outcomes for patients and can help to bridge gaps in the system to provide more seamless care.
Qualitative comments in the survey suggest the main areas of care respiratory nurses do not feel able to fully provide due to time constraints are patient education and support for patient self-management – both vital to health outcomes across a range of conditions including asthma and COPD. Lack of administrative support was identified as limiting respiratory nurses’ ability to provide more time with patients.
Professor Janelle Yorke, global leader in respiratory research at University of Manchester and Chair of the British Thoracic Society Nursing Advisory Group, commented:
“The role of the respiratory nurse is vital to quality patient care, both in hospital settings and in the community.
Our survey study highlights how we must ensure that nurses in the specialty are given sufficient time and resource to provide the best care for patients. One clear task is to invest in administrative support to alleviate some of the strain on nursing teams, freeing up more time for patient contact. This would enable a more efficient and cost-effective use of specialist nursing skills.
“We also need to future-proof the profession by recruiting and retaining sufficient numbers of nurses, given that half plan to retire over the next decade. The role of respiratory nurses will only become more important in the future as the number of people with longer-term lung conditions increases. We hope the results of this study will help inform future NHS commissioning in providing targeted support within the sector – to safeguard patient care.”
The survey study included data from two online surveys – organisation-level survey looking at structure of adult and pediatric respiratory nursing services in acute, integrated and community services (148 respondents), and an individual respiratory nurse survey (457 respondents). The surveys were conducted by the BTS between April and July 2016 drawing on BTS members.
The following organisations collaborated on the production of the survey study: The Association of Respiratory Nursing Specialists (ARNS); British Lung Foundation; Cystic Fibrosis Nursing Association; Education for Health; Interstitial Lung Disease Interdisciplinary Network; National Lung Cancer Forum for Nurses; National Pediatric Respiratory and Allergy Nurses Group; Primary Care Respiratory Society-UK; and the Severe Asthma National Network.
Note to Editors:
The British Thoracic Society is the UK’s professional body of respiratory specialists. The Society seeks to improve standards of care for people who have respiratory diseases and to support and develop those who provide that care. A registered charity, it has over 3,400 members including doctors, nurses, respiratory physiotherapists, scientists and other professionals with a respiratory interest. For more information, go to www.brit-thoracic.org.uk