Britain’s sickest children are being treated in intensive care units, which are struggling with a serious shortage of specialist nurses needed to care for them, according to a report.
The shortages in the UK’s 30 pediatric intensive care units (PICUs) are so severe that healthcare assistants are taking over nurses’ work to ensure staffing levels are maintained.
Only one of the PICUs – at James Cook University Hospital in Middlesbrough – was found to have enough nurses to provide expected standards of care. Around 15,000 children and young people with often life-threatening diseases are treated in intensive care units every year.
Clinical standards prevailing on PICUs require them to ensure that seven nurses are on duty for each bed on a 24-hour cycle. But the report by the Pediatric Intensive Care Audit Network (PICANet), a group of experts from the Universities of Leicester and Leeds, found that 29 of the 30 had too few nurses to do so and that all 30 had vacancies, sometimes in large numbers You.
“Parents will find this extremely alarming,” said Patricia Marquis, principal of England’s Royal College of Nursing. “Most people would not believe that just one pediatric intensive care unit across the UK has enough staff to function properly, but this is the reality of the staffing crisis. Key positions in specialized care teams have been vacant for years.”
The PICANet team identified nurses’ salaries and the cost of living in urban areas as the main reasons. It found that three of the five hospitals with the fewest number of ICU nurses were in London: Portland Private Hospital, and NHS hospitals Royal Brompton and Royal London. John Radcliffe from Oxford and the Royal Hospital for Sick Children from Glasgow were the others.
“The shortage of nurses is crippling,” a pediatric intensive care doctor in London told the Guardian. “This means we routinely cancel elective surgeries that require a PICU bed. Literally every single hospital in London with a PICU has had to do that lately.” The post-Brexit loss of PICU nurses from EU countries like Spain and Portugal has exacerbated the situation.
A leaked NHS memo about three London hospitals shows that on December 12 just nine nurses were on duty to look after 12 children in the intensive care unit at King’s College Hospital, seven to look after 11 young people in St George’s hospital to take care of, and 19 who had to take care of her 18 patients in the Evelina Children’s Hospital. “Clear [the nurse-to-patient staffing] Ratio is not provided so yes, children are cared for inferiorly.”
A second pediatric intensive care doctor said: “The shortage of nurses in the ICU is appalling. Healthcare assistants can be very good. But their main strength lies in soft skills, like being a shoulder to cry on. But they can’t set up a kidney hemodialysis machine, for example, or calibrate a ventilator for a child who’s getting oxygen. Only a nurse can do that.
“Units are trying to stretch smaller numbers of nurses to take care of more patients. They’re trying to provide the same level of care with fewer staff, which is a patient safety issue,” he added.
Carli Whittaker, a registered nurse and president-elect of the Pediatric Critical Care Society, said fewer PICUs were meeting staffing standards. Understaffing has led to an “erosion of morale” among ICU nurses, affecting their emotional and psychological health, she added.
However, she welcomed PICANet’s finding that despite the widespread shortage of nurses, the quality of care for children and adolescents in intensive care units had not been compromised.
The Department of Health and Social Care has been asked for comment.