Editorial Tuesday 15 January 2013: Fixing low nurse staffing with the old 'one-two'

There has been considerable debate about nurse staffing levels, with the Telegraph story from the weekend drawing together CQC assessments that 17 acute trusts are dangerously under-staffed.

The imminent arrival of the Francis Report will return the issue to salience.

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I have a suggestion for nurses who find themselves asked to work in situations that they consider dangerously unsafe.

It's a simple solution: the old 'one-two'.

It first starts with checking with your colleagues that it isn't just your view: that this is something generally thought to be unsafe by peers you trust and respect. (It's always good to get feedback, and check it isn't just you, or just a personality clash: both can happen.)

Once you're sure it's real, then you get together a letter to the director of nursing, signed by all (or at least the majority) of your nursing team.

The letter is short and polite: it explains that in your professional judgement as a team, delivering care with so low a ratio of nurses to patients is unsafe. You appreciate the financial pressures on the NHS, but also that in your professional duty, safe patient care must come first.

Therefore unless action is taken with immediate effect to remedy the situation of low staffing on an ongoing basis, in two weeks' time you will be withdrawing your labour and mounting a protest outside the hospital.

The DON will understand that you have faith they will respond to this concern, and you will need an update on their progress in addressing the issue within one week from the letter.

If you do not receive from your DON the assurance required after the stated one week, then you issue a press release to local, regional and national media outlining your plans.

The management get one warning, and two weeks. The old 'one-two'.