The government says the RCN must work to improve standards instead of as a union for nurses after they hit out at new training plans.
As the government and nursing unions fight over how best to improve care, ITV News asked viewers to share their experiences.
Nurses gave Andrew Lansley a tough time today as he tried to defend reforms of the health service.
The number of NHS nurses on some wards is "wholly unsatisfactory" in "far too many cases", the head of the Royal College of Nurses has told ITV News.
However, Dr Peter Carter also warned that a new minimum standard of having eight patients for each nurse on duty would not solve staffing problems.
Dr Carter said that on some wards the ratio should be as low as one nurse per patient.
It is "no surprise" that 82% of nurses who said they did not have enough time to provide adequate patient care, according to a health chief.
Chief executive of the Royal College of Nursing, Dr Peter Carter said:
– Dr Peter Carter
This survey will sadly come as no surprise to nurses. Our members tell us that they are working extra hours just to get the essentials done but the NHS can't function on goodwill and commitment alone.
Nurses want to come to work and make a difference. It is hugely demoralising, not to mention potentially unsafe, if staff can't deliver for all their patients.
There is evidence of hospitals heeding the warnings of the Francis report and taking on more staff, but this is from a very low base at a time when demands are rising fast.
The number of patients cared for by each nurse in the UK is "worrying" and "can compromise patient safety," according to experts.
Chief executive of the Royal College of Nursing, Peter Carter, expressed concern over findings which showed nurses were expected to care for nine different patients on a daily basis.
– Peter Carter Royal College of Nursing
It is worrying to see that researchers found the mean ratio of patients to nurses in England is above eight, as we know that this can compromise patient safety.
The RCN has also expressed concern at the skills mix in UK hospitals as trusts get rid of more senior nurses to save money, meaning there is far less experience on many wards, and the full extent of this will be revealed in our upcoming Frontline First report.
The government will consider proposals which would punish senior NHS managers with criminal sanctions if they ignore concerns raised by whistleblowers
Health Minister Dr Dan Poulter has told Daybreak that the coaltion is looking to introducing a "new culture of openness" in the NHS to prevent poor quality care.
The Royal College of Nursing is calling on the government to extend whistleblowing legislation to student nurses.
The union claims that the current Public Interest Disclosure Act doesn't cover training nurses who raise concerns about patient care.
The government said it would consider the proposal, as it seeks to implement some of the recommendations made in the public inquiry into the poor standards of care at Mid Staffordshire NHS Foundation Trust.
Speaking to ITV News, Dr Peter Carter, Chief Executive and General Secretary of the Royal College of Nursing said sometime things will go wrong in the NHS. But it was important to create a culture where it can be put right.
According to the survey by the Royal College of Nursing:
- A third of nurses questioned said they didn't know whether their organisation had a whistle blowing policy
- Of the 64% who had raised concerns, nearly one in ten said they had raised concerns as little as a week ago
- Nearly half of the concerns raised were about staffing levels
- 21% were about patient safety
- 45% of nurses who had raised concerns said their employer took no action
One of the key recommendations made by the Mid Staffordshire NHS Foundation Trust public inquiry chair, Robert Francis QC, was that concerns and complaints should be able to be raised "freely without fear".
These responses illustrate that despite the recent attention which has been drawn to the importance of whistle blowing, many nurses are still experiencing a culture of fear and intimidation if they try to speak out.
This is putting patient safety at risk. One of the key lessons from the Francis report was that frontline staff must feel confident that they can raise concerns about patient safety without fear of reprisals.
– Dr Peter Carter, Chief Executive and General Secretary of the RCN
Nursing staff want to provide excellent care, but sometimes the systems they work in do not allow this. Staff know what is safe for their patients and what is not.
However, they cannot raise concerns if they feel unsure about what their employer's policy is or what the repercussions will be.
The Royal College of Nursing says a quarter of nurses have been discouraged about blowing the whistle on concerns over patient care, in spite of the Stafford Hospital scandal. A survey found 24% of nurses said they had been warned off raising concerns.
The nursing union says the figures reveal a "culture of fear and intimidation" at work.