How Many Nurses do we Need—Standards or Pseudo Work Study?

In manufacturing industries, measuring productivity is relatively easy. In many service industries where the job is discrete (e.g. mowing a given area of grass or serving a number of cups of tea), work study methods are still easy to apply. In medicine and nursing where both the product and its process of ‘manufacture’ are hard to measure, things become more difficult. Nowhere is this more so than in psychiatry. Perhaps because of this, the standard often applied in the past has been professional judgement, and the Royal College of Psychiatrists, for example, has suggested appropriate levels of nurse staffing in psychiatry of old age. Such standards are now being questioned and an alternative is being propounded, at least in the Yorkshire Region, based loosely on work study methods. Psychiatry and psychiatric nursing have nothing to fear from work study, provided that acceptable standards of service are defined, and work study methods are properly applied. The first of these is partly a political task although it is to be hoped that the politicians would take guidance from patients, their relatives, and the appropriate professionals. Work study can ensure that such standards are achieved in the most economic way. It cannot set the standards. The authors are concerned because an exercise has recently been mounted throughout Yorkshire that purports to be a measure of nursing load, but which neither defines the standards of nursing care to be achieved, nor uses adequate methods to measure the work involved.