When Georgina Day became a nurse five years ago, she had dreams of becoming the next Florence Nightingale.
But the reality has been very different.
Georgina works as an A&E nurse in a London hospital.
Every shift, her team of just over 20 starts four nurses short because there are posts it cannot fill.
“It can be worse – if people are sick or agency staff don’t turn up. It makes providing good patient care difficult.”
She says the demands are huge – her department sees more than 400 patients a day.
But the shortages mean patients face delays or have to be given care, such as intravenous antibiotics, in corridors instead of in cubicles.
She says that can make patients angry, recounting the experience of one father shouting at her and saying she didn’t care about his sick son.
“I care massively,” she says. “When patients are angry it makes me really sad. I want more for them.
“We try our absolute best, even when we are short. It makes you sad and frustrated you don’t have the resources to make sure they have a good experience. I feel like more and more, you get patients complaining.
“It is a lot harder than I expected it to be. It is really tough, feeling you are not doing a brilliant job all the time.
“We need more support. We need more nurses. A lot of my colleagues are thinking of leaving nursing.”
How shortages are a national problem
Georgina’s experience is not unique. A survey by the Royal College of Nursing found six in 10 nurses felt they could not provide the level of care they wanted to.
Currently, there are more than 43,000 nursing vacancies in England – one in eight posts.
Despite efforts over recent years to tackle the issue, there has been no progress over the past 12 months.
It has left the NHS with one of the lowest proportions of nurses in the developed world.
A study in the British Medical Journal this week showed there were 9.3 nurses, on average, for every 1,000 people in rich nations. In the UK there are 7.8; in Germany, 12.9.
RCN England director Patricia Marquis said: “Nursing staff want to deliver the best for patients but have one arm tied behind their back.
“They deliver the vast majority of patient care and a shortage of them is one of the single biggest challenges facing services.
“Until this is solved, the public and patients are being short-changed and their care is genuinely compromised.”
What is the solution?
Anita Charlesworth, of the Health Foundation think-tank, said staffing had emerged as the “make-or-break issue” in the NHS as the election draws closer.
All three main political parties in England – health is devolved, so Westminster MPs do not have control of policy in Scotland, Wales and Northern Ireland – have said they want to increase the number of nurses in the NHS.
To encourage more into training, all three are promising to reintroduce maintenance grants – worth at least £5,000 a year – to help student nurses during their degrees. Labour has also promised to abolish tuition fees.
The parties have also pledged to invest in career development – the Tories say there will be the equivalent of £1,000 of training and support available for each nurse over the next three years.