Nurses’ judgements about the number and skill mix of staff they need are becoming increasingly difficult to justify to cash-strapped managers. Adopting the right skill-mix tool for your ward is the best method of securing the staff you need and ensuring patient safety, write Adele Waters and Debbie Andalo

Experts believe that nurses can no longer rely on their own judgement to decide the right number and skill mix of nursing staff on today’s wards. The problem is not their professional judgement-an experienced nurse’s instincts about staffing needs are usually right - it is more that a nurse’s decision alone is no longer trusted by managers. Nurses need to be able to produce evidence to make an airtight case for staffing changes.