Staff at Perth Royal Infirmary must receive urgent help or patient care and safety will suffer, the Royal College of Nursing has warned.
Nurses at the hospital are said to face a daily battle to retain services in the face of rising demands and a long-term and deepening recruitment crisis.
The RCN said they were under “unprecedented” pressure as they battle to provide safe patient care.
It says an overhaul of how health services are delivered is desperately needed as the hospital merges wards and cuts back on surgical procedures.
Nonetheless, it believes urgent recruitment is the only way to continue to ensure the safety of patients – and relieve the increasing burden being placed on existing staff.
NHS Tayside admitted this week it been forced to introduce “contingency measures” at PRI to cope with its nursing shortage.
Royal College of Nursing Senior Officer Bob McGlashan said: “The reality is that there is a shortage of nursing staff across Scotland.
“The Scottish Government can point to an increase in the number of nursing and midwifery staff nationally, but the reality in many areas, including at Perth Royal Infirmary, is that while nurses want to do their very best for their patients, rising demands on our health and care services and a shortage of nursing staff mean that the hospital and the staff who work there are under pressure like never before.”
Mr McGlashan said the RCN had been working tirelessly in partnership with staff and NHS Tayside to try and address the specific recruitment issues faced at PRI.
He said: “A change to how services are delivered is needed, but our over-riding concern must always be the safety of patients and that means having enough nursing staff on the wards and out in the community to care for them.”
Perth Royal Infirmary has faced long-standing issues with providing enough staff to keep services running properly.
In 2013, NHS Tayside was forced to issue a statement saying it was implementing significant staffing changes after nursing staff raised concerns over patient safety and care.
They came about following high level meetings between senior nursing management and ward staff at the hospital after nurses wrote an emotive open letter.
In it, they claimed that too few staff were being forced to care for too many patients, leaving them “exhausted, disillusioned and stressed” and worried that safety was being compromised.
The letter also warned of plummeting morale and the very real possibility that “many highly-qualified and experienced nurses” would leave.
Perth Royal Infirmary’s staffing situation has only worsened since then, despite significant efforts by NHS Tayside to fill posts.
The health board is in the midst of a major overhaul of services and the way in which it works as it bids to save millions of pounds.
It hopes that by operating more efficiently and using the staff it has more effectively it can maximise the quality of care provided, while lessening the burden on staff.
That may help to address some recruitment issues, but it is also working to make a job with NHS Tayside more attractive.
A staff group has been established to develop long-term recruitment plans for NHS Tayside as a whole.
Extensive short-term efforts are also continuing to fill vacant nursing posts at PRI.