Fewer than one in 10 NHS nurses feel able to always provide safe levels of patient care, according to a survey.
The poll of more than 3,000 nurses also found 81% thought levels of care were worse than five years ago.
Just 8% reported that they felt they "always" had time to deliver safe care to patients, while 42% answered "most of the time", 45% said "sometimes" and 4% responded that they felt they "never" have the time to provide a safe service.
The research, carried out by the Sunday Mirror and Nursing Standard magazine, also found 83% felt staffing levels were not safe.
More than half reported that they are considering quitting the health service, while 56% said they felt under pressure to save money in how they work.
Janet Davies, chief executive and general secretary of the Royal College of Nursing, told the Sunday Mirror: "This is a sombre snapshot of the state of the Health Service, direct from the staff keeping it afloat.
"As pressures rise to new and extreme heights, the Government is digging a deep, dark hole for our NHS."
It comes after the NHS faced huge pressure over the winter, with accident and emergency waiting times of four hours and more reaching record levels, and fears of a staffing crisis.
A question mark remains over the post-Brexit status of the 22,000 nurses who come from the EU, even after Health Secretary Jeremy Hunt told the Chief Nursing Officer for England's summit last week that keeping them in the health service is "one of our absolute top priorities".