The everyday work pressures experienced by nurses and midwives is having a significant impact on their mental wellbeing and the care they are able to give their patients.
This is according to a report published by the Society of Occupational Medicine (SOM), the RCN Foundation and Birkbeck, University of London, which found nurses and midwives are at considerable risk of stress, burnout and poor mental health because of the demands of their role and linked factors including staffing shortages and resourcing issues.
Mental health in the NHS
It says urgent action is needed to address the issues that exacerbate the pressures they face and that occupational health departments, line managers, professional bodies and organisations all have a major role in achieving this, as well as the individuals themselves.
Despite being engaged in the work they do, the study, which involved analysis of 100 studies undertaken over the past decade, found satisfaction with job demands, control, support and role clarity are lower among nurses and midwives than other professional groups in the UK and are strongly linked to stress and burnout.
They also face a greater risk of harassment and bullying, especially Black, Asian and minority ethnic (BAME) nurses and midwives, and have a poor work-life balance.
Rather than take time off to recover, nurses and midwives often continue to work while unwell, often because of low staffing levels, feelings of responsibility to their patients, and a reluctance to let their colleagues down.
The report makes 45 recommendations to help improve the mental health and wellbeing of nurses and midwives. In particular, it has called for organisations to implement comprehensive mental health strategies that include evidence-based interventions, access to support from occupational health practitioners and line managers, the improved ability for staff to take breaks in suitable facilities, and for optimum staffing levels to be introduced.
Professor Anne Harriss, president of SOM, said: “The report points out the lack of knowledge and training of managers to deal with stress experienced by nurses and midwives. For example, many ward managers receive minimal, if any, training regarding the impact of shift work on the health of staff. This knowledge is essential when planning staffing rotas to mitigate any possible negative impact on health.”
Another of the report’s authors, Professor Gail Kinman, said: “Action is urgently needed to improve the mental health and wellbeing of UK nurses and midwives. The additional demands placed on staff by the pandemic means their wellbeing is likely to deteriorate further if the findings of this report are not acted upon. Our report has highlighted the need for evidence-informed systemic interventions to tackle the causes of work-related stress in the sector and identified some initiatives that might be particularly effective.”
Considering occupational health support in particular, The Mental Health and Wellbeing of Nurses in the United Kingdom report said all nurses and midwives should able to self-refer to their employer’s occupational health function and other support services, rather than going through their managers.
It said: “Occupational health staff need to be aware of the working conditions of staff and how they can impact on mental health and wellbeing. They also require additional training on supporting mental health, including taking a proactive preventative approach.
“Occupational health professionals should be given the opportunity to work closely with managers and human resources to provide optimum and individualised support to nurses and midwives within their workplaces.
“It is particularly important for occupational health staff to have the training, resources and tools to meet the needs of staff and staffing levels should be enough to meet the increasing demand inherent in healthcare organisations.”
It added that organisations need a “culture change” around mental health and should introduce clear and accessible policies that are evaluated to ensure they remain effective.
Employers must also ensure that “basic human needs” are met, the report concluded, including entitlement to breaks and access to appropriate food and drink and bathroom facilities.