Tag: stress

Nursing stress (2)

Further to my last post on nurses and stress: an email to the RCN has produced this link to the full Beyond breaking point report.

For those interested, here’s what the conclusion from the Executive Summary says:

The 2012 survey findings highlight the high levels of stress among the nursing workforce. Stress can be a causal factor for health problems, physical injuries, psychological effects and burnout. In addition to the high personal toll, stress is a major cause of both sickness absence and presenteeism and affects the ability of workers to be effective.
The survey reveals that the main causes of stress are high workloads, long hours, unrealistic expectations, lack of job control, conflicting roles, bullying and violence, poor working relationships and a lack of engagement in workplace change. Addressing these problems is an obvious way to improve nurses’ working experience, and in turn improve the safety and quality of care for patients.

Issues of workload, stress and working life are, however, often symptomatic of systemic organisational problems. Poor work environments and working relationships damage the ability of nursing staff to provide safe care and there is a direct correlation between job satisfaction and patient satisfaction.

Nursing stress

Today The Guardian reports on a Royal College of Nursing survey into levels of stress amongst 2,000 NHS and private sector nurses. Some of the nurses participating give dire accounts of their working lives when it comes to sickness and time off due to ill-health. Here is a snip from today’s paper:

The RCN said many of the nurses questioned reported that sickness absence policies at their place of work were so punitive that they had no alternative but to attend work despite feeling unwell.

One of the nurses told the RCN: “I’ve been told that if I don’t meet the 100% attendance at work I will be up for a capability hearing. I had three admissions into hospital due to a cardiac problem, so if I get chest pain I have to ignore it because I have to go to work.”

Another said: “I am currently off work following breast cancer. A senior manager called three weeks after my surgery and asked if I was coming back as people with cancer often don’t return and they wanted to fill my post.”

As someone who has investigated stress and burnout in nurses in the past I am interested to know more of this survey (or ‘poll’, as it is described). I can’t find anything in the Guardian‘s news report on the type of study which has been conducted, and I’m turning up a blank when I navigate to the RCN website for a full report. Perhaps I’m missing something?

Stress and community mental health nurses

A particular aim of mine in starting this blog was to bring research I have been involved in to a wider audience. So with this in mind, here is a post introducing readers to a series of studies I worked on, with Cardiff colleagues, from the late 1990s to around 2006.

The All Wales Community Mental Health Nursing Stress Study was our first project, led by Professor Philip Burnard. Included in the team were Deborah Edwards, Dave Coyle, Anne Fothergill and myself. Our funding was from the GNC for England and Wales Trust, and we aimed to find out about the causes, moderators and outcomes of stress in community mental health nurses (CMHNs) working in Wales. Our data were generated using a demographic questionnaire and these previously created measures:

  • Maslach Burnout Inventory
  • General Health Questionnaire (GHQ-12)
  • Rosenberg Self-Attitude Questionnaire
  • Community Psychiatric Nursing Stress Questionnaire (Revised)
  • Psychnurse Methods of Coping Questionnaire

Our first published paper was this literature review, which Scopus tells me has thus far been cited in 66 subsequent publications. We went on to publish a series of data-based articles from the study, in some of the journals whose names I have added to the word cloud above. The references for these papers are listed here, along with a brief summary of our headline findings.

The team’s next study was a systematic review of stress management in the mental health professions. This was funded by the Wales Office of R&D for Health and Social Care, which was the predecessor body to NISCHR. We found far more papers describing how stressed people are than we found papers suggesting solutions to this problem. Follow this link for a reference list and project summary.

Finally in this series of projects was a study ‘to identify the factors that may influence the effectiveness of clinical supervision and to establish the degree to which clinical supervision might influence levels of reported burnout in community mental health nurses in Wales, UK‘. An expanded team this time included Linda Cooper, John Adams and Tara Jugessur. This study involved the distribution of two questionnaires, again to community mental health nurses in Wales:

  • Maslach Burnout Inventory (MBI)
  • Manchester Clinical Supervision Scale

This project, too, has a webpage giving details of our main findings and of our published papers.

In the years since this last project concluded I have had conversations with people on what the next line of inquiry might be. The questions we first asked some 15 years ago seem to me to be as relevant today as they were then. I imagine there remain large numbers of very stressed and burned-out mental health practitioners out there. I also suspect there is still work to do to protect the well-being of staff, and to promote their resilience.