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Exclusive: Nurses feeling under pressure, understaffed and undervalued

Eight out of 10 nurses feel they are under more pressure at work than they were 12 months ago, with seven out of 10 suffering the side-effects of stress, a major survey by Nursing Times has found.

In addition, more than eight out of 10 nurses say their ward or team is short-staffed at least once a week, with half of these reporting that this is “always” the case, according to our survey of 2,200 readers.  

The results of our 2013 annual survey reveal a stark picture of nursing staff attempting to care for their patients under increasingly difficult circumstances and, in some cases, putting their own health on the line to do so.

“I love my job but sometimes [I get] sick of being treated like this,” said one respondent, while another added: “I used to love being a nurse, now I feel over worked stressed [and] demoralised.”

The survey shines a light on the situation on the front line just six months after the Francis report into care failings at Mid Staffordshire Foundation Trust highlighted the serious risks attached to staffing shortages.

The findings also come as two highly critical reports by the Care Quality Commission have uncovered severe staff shortages at United Lincolnshire Hospitals Trust and Sherwood Forest Hospitals Foundation Trust.

When asked to rate staffing levels on their ward or team, 41% of respondents said they were “always” short-staffed, while 33% said they were short-staffed “more than once a week”. Less than 1% said they were “never” short-staffed.

More than half, 56%, said they felt they were under “significantly more” pressure at work than they were at the same point a year ago, and 30% thought they were under “a bit more” pressure. Only 3% reported being under less pressure.

The results suggest that nurses are being asked squeeze more tasks into their shifts, with breaks becoming a thing of the past. Respondents often described difficulties in keeping hydrated or being pressured to delay lunch breaks till the end of shifts.

Only 18% of respondents said they “usually” or “always” worked their allotted hours. Nearly 20% said they regularly worked between six and 10 extra hours a week. Nearly half, 46%, said they were working noticeably longer hours than this time this year.

One respondent said: “The NHS has always run on ‘good will’ for care to be carried out, only now they are ‘pushing it ’ too far – they expect it. No longer is this voluntary.”

Another said: “Employers want more and more from you, I am happy to give 101% but that is not often enough.”

The results also suggest the increasing pressure is taking its toll on nurses’ health. Nearly 73% of respondents said they had suffered the side-effects of work-related stress, such as physical or mental health problems, in the past year.

More than a third, 37%, thought they had taken more sick leave in the past 12 months than they normally would. Line managers suggested an even worse trend, with 60% saying they had noticed “slightly” or “significantly” more of their staff taking time off sick over the past 12 months. 

Worryingly, only a quarter of respondents said shifts were covered “always” or “most of the time” when staff were off sick. One respondent said: “When we are fully staffed other wards take our staff, but when we are short, we do not appear to get any help.”

But of potentially even more concern, 74% said they had felt under pressure from their organisation to come to work when they were feeling ill this year and, of these, eight out of 10 thought the pressure to come in had increased since the year before. 

Nearly two-thirds said they were not happy with their work-life balance and 73% thought their trust failed to attach a high enough priority to staff health and wellbeing.

Our results are reinforced by findings from a separate survey published on Monday by the Royal College of Nursing.

The RCN’s Beyond Breaking Point? survey of over 2,000 nursing staff found 55% had been made unwell by stress over the previous year and 82% had gone to work despite feeling too ill to do.

Peter Carter, RCN chief executive and general secretary, said: “Our whole care system is currently facing the huge challenge of delivering care at a time of increased demand and scant resource. This is the reality which nurses face in every working day.

“Individual nurses are clearly going the extra mile to make sure the job is done, however, the risk of burnout is very real, and very widespread,” he said.


What do you think?

We will be discussing the results of the survey on twitter at 1pm on Wednesday 2 October. Come and join the NT team and the nursing twitter community to discuss your views.

To join in search for #NTtwitchat and use this hashtag in your tweets so they appear in the feed.

Readers' comments (20)

  • Tiger Girl

    I think this is more a case of confirmation than of genuine discovery.

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  • I usually lose a morning on my day off after a shift as I am too tired to get on with my own things to do. I end up doing nothing so I can recover.
    As someone said if they have enough staff they end up having to send their staff where there is more shortage.
    On my ward which is extreamly heavy and acute, we work with 3 staff nurses instead of 4 on a shift. If one nurse is considered to have lighter patients than the other two, then they have to help the other two even though there are things like weights, recordings, updating risk assessments, filling in fluid charts etc to get done, there are patients waiting to be washed, fed, toileted and turned/ moved.
    As for medicine adminstration we have signs on the medicine trolley do not disturb the nurse, but no one takes any notice, they feel as long as they say sorry first before asking the nurse for her/his time that is good enought.

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  • "Exclusive: Nurses feeling under pressure, understaffed and undervalued"

    Not really new, is it?

    Also not new is that nurses love to list just how bad their working lives are, but never think to say "enough is enough" and join together (don't blame the unions because you never vote in their ballots and they need you to give them a mandate to take action) to support one another and stand up to management and government. I will bet the last brick in my house that in 5 years time, the situation will be worse and nurses will still moan and do nothing. I wish I was wrong.

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  • I would totally agree, short staff has always been a problem in the NHS. As a first year first placement student working on a acute orthopaedic ward I have seen good days and bad. I sometimes question myself if I want to become a nurse as I don't want it to have an affect on me physically and mentally.

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  • Bla bl@@dy bla. What are we going to DO?
    Yes, we could strike and go on marches, but what about the one Unison organised last week in Manchester? BBC never covered it. Even if we stop squabbling with eachother and get organised, how confident are we that the press will take a blind bit of notice? The public may do, let's face it, we know enough people and patients, but if there's nowt in the press and no calls for action to politicians, it's just a cold day in the rain with s@d all to show for it.

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  • Anonymous | 1-Oct-2013 1:39 pm

    Why are you concerned about the media? 400,000 nurses UK wide taking action in a concerted and organised way would force the government's hand. Small, one off, poorly supported (by union members) days achieve nothing. On the Unison day of action in 2011, most union members stayed at home or went shopping. Hardly any attended a march or stood outside hospital gates. Nurses were the worst.

    ALL the nursing unions, particularly the RCN which has the biggest membership, need to act together. It won't bloody happen because of people like you who throw in the towel because you got a bit damp!

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  • Anonymous | 1-Oct-2013 4:58 pm

    Thanks for that (I mean that honestly). So do you think that nurses getting organised with or without the media will work? I just thought getting coverage helps force the Govenrment's hand. Yes I did get wet and peed off but more with the frustration that nothing I seem to do or say makes a blind bit of difference. What would? Genuine question. I'm in my late 20s so have little experience other than banging me head against the wall and would value advice from wiser heads. Thank you!

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  • Unions are not as they used to be.
    They always seem to be doing deals with our managers to make life easier for them.
    I had a unison steward to represent me. He was only there for the pay he could get. I had to chase him, he hardly said a thingh to me. In the end I was really on my own. A friend of mine also with unison not getting the right support currently with his case.
    I know not all stewards are the same, but I am not hearing much positives from the unions.

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  • Thing with being a steward (I am one) is that you are very tied to what you can and can't do. Also you have to remember that we put ourselves in the firing line with management and I get tired of people saying to me well why is the trust doing this and that, yet when I say to them well do you go to the meetings to show your support for the union, Often the reply i get is I'm too busy.

    I'm beyond tired of nurses getting bad press for hard work that they do. I remember as a newly qualified I loved my job. Now I debate whether I should carry on as a nurse or retrain as something where I will be more appreciated.

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  • And in other news:
    The pope is Catholic.
    Bears poop in the woods.

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  • Anonymous | 1-Oct-2013 6:02 pm,

    Anonymous | 19-Aug-2013 5:25 pm How about starting campaigning?

    Use the Internet
    Use Twitter to campaign
    Use Facebook
    Use YouTube

    Get facts and figures and evidence and send it to the press and the Internet.

    Demonstrate in Hyde Park explaining the lack of resources and make it urgent

    You have support in the country
    Tell the public what is going on and they will support you. They will help you fight and win.

    The reason the government are continuesly winding you down, getting you burnt out, endlessly pressurising you so you are simply too tired, too exhausted to fight back is you have no voice.

    You need to find a voice and you need to make it national.

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  • No one wants to listen to ordinary nurses about what it is actually like on the wards and the physical / mental demands of nursing. Management only want to be told that acuity tools know more about your patient dependency than any nurse.
    Also note that one acuity tool is to be applied to all wards, weighted to acutely sick not heavy dependant patients!

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  • When you are short of staff in many areas what support do you get from Matrons, CNS, Chief nurse, head of operations, medical directors, consultant?

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  • A bit spooky that this episode of Nursing Times arrived in my postbox the day I was signed off work for 2 weeks for stress and anxiety. Goes a long way to assuaging my guilty feelings to know that it isn't just me that's having problems, but as others have commented, it begs the question what are we doing/going to do about it? Quite often it feels as if the answer is there's nothing we CAN do: our managers know what the problem is (i.e. lack of staff/coverage for people who are sick), but the Powers That Be in the hospital world often do NOTHING about it. We are just expected to be able to cope, and then we feel guilty because we can't.

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  • Please feel satisfied in knowing you have done your very,vey best for all your patients.

    I know you have.


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  • I think the reason people don't bother going to union meetings is that the hands of the local reps are tied,or else they lose their jobs by managers' harrassment and bullying; and a substantial proportion of full time officers do what the managers want, for an easy life, as mentioned above.

    I would like there to be nurses for when I get old and sick, but I would not advise anyone to do heavy work / long hours too far into their 30's. That's the dilemma!

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  • Let's be honest. The reason that people don't attend branch meetings or even vote in a ballot is because they are too apathetic. They want everything to be fixed by someone else.

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  • Nurses need to stand up but they are too apathetic.
    There has been an epetition regarding nurse staffing ratios going for nearly a year in one guise or another. If people just posted a linkon their FB pages it might actually have a chanceof getting to 100,000 sigs. It barely managed 5000 last time.
    But post a pic of a What does the fox say video and its viral within a week.

    They need to stop expecting someone else to do it for them and become pro active

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  • I'm not making excuses but perhaps one of the reasons people are apathetic is that they've tried but not got anywhere or are so knackered by the day job we've got no energy left. By the time I've finished work and sorted out family stuff I can't face much else apart from watching telly on the sofa. And yes, that does mean if I can't get off my backside I should stop moaning and most days I do just get on with it, but I do wonder sometimes how bad things have to get before some thing happens, whatever that is.

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  • Anonymous | 4-Oct-2013 11:16 pm

    You have just wheeled out most of the excuses used by nurses. But you seem to be passing them off as reasons. They are excuses.

    Nurses elsewhere, faced with the same challenges, don't accept the conditions UK nurses do. They don't seem to have the learned helplessness of nurses in this country. Maybe it's cultural. I don't know. What I do know is that the majority of nurses on Britain are not at all happy with their pay and conditions and the barriers to their ability to provide adequate care. They do nothing about it.

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