Nurses more stressed than combat troops
Giving nurses protected time to discuss and reflect on practice can more than halve levels of stress and burnout, according to a clinical psychologist who is leading pioneering research into the area.
Sonya Wallbank, associate professor of child health at South Warwickshire Foundation Trust, told Nursing Times that stress and burnout levels were often higher among nursing staff than serving members of the armed forces.
She has carried out a number of studies into the stress levels of health visitors, midwives and nurses. They form part of her work developing a programme for “restorative clinical supervision”, which is attracting national interest.
She found nursing staff typically have a stress score of 43.35 on the internationally recognised Impact of Event Scale. A score above 44 is categorised as severe and potentially altering the ability of an individual to function.
The nursing score is around 1.5 times higher than the average for soldiers surveyed after a military trauma in a warzone, and more than twice as high as individuals working in emergency services with recent experience of handling human remains.
The scores are based on 1,865 participants working in UK healthcare between 2007 and 2012, 86% of whom were nurses, health visitors or midwives.
Professor Wallbank said she thought nurses had higher stress scores because “their fields of work” did not have the same degree of stress recognition as other stressful occupations.
“Therefore, the support for [nursing] professionals to recognise and process their emotional reactions is limited or defined as an abnormal response,” she told Nursing Times.
The restorative clinical supervision programme involves regular sessions with a supervisor during which a clinician discusses the emotional impact of their work. It is currently being rolled out for health visitors across the Midlands and East region.
Initially the supervisor is a clinical psychologist. But over the course of six sessions, the health professional is taught the techniques and can then provide supervision themselves to up to four colleagues.
After taking part in the programme scores for stress more than halved while scores for burnout, using a different scoring system, also fell significantly.
The use of the programme has so far focused on health visitors in a bid to tackle low morale and retention issues. However, South Warwickshire director of nursing Helen Lancaster is working on a plan to roll it out to all areas of the trust.
Professor Wallbank said interest in the programme was increasing ahead of the expected publication next month of the Mid Staffordshire Foundation Trust public inquiry report.
“There is a lot of interest in whether this could be linked to increasing compassion in nursing and helping staff stay focused on the patient,” she told Nursing Times.
Professor Sue Bailey, president of the Royal College of Pyschiatrists, told Nursing Times it was important that healthcare staff, including nurses, had time to reflect and there was evidence it made them better at their job, reduced absenteeism and attrition, and saved money.
However, she said it was “ironic” that giving staff this time was seen as innovative. “If you go back long enough, before the NHS became so task focused, this would have been normal practice for health visitors or nurses, although perhaps not in such a structured supportive way,” she said.
“This issue is at the heart of giving good care and will be will be at the heart of the Francis report,” she added.