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'We must recognise that we are role models to our patients'

In 2009, the Boorman report highlighted the importance of NHS staff health and wellbeing, not only for individual employees but also so they can delivery quality healthcare.

The report also showed how much some NHS employers needed to do to improve the health and wellbeing of their staff. 

The link between staff well-being and quality of output is not new. Cadbury, Lever and Owen were just some of the employers during the 19th century who placed great emphasis on their employees’ wellbeing. The investment these employees made in their working and living conditions not only improved the health of workers and their families but also company productivity. They proved that a workforce with a strong sense of wellbeing made for good business - a situation which is as true today as it was then.

Our business may be different, but the principle applies to nurses just much as it did to confectionery or yarn spinning. Nurses with a sense of wellbeing work more effectively as a team, provide better care and are more willing to make additional efforts. They are also healthier, have better attendance and are more able to deal with stressful situations.

Although we do not face the same hazards as Victorian workers, we still have to deal with modern pressures that can pose a threat to our health and wellbeing. The current economic situation is likely to exacerbate the pressures we already experience from staff reductions, increased patient acuity, treatment complexities, the impact of an aging patient population and the need to meet targets. These unavoidable realities mean there is all the more reason to ensure working conditions and staff support are such that we can continue to deliver quality care. Once staff wellbeing is eroded it begins to impact on patients. At its worst, staff stress can lead to abuse of patients but more often adverse impacts are outcomes such as medication errors, increased infection rates, omissions in care or a fall in overall standards of care.

While we rightly look to our employers to ensure we have good working conditions, we also need to recognise that as nurses we are role models for our patients. We therefore need to consider how our own behaviours might influence others. It is difficult to maintain credibility when advising patients on health behaviours if we do not practice what we preach. One example is smoking - probably the greatest single avoidable health risk. Patients do complain about nurses smelling of cigarette smoke - even those who are smokers themselves.

In one hospital, as part of their health promotion programme the number of days on which chips appeared on staff menus was reduced.  This brought complaints not from junior staff, but senior managers. In another, salt cellars were removed from the tables in the staff dining room although they were available from a central point. This triggered complaints from a number of consultants.

Ultimately, health and wellbeing is a two-way process. Our employers need to look after us, but we also need to look after ourselves.

Jim Robinsonis equality and health improvement facilitator, Lothian University Hospitals

Readers' comments (1)

  • This I absolutely agree with, for a number of reasons.

    In terms of NHS employers, then big changes need to be made on a cultural level more than anything in order to improve our health/wellbeing/work life balance. Things like removing salt cellars and chips from the menu are all well and good, but they are chipping away at the surface of the problem, not solving it. There does need to be a lot more of these small things, such as free hospital gyms or heavily subsidised gym memberships, etc, but there also needs to be a huge focus on our working conditions. Sort out shift patterns that take into account work/life balance, no work patterns that destroy our circadian rhythms, limited nights with good turnaround (not 1 bloody day as I have refused in the past!) When we are on shift, make sure there are enough staff, equipment and services available so we can do our job without dropping dead at the end of the shift! These things are pretty bloody essential really. It has been proven time and time again, as this article reiterates, that focusing on this IMPROVES productivity, reduces sick days, etc, if the trusts ever need a financial incentive to do
    so (they always do!)

    But I also agree that we as professionals should be expected to maintain a certain level of personal responsibility for our own health.

    On one level, this does mean don't be so foolish as to simply accept the piss poor working conditions, don't work three hours after your shift without pay because you don't have time to do everything for god knows how many years and then wonder why you have to go off with stress.

    On another level, this involves practising what we preach. Smoking, as the article says, is a big issue. Look outside the entrance to every hospital, how many Nurses are there huddled furtively from the cold having a fag? Great public health image. It makes it worse if those Nurses go in and then advise patients to stop smoking!!! To take another extreme example, I will never forget during the latter months of my student days, a study day on nutrition and healthy eating, being given by a nutritionist who happened to be severely clinically obese. I am not kidding, and do not mean to be overly rude, but this girl was huge. I could not take her seriously as a professional, and I have serious doubts any of her patients could either.

    I am not saying all Nurses have to be athletes and in the peak of physical condition, but there does have to be a line drawn.

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