If the NHS gets staffing right, employees are less likely to burn out and should be able to hold to their values, says Andrew Clements
Following the Francis report, there has been a lot of talk about the values of health professionals, particularly nurses. The Health Education England mandate calls for values-based recruitment in the NHS. Recruiting nurses and midwives with the right values can reasonably be expected to be useful.
When employees’ values match those of their organisation, they are generally happier at work and less likely to quit. When staff are committed to their profession and employer, they tend to be better at their jobs and will go above and beyond the call of duty. Commitment in nurses has been linked to retention.
While there are benefits in recruiting committed and value-driven nurses and midwives, I am not sure the problem facing the NHS is a lack of committed employees. However, I do think commitment offers insight into the problem at hand - and the problem is not people as much as systems.
“Burnout leaves employees feeling cynical, exhausted and disengaged. It is little wonder that burnt-out employees perform poorly at their jobs, and are more likely to quit”
In the work psychology literature, commitment is often seen as a relationship with a target, such as one’s employer or profession. A relationship is based upon exchange - to be committed to work, people generally need to feel supported by their employers. A good deal of research evidence shows such support boosts staff wellbeing. A supportive work environment is therefore a critical factor in employee wellbeing as well as employee performance.
Nurse staffing levels have been raised as a concern by the Royal College of Nursing and others. I wonder how supported nurses, midwives and other health professionals feel.
Low levels of staffing not only threaten patient safety directly but also are likely to foster burnout in nurses and midwives. Burnout leaves employees feeling cynical, exhausted and disengaged. It is little wonder that burnt-out employees perform poorly at their jobs, and are more likely to quit. Burnout is therefore a serious problem for the NHS.
Evidence suggests that nurses have strong values early on in their careers, but find these values thwarted by the organisations that they work within. Recruiting compassionate nurses and midwives then grinding down their values through the working conditions that are prevalent in the NHS is not going to achieve the goal of providing high-quality healthcare.
A report by the Point of Care Foundation published this year indicates that a sizeable proportion of NHS employees are disengaged and do not feel valued. Engaged employees tend to be better performers, so making a demonstration of employee value to the organisation may do much to improve the climate at work. Attention must be directed towards getting the work environment right.
Professional values are important. My concern is that a focus on individual values may be more convenient than addressing systemic issues - such as safe staffing levels - which require an investment of resources. Individuals can be blamed, fired and forgotten, while the work environment remains the same. People must be held responsible for their actions but we do not live sealed away from our environments.
If the NHS gets staffing right, employees are less likely to burn out and should be able to hold to their values better. A supported workforce is one that will perform better, to the benefit of patients and staff alike. It is time to treat the experience of staff as crucial to the NHS strategy, and that means demonstrating commitment to nurses, midwives, and other health professionals.
Andrew Clements is lecturer in organisational psychology at the University of Bedfordshire