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NHS stress driving up nurse sick leave levels


NHS staff are almost four times as likely to be absent from work with stress as people with other occupations, and nurses are the most stressed of all, Nursing Times can reveal.

Workforce data on 30,000 staff working across 17 NHS trusts shows stress and associated psychiatric problems accounted for as much as 15% of all days lost due to sickness absence in 2008.

This compares with 4% of days lost in the same year due to stress among 40,000 staff, working across a range of other occupations –in both the public and private sector – including education, manufacturing, retail and local government.

The figures were produced by FirstCare, an absence management company, which carried out an exclusive analysis of its data for Nursing Times.

Staff working for FirstCare’s clients are required to call the company’s call centre instead of their line manager. The reason for their absence is then logged by FirstCare and employees are referred to a nurse who can offer advice or arrange treatment. 

Overall, the company’s figures for 2008 show that NHS staff took an average of 10.9 days off sick, compared with 8.7 days among non-NHS staff.

A further analysis of last year’s figures looked in depth at absence within the 17 NHS trusts, comparing 7,500 nursing with 22,800 non-nursing staff from all levels, from doctors to HCAs.

Within the health service, it suggested that nurses experienced higher levels of stress-related absence than other staff. But perhaps unsurprisingly – given the prevalence of lifting injuries among nurses – the data showed nurses took the most days off for musculoskeletal problems (see above).  

Aaron Ross, director of FirstCare, said: ‘Musculoskeletal is a big one for nursing. Quite often nurses are going back to work without full recovery, as a result these are turning into a more sustained condition.’  

Kim Sunley, RCN senior employment relations adviser, said the NHS had worked hard to reduce moving and handling injuries among nurses and other staff but added that nurses regularly topped polls as a profession facing one of the highest levels of stress.

The RCN will be holding series of workshops around the country, in conjunction with NHS Employers, to look at stress among nurses and how it can be tackled, she said.

Additionally, Ms Sunley said she hoped that a joint Department of Health and NHS review of the health and well-being of the NHS workforce – launched in February – would produce serious recommendations on how stress-related problems could be reduced in the NHS.

A spokesperson for Unison said comparisons between the sickness records of nurses and those in other employment settings were difficult because of the wide variation in the types of jobs staff carried out.

‘People in the NHS would agree that it is a tough job, which can be emotionally and mentally demanding, and there can come a time when the stress means that staff have to take time off,’ she said.

Looking after the well-being of nurses is one of the pledges made in the new NHS Constitution, launched last summer, with the NHS Next Stage Review. The health of nurses and other NHS staff was also the focus of another government report published last week.

The report Healthy Weight, Healthy Lives: One Year On outlined progress on the government’s cross-department strategy on tackling obesity, launched in January 2008, and set priorities for ‘future work to enable everyone in society to maintain a healthy weight’.

Among its recommendations it encouraged overweight nursing staff to set a good example to the rest of the population on obesity by taking action to lose weight.

‘The public sector should lead both as an example of government action and due to the large numbers it employs,’ stated. ‘We need to prioritise how to best improve the health and well-being of NHS staff, with an initial focus on nurses, midwives and health visitors,’ it said.


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Readers' comments (12)

  • John Howes

    I recently attended a Trust mandatory update study day. Apart from the many useful elements, Basic Life Support , Infection Control etc. We were asked as a group to comment on current issues around the Trust. A response to one comment was "we want to discuss positive issues.." I have to say it is not the positive issues that are stressors, it is the negative issues which our employers would prefer we did not take issue with.

    How long will it be in this age of spin and self delusion which seems to be a fundamental part of all public services, starting at Government level and cascading down; before someone at Executive level starts to listen?

    Somewhere between the frontline, where we see, treat and are often attacked by patients the message to the Boards is lost. Unless this fact is addressed the stresses will continue.

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  • I have to say this doesn't surprise me at all. I did a 14hr shift yesterday without a break. Until the trusts start abiding with the law and issue nursing staff legal breaks, this will only continue to rise.

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  • Management strategy of back to work interviews, which they say is meant to help, has actually turned into a witch hunt with managers stating that disciplinary action will be taken. How is this meant to help? Nurses do return to work before they are fit because they are feared of the consequences. I speak from personal experience and that of many of my colleagues.

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  • Why do NHS employers always skirt around the true issues causing work-related stress in hospitals? The lack of staff, proper breaks and appreciation for the job we do are the main issues causing stress yet these are the only subjects that they dont tackle!

    I have been nursing now for just over a year and already I feel desperate about the current climate in which we work. Although I work flat out, rarely have breaks and never leave work on time (much the same as all of my colleagues) I am still left feeling negative at the end of my shift, as if I havent worked hard enough, even though I feel totally exhausted. If the NHS and the government dont wake up to reality soon, they are going to have alot worse problems to deal with!

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  • Phil Dup

    I've worked in A&E for 11 years now and much like most of my colleagues have REGULARLY gone into work whilst feeling dreadful - often treating patients who are not as unwell as myself - I do this because I know my workmates will end up having even more work to do ! When I have had the very occasional time off it has been because I am ill to the level of being almost bedbound. No one comes into Nursing as a soft option and these sickness levels would show even higher if we took the time off we should do when we are ill.

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  • I have been a health care assistant for over 10 years, i have seen the changes and lack of staffing levels, which has added stress on the nurses in meeting government targets. The government must soon take action before students like myself will seek other career options.

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  • Discrimination must be mentioned as one of stressors among NHS nurses though NHS management chooses to be in denial when it is mentioned. Other factors contributing to nurses stress are lack of support and insensitivity to the problems encounter by nurses on the job e.g. attack and abuse by patients and others (Some NHS management make patients feel like a customer in a five star hotels rather than a partner and team member in their own care). Another one is lack of proper break. I work in a trust where Doctors-on-call are provided with a furnished flat and another furnished room for them to have their break but on-call nurses and sit-in-Crisis night nurses are expected to go out to have their break even at night. Lastly shortage of qualified staff to cover assignments and pressure on the few nurses available to meet the management/government targets.

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  • I have just done my first shift following 6 months off with stress and exhaustion. I have always enjoyed the ups and downs of my job and pride myself on doing the best I can for my patients, staying late, not having breaks etc. Having had this long period of sick leave I really wonder if coming back is going to be the right option for my own health and yet I am reluctant to leave nursing in this way.

    At the same time I am not sure I can continue with the continual increasing levels of work load being piled on and no increase in staffing levels, infact nurses that leave are not always replaced. The figures just dont add up, I want to give the best care I can i.e. what i would like to receive if i were a patient but it is becoming impossible to do so consistantly. Cutting corners has crept in and i dont like it or the additional pressure it puts me under yet still management dont listen...... how many staff will they lose before they actually stop and realise what they have lost? I dont want to end up so worn out that there is nothing left in me so I guess I will have to leave my profession.

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  • I hate my current job as a sister in A&E. I used to love A&E but changed hospitals for a promotion and now really hate it, luckily my best friend does exactly the same job in the same hospital so we have each other to rant to.
    I'm new to people management, every shift I go into there are a new bunch of agency nurses, thats the days we're lucky to get agency nurses.
    I don't want 'stress' on my record but I don't think my partner will be able to put up with me constantly in petrified tears before any shift.
    To top it all off last week amongst a dept of around 12 overnight stays, another 12 behind those 12 awaiting beds too, no beds in the hospital, a majors full of agency nurses and none of us having had a break or even a chance to go to the loo, some big bod manager decides she's going to come over to me and shout at me about my footwear , normal medical closed toe, no holes that she'd taken a dislike to .
    I used to love A&E, now i dread every single shift.....

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  • Anonymous | 16-Apr-2009 11:37 pm
    I feel exactly the same at the minute i am one year newly qualified. I have been to many different environements and chose this one(where i currently work) as my first job. i enjoyed it to begin with but but have been off for two months recently with stress, anxiety and depression due to taking home jobs, problems and worries.i cant switch off. I have never been like this, i feel also that I want to give the best care I can i.e. what i would like to receive if i were a patient but it is becoming impossible to do so consistantly due to staffing levels and my knowledge of clinical skills. Cutting corners has crept in with many people and i dont like it or the additional pressure that has been put upon us. i am at the stage now where i have finished my phase return and am still finiding it difficul currently on medication to lift my mood (which for me was also a hard decision). i have done my nurse training with lots of problems, but i did it, and now very relcutant to give it up or admit defeat as i have been through all this stress. on a good day i have a brilliant day, come home smiling but these are few and far between now. i am stuck as to what to do, find a different job trial it out fearing the same or just go back to being an auxillary with a pay cut. because i want to nurse but am finding it too much in the current climate! and do not want to change my morals of being the best nurse i can.

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