Nursing can be stressful. Ensure you know how to access resources to ease anxieties
In this article…
- Research on wellbeing in healthcare
- What managers and clinical leaders can do to support staff
- Different resources to help manage stress
Sue Nash is a facilitator of individual, team and service development, Action Learning Teams Consultancy, an associate of the Royal College of Nursing Consultancy.
Nash N (2011) Health and wellbeing part 1: helping ourselves and others. Nursing Times; 107: 22, early on-line publication.
In the first of a two-part series on health and wellbeing, this article looks at how nurses can focus on their own health and wellbeing, and signposts resources to help them find coping strategies to prevent stress. Although many of the reference documents concerning health and wellbeing relate to the NHS themes from them, lessons learnt and suggested recommendations are relevant to anyone working in health and social care organisations.
Keywords: Health and wellbeing, Stress, Coping strategies
- This article has been double-blind peer reviewed
Nursing is known for being a stressful occupation. In 2006, Ball and Pike reported that nurses’ level of psychological wellbeing had fallen during the five years between the two Royal College of Nursing employment surveys in 2000 and 2005 (Ball and Pike, 2005; 2000).
In 2008, the Health and Safety Executive (HSE) identified self-reported work-related stress within the profession. That same year, the Department of Health
commissioned The NHS Workforce Health and Wellbeing Review (Van Stolk et al, 2009). Its aim was to gather evidence, develop an evidence base for potential action to improve the health and wellbeing of staff, and make practical recommendations.
The review highlighted a group of NHS staff who were subject to regular absenteeism or presenteeism (going to work despite being ill). Of those surveyed 10% said they had taken more than six days off due to illness in the previous three months. Interestingly, 20% had attended when not capable of working. Staff applied personal pressure on themselves to return to work earlier than they should; this was because of team loyalty rather than feeling pressured by colleagues or managers.
This review helped to inform the Boorman (2009) report. The interim report findings demonstrated “there is a strong business case for investing in staff health and wellbeing”. The business case suggested reducing sickness absence rates would result in an additional 3.4 million working days, giving a cost saving of £555m.
The Boorman report recommended all leaders and managers should be able to recognise the links between staff health and wellbeing and organisational performance, and act appropriately. It also highlighted concerns about reported levels of stress. Some of the management practices that contributed to this included:
- Bullying and harassment of staff;
- Culture of long working hours that staff found difficult to challenge. This included the pressure they put on themselves to work long hours;
- An apparent lack of support and interest by management in staff concerns about their own health and wellbeing.
What managers and leaders can do
The DH’s Wellbeing Delivery Group has developed five high-impact actions that it believes will help embed staff health and wellbeing (tinyurl.com/five-key-actions):
Ensure health and wellbeing initiatives are backed with strong leadership and visible support at board level. Producing an annual report of the organisation’s wellbeing will help to communicate commitment and progress;
Develop and implement an evidence-based staff health and wellbeing improvement plan to meet your organisation’s needs. This should be prepared and agreed in partnership between management, staff and unions with progress monitored regularly;
- Build the capacity and capability of management at all levels to improve the health and wellbeing of staff. This will include recognising and managing presenteeism, conducting return-to-work interviews and supporting staff with long-term conditions;
- Engage staff at all levels with improving their own health through education, encouragement and support;
- Use an NHS occupational health service that offers a targeted, proactive and accredited support system for staff and organisations.
What you can do to manage stress
The following resources may help you to cope with stress and look after your own mental health and wellbeing.
Conflict resolution is one of the many online courses for nurses available from Nursing Times. The unit helps you to resolve conflicts using active listening, cooperation, boundary setting and other techniques. It teaches about the main elements of the NHS Security Management Service national syllabus for conflict resolution, common causes of conflict, how to recognise conflict warning signs and to understand the different communication models and methods of dealing with actual or potential conflict. For details, go to www.nursingtimes.net/learning
Time management is a frequently used phrase, but it is actually how we manage ourselves and prioritise what is important. The RCN Learning Zone resource “Time and Stress Management” suggests individuals consider the subject of “time thieves”. These are issues, people, situations, events and chores that “steal away your time”.
The RCN Learning Zone is for members only. Click here
The students Against Depression website has a wide appeal. High stress levels can lead to depression, anxiety and anger and often a mixture of all three emotions. The website looks at different interpretations of depression, and also how low mood, depression, anxiety and anger can result
in habits of behaviour that feed off
The website advises individuals to avoid “all-or-nothing” strategies to tackling depression and suggests they plan small steps at first as often even the small changes can set off a chain effect that can make a big difference:
Ask yourself what is the smallest change you can make that will make the biggest difference?
- What are the easiest first steps?
- Raise your activity levels;
- Distract yourself constructively by focusing outward rather than inward;
- Look at which of your daily habits need changing;
- Minimise debilitating sleep disruption by sorting out sleep patterns;
- Understand how food can affect your mood;
- Decrease vulnerability by checking alcohol and drug consumption.
For further information, go to www.studentdepression.org
The Royal College of Psychiatrists website refers to the downward spiral that can result from thinking negatively about
ourselves, the world and other people and how what we do affects our thoughts and feelings.
Table 1, taken from the RCP website, highlights how the same situation can lead to two different outcomes depending on our thoughts and our actions. The website also provides a link to an online, interactive resource “Moodgym” – an online form of cognitive behavioural therapy.
The Moodgym aims to help you:
- Understand how emotions arise, and how they may be modified;
- Learn how to modify thinking so you are less prone to get upset;
- Pick up a few hints on managing stress;
- Learn a few things about what influences self-esteem;
- Develop a better understanding of relationships and how they may be handled;
- Gain assertiveness and interpersonal skills;
- Develop some practical ways to help you cope better with difficult events.
The RCP website also has some helpful tips and electronic leaflets to help with other mental health and wellbeing issues such as alcohol, drugs and other dependencies, anxiety and phobias, bereavement and depression. NT
For further information email email@example.com or visit www.actionlearningteams.co.uk
Ball J, Pike G (2006) At Breaking Point? A Survey of the Wellbeing and Working Lives of Nurses in 2005. London: RCN.
Ball J, Pike G (2005) Managing to Work Differently: Results from the RCN Employment Survey 2005. London: RCN.
Ball J, Pike G (2002) Working Well? London: RCN.
Boorman S (2009) The NHS Health and Well-being Review – Final Report.
Health and Safety Executive (2008) Stress-related and Psychological Disorders. London: HSE.
Van Stolk C et al (2009) The NHS Workforce Health and Wellbeing Review – Staff Perception Research. London: DH.