Expectation for nurses to be resilient and stoic can be toxic
Burnout and stress should not be considered a sign of weakness states report on psychological ill-health for nurses, and expectations on staff can be ‘toxic’
The expectation for nurses to be resilient and stoic in challenging circumstances can be ‘toxic’, new guidance on psychological safety suggests.
Burnout and stress should not be considered a sign of weakness
Authors of the guidance say burnout and stress are a normal consequence of the difficult work nurses do and should not be considered a sign of weakness.
The guidance on preventing and tackling psychological ill health among nurses, midwives and paramedics is the result of a two-year project, Care Under Pressure 2: workplace psychological ill-health for nurses, midwives and paramedics, that analysed research evidence to find out what really works.
Joint lead author Jill Maben, professor of health services research and nursing at the University of Surrey, said tackling stress and burnout among nurses was key to ensuring good patient care and improving recruitment and retention.
However, she said a lingering stigma around poor emotional and mental health in the profession was getting in the way: ‘It is very stigmatised in nursing. You’re expected to carry on with a stiff upper lip and feeling stressed or going off sick due to stress is a sign of weakness.’
Employers need to think about psychological health in the workplace
One of the report’s key recommendations is the need to recognise that burnout and stress in nursing are ‘normal outcomes of the job’.
‘The question is not whether someone will experience stress, it is how severe their stress will be, and how it will affect them,’ the document states.
Professor Maben said employers must factor this into planning and support and think about psychological health in the workplace in the same way they consider physical health.
‘We have training for moving and handling and lots of preventive work around how to protect people physically but we don’t have that for psychological health,’ she said.
‘We think it should be normalised and anticipated. Given the kind of work people do, we should expect there will be stress and burnout at some point in their career rather than being surprised when it arrives.’
The latest NHS Staff Survey shows about 40% of registered nurses and midwives said they often or always feel burnt out at work. Meanwhile, nearly half – 46.8% – said they often or always found their work emotionally exhausting.
Nurses should feel able to speak up about issues without any fear
Steps employers can take include providing mental health first aid training for team managers and giving staff the opportunity to take a break from high-stress roles.
‘Employers can help staff rotate away from challenging areas for a time and actually plan that into jobs,’ said Professor Maben.
The guidance emphasises the importance of meeting the basic needs of staff, including access to food and rest areas, and ensuring nurses and others can speak up about issues without fear of blame or punishment.
All NHS employers are now expected to appoint a health and wellbeing guardian. The guidance says it is vital to ensure guardians have the authority and budget to make real change possible.
Fellow joint lead author of the guide Cath Taylor, professor of healthcare workforce and organisation at the University of Surrey, said: ‘Our message to nurses is to remember that if your health is affected when facing psychological challenges at work, it is not a personal failing but a reflection of the intense environment that you are trying to navigate.’
She said nurses need to prioritise their well-being, accept help from colleagues, family and friends and recognise their support needs may change throughout their career.
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