Why do nurses feel they must carry on working when they’re ill?

Presenteeism is a product of the staffing crisis engulfing the health service. It’s unfair and unsustainable, and to eradicate it requires political will that is simply not forthcoming

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Who has struggled into work when feeling unwell? Or should the question be: who hasn’t?

Our recent well-being survey suggests four out of five nursing staff have gone to work despite experiencing mental ill health, exhaustion, non-COVID virus, musculoskeletal issues, the effects of long-COVID or menopause symptoms.

Skipping breaks and working beyond your hours

The NHS has long run on presenteeism, with staff working long hours, foregoing breaks and going above and beyond their contractual duties, often to the detriment of their own health. This familiar theme is currently being explored in all its blood, sweat and tear-stained detail in the BBC’s adaptation of Adam Kay’s darkly comic book, This is Going to Hurt, chronicling his life as a junior doctor.

But the daily grind of staff stretching to meet ever-increasing demand doesn’t generally make for gripping viewing – or laughter either.

COVID-19, coupled with chronic short staffing has meant the health service has been operating even more than ever on the goodwill or guilt of its employees. But how long can this go on?

‘Feel COVID-19 is only justifiable reason not to go in,’ one of the 1,230 respondents told our survey.

Lack of political commitment to mandatory safe staffing

Now it appears – following enquiries by Nursing Standard – that the government in Westminster is quietly dropping plans to make sufficient and safe staffing a legal requirement in England, maintaining instead that it is each employers’ responsibility.

Legislation is not a panacea for all staffing issues – as evident in Wales, for example, where safe staffing laws apply to hospitals and yet nurse recruitment and retention issues persist. However, it is another piece of the jigsaw, as are improved pay and conditions.

For the health service and its workforce to recover from the staffing crisis that has made presenteeism feel unavoidable to nurses, politicians must see the whole picture and take appropriate action – and that, almost certainly, will hurt.

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