Analysis

Exclusive: Nursing Standard-Sunday Mirror survey reveals realities of front-line nursing

Almost 60% of nurses feel stressed all or most of the time, according to an exclusive Nursing Standard survey with the Sunday Mirror and the Sunday People.

Almost 60% of nurses feel stressed all or most of the time, according to an exclusive Nursing Standard survey with the Sunday Mirror


Eight out of ten respondents told Nursing Standard that they felt
more stressed now than five years ago.

More than 3,000 nurses have responded to a survey that has revealed the increasing pressure felt by those in the profession.

Respondents reported going on sick leave due to stress and taking anti-depressants. Eight out of ten nurses said they believed the quality of care received by patients had declined over the past five years. About half said they had seen patients suffer as a result of services being cut and had felt under pressure to save money. More than half said they only sometimes or never had time to deliver safe care.

Nurses described how they had switched to night shifts, retired, left jobs or returned on reduced hours to reduce to avoid the stress they were under.

Staffing problems 

'Staff burned out, going off with stress and anxiety and increasing pressure on the remaining staff,' one respondent wrote.

Too few nurses, recruitment difficulties and escalating paperwork were highlighted as the main reasons for stress and poor morale.

One acute trust staff nurse said difficulties recruiting meant that  50-70% of most shifts were staffed by agency nurses.

But a strong team spirit was also highlighted by many nurses, who described how their colleagues helped to keep them going.

Care scandals

'I work in a good team,' one hospital staff nurse wrote. 'But it is ourselves in our own team that keep the morale up. We get nothing from management.'

A ward sister wrote: 'Increasing workload, never any empty beds, high patient flow rate, sicker patients and less staff.'

Another in the same role said: 'People are ill, run-down, sleep-deprived and can rarely go to the toilet at work without managerial complaints or staff and patients talking to them through the door while they use the toilet.'

The concerns highlighted by nurses come a week after Sir Stephen Moss, the nurse who helped to turn around the failing Mid Staffordshire NHS Foundation Trust, spoke about his fears that other care scandals could take place. He said increasing pressures were recreating the difficulties that caused problems at Mid Staffs.

Staff burnout

'Increasing demand, unremitting pressures, workforce shortages and challenging financial imperatives are all too familiar, and all were prevalent when I joined Mid Staffs,' Sir Stephen wrote in Nursing Standard.

Mid Staffs whistleblowing nurse, Freedom to Speak Up guardian and ambassador for cultural change Helene Donnelly now champions the importance of raising concerns nationally. She said the level of pressure faced by nurses could affect their health as well as their ability to provide good care.

'Stress is clearly negative, and we have to try and offset it as best we can, by exercising, sleeping and eating well,’ she said. ‘If we don't look after ourselves, we can't look after other people.'

The Boorman review into NHS staff health and well-being, published in 2009, found that depression, anxiety and stress were the second biggest causes of sickness in staff, accounting for more than a quarter of cases. The interim report said that management practice contributed to stress and ill-health, and deep-rooted cultural issues such as long hours and high levels of bullying and harassment had to be addressed.

Eight out of ten respondents to Nursing Standard's new survey said they were more stressed now than five years ago.

RCN advice on stress recommends exercising regularly, socialising, maintaining a healthy diet and being mindful that stimulants such as alcohol, caffeine and nicotine can exacerbate problems. The college's publication, Stress and you: A guide for nursing staff, also suggests taking regular breaks at work and negotiating or delegating when staff sense that others are offloading their work onto them.

RCN senior employment relations adviser Kim Sunley urged employers to improve working conditions for nurses. She said that employers had a responsibility to create a healthy working environment, and employees should seek advice from their union representative if necessary.

Improved care quality 

'Healthy, happy nurses deliver the best patient care,' Ms Sunley said. 'What is clear, however, is that nurses truly love the job they do. Stress can be hard to handle, particularly when you are caring for others. Through creating a healthy workplace, including flexible working opportunities, well-designed shift patterns and a supportive culture, employers can reduce the risk of nurses becoming unwell due to stress.'

But survey respondents also spoke about how care and the quality of nursing had improved over the past few years, and highlighted improvements to nursing education for newly qualified staff.

'Thanks to enhanced care plans and liaising with patients and their families, care is more individualistic,' a hospital healthcare assistant said.

A Northern Ireland nurse academic said that nursing skills were increasing: 'Patients may wait longer, but nurses are more knowledgeable and compassionate than ever before.'


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