Nursing staff ‘at breaking point’

 The Royal College of Nursing’s Beyond Breaking Point? survey, of over 2,000 nursing staff working in a range of settings across the NHS and in the private sector, found that more than half (55%) have been made unwell by stress over the previous year. The most significant causes of stress are being unable to deliver the care they would like, increasing workloads, feeling unsupported by managers and the rapid pace of change. Despite this, the vast majority of nurses (82%) reported that they have gone to work despite feeling too ill to do so over the same period, raising concerns that safe patient care could be jeopardised. The RCN’s report also raises concerns about the working culture which is operating in the care system in the UK, both in hospitals and community care. More than half (56%) of survey respondents reported that they have experienced verbal or physical violence from patients or service users over the last year, while around one in five (23%) reported being bullied by managers. Further findings from the survey include:
 
• Almost a third (30%) of respondents reported that work often or always has an impact on their health and wellbeing.
• One in nine (11.5%) had been injured by moving and handling patients during the last year, with a further 4% being injured by potentially serious needlestick injuries.
 
Many nurses reported that sickness absence policies were so punitive that they had no alternative but to attend work. One said: “I’ve been told that if I don’t meet the 100% attendance at work I will be up for a capability hearing. I had three admissions into hospital due to a cardiac problem, so if I get chest pain I have to ignore it because I have to go to work.” Another said: “I am currently off work following breast cancer, a senior manager called three weeks after my surgery and asked if I was coming back as people with cancer often don’t return and they wanted to fill my post.” On the subject of bullying, comments include: “The entire culture of the organisation is shifting, becoming hard line and unforgiving. As pressure builds up on individuals, some respond by exhibiting bullying behaviour to others.” A nurse working in the community said: “We are over capacity working 62 hour weeks. When brought to managers’ attention they say it’s our fault saying ‘if you choose to work over your time that’s your choice’, ‘poor time management’, ‘driving like a snail’ or ‘being too thorough’. It’s totally unachievable every single day and worst of all it is affecting patient safety and care.” Dr Peter Carter, chief executive and general secretary of the RCN, said: “In the aftermath of the Francis Inquiry, it is clearer than ever that working cultures in the NHS and beyond have a direct and serious effect on the level of care that staff can provide to patients. Our whole care system is currently facing the huge challenge of delivering care at a time of increased demand and scant resource. This is the reality which nurses face in every working day. “There is much that managers and employers can do, and should be doing, to support staff and keep patients safe. By ensuring there are enough staff to deliver care, and enabling staff to raise concerns safely, the positive working culture which exists in many places could be the reality everywhere. The Boorman Review of 2009 made recommendations which, if implemented, could save more than half a billion pounds from NHS funds. Action is needed now to make that a reality before more money is wasted by driving staff to breaking point. “Worryingly, this report shows that rather than an environment which supports staff, some employers are instead adopting panic behaviours. Staff report being intimidated and blamed, and feel they have no way of speaking out about threats to patient care. Individual nurses are clearly going the extra mile to make sure the job is done, however, the risk of burnout is very real, and very widespread.” As well as calling on employers to take urgent action to protect staff welfare and patient care, the RCN is also calling for the Health and Safety Executive to take enforcement action where employers are failing to meet the legal requirement to assess and manage the risk of work related stress.