Wellness of the Nursing Workforce

By Jessica Sainsbury (@JessLSainsbury).

This week’s @EBNursingBMJ Twitter Chat will be hosted by the @StNurseProject. To join in or follow the chat please add #ebnjc and #StNProject to your tweets.

The health and well-being of any workforce, yet alone a nursing workforce, is a vast topic that we will find tricky to cover in an hours’ worth of conversation on twitter. However, I hope that the discussion sparked in our chat on Wednesday evening will empower you (the nurse or the student nurse) to take control of your health and well-being if you do not have control at present. You can do this.
Nursing starts whilst you are a student, yet it has been found that the health profile of pre-registration nurses is poor despite significant education relating to health promotion and health behaviours as part and parcel of their nurse education. It appears that the knowledge that is bestowed upon this group, is not transferred to their own behaviour (Blake et al., 2011).

Furthermore, achieving work-life balance has been reported to be a specific challenge for student nurses, claiming that it was difficult to balance commitments of placement, university, and home life (The Burdett Trust for Nursing, 2017). Do you have difficulties achieving work life balance? And do you think it is different for registered and student nurses?

In 2013, the Royal College of Nursing surveyed nursing staff and found that nearly 50% of all respondents had noted an increase in stress levels in the last twelve months. The main reasons for increased stress levels included staff shortages, high workload, not having enough time to perform their role, and not having enough time for breaks (Royal College of Nursing, 2013). In addition to this, findings show that there are approximately 40,000 registered nurse vacancies in England with the vacancy rate having nearly doubled in a period of three years (Royal College of Nursing, 2017, p.16). Do you feel that the mental health of the nursing workforce is impacted by staffing pressures?

When you travel on an aeroplane, during the safety announcements you are told to put your own oxygen mask on before helping others. Because you are unable to look after others’ safety before you’ve looked after your own. So why is it that nursing staff are regularly missing breaks and not looking after their basic physiological needs (nutrition, hydration, rest) McLeod (2012)? What are the barriers to achieving health and well-being in your workplace?

Nursing staff report that health and well-being is essential for the care they provide, and if they didn’t feel well in themselves and weren’t looking out for themselves both physically and mentally, they felt hypocritical when promoting health to their patients (The Burdett Trust for Nursing, 2017). Should nurses be role models for good health and well-being? What should this look like?

Wellness is much more than simply being free from illness. “Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” (World Health Organisation, 2019). What steps do you plan to take to achieve and maintain personal wellness?

Questions for our chat
• 1) Do you have difficulties achieving work life balance? And do you think it is different for registered and student nurses?
• 2) Do you feel that the mental health of the nursing workforce is impacted by staffing pressures?
• 3) What are the barriers to achieving health and well-being in your workplace?
• 4) Should nurses be role models for good health and well-being? What should this look like?
• 5) What steps do you plan to take to achieve and maintain personal wellness?

Post-chat summary

Thank you to everyone who made our twitter chat on 20 February 2019 such a great success.  Here is a summary of what we chatted about.

Work-life balance is important to everyone but time at home can be disturbed when you feel guilty about not accepting an agency shift to help short-staffed colleagues.

It is important for the University to help students develop wellness habits and coping skills.

  • Support for those with learning disabilities and general support for student well-being (and check out #DLTips)
  • Time management
  • Not feeling guilt if you need time off
  • Making sure we talk about wellness every time we meet with a student
  • Well-being sessions (e.g. a walk and talk group)
  • Understanding how stressful it can be to be a student
  • Appreciating many students must seek paid employment over and above course requirements
  • Greater preparation for transition to NQN
  • Learning to switch off (including social media)
  • Appreciating that sick time may mean not being sick yourself but looking after others

Employers should support staff.  There are not just links to ill-health but also benefits for recruitment and retention.

Some unhealthy workplace habits include

  • Judging people as ‘lazy’ without checking out what the issue is
  • Inconsistent messages (water allowed/not allowed)
  • Judgemental staff
  • Failing to listen
  • Focus on hours achieved (as a student)
  • Focus on overweight as an issue (“Wellness is so much more than your BMI”)
  • Talking about occupational health referral as if it is a punishment

Ideas for de-stressing and promoting well-being included

  • Journaling to ‘dump’ daily stresses and help promote good sleep and to record important events or reflect on them
  • A gardening club, gardening and enjoying nature on (dog) walks
  • Being surrounded by nature and plants at work
  • Spending time with others, seeing family and friends
  • Taking a lunch break (applies to all nurses, not just those who work clinically)
  • Using a mantra e.g. I must be kind to myself
  • Apps such as Headspace
  • Stretching and yoga/exercise
  • Eating well
  • Self-care days
  • Mindfulness (see the #ebnjc feed for some specific recommendations of books)
  • Being open with work if there is a problem
  • A good bedtime routine
  • Schwartz rounds and de-briefs
  • Not taking on too many shifts

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