Stress is a sweeping term describing different feelings, behaviours and symptoms that are often a typical reaction to challenging circumstances.
Analysis by the RCN reveals that for nursing staff, stress-related illnesses accounted for nearly a quarter (24.3%) of the 7 million days lost to sickness in 2023 – more than double any other kind of illness.
It’s equivalent to 350,000 nursing staff and health visitors taking an extra week off a year because of stress, anxiety or depression.
What are the signs?
Everyone responds differently to stress, so the signs and symptoms can vary from manageable to debilitating.
Stress triggers a “fight or flight” response in the body, which releases adrenaline and in a potentially threatening situation this may save your life.
However, living in a heightened state isn’t good for you, and your body may begin to signal this to you in various ways:
- restlessness, sleeplessness or waking early and not being able to go back to sleep
- increased irritability and loss of emotional stability; crying more or doubting your decisions at work
- eating more unhealthy foods, drinking more alcohol or smoking more
- physical symptoms such as headaches, breathlessness and unexplained fatigue.
You should seek support from your manager or speak to your GP if you have any of these symptoms.
How can I practise self-care?
- With your body. Eating a variety of different, nutrient-dense foods (think fruit and vegetables, rice, pasta and protein) and reducing alcohol intake will allow your body to get what it needs and prevent illness. Exercising triggers the release of natural mood elevators – endorphins and serotonin – which can reduce tension, stress, and encourage better sleep.
- In your mind. Writing a few simple thoughts down on paper at the end of the working day has been proven to be a useful way to reduce stress and “let things go”. Saying “no” to extra demands and responsibilities at work and at home allows you to feel more in control and reduce stress.
- At work. Taking a break is important. Although you may be busy, part of your responsibility and your employer’s duty is to ensure you can take a break. Even short breaks can prevent stress building up. Asking for help or extra time to complete a task when needed should be something you’re able to do at work and not be afraid to ask for.
How can I reduce stress during winter?
For health care staff, the period between October and March is when the highest rates of staff sickness are recorded, mainly due to the increase in viruses such as colds and flu.
The combination of patient demand, a higher infection risk, and extra duties at work due to last-minute staff shortages, can significantly strain the physical and mental wellbeing of nursing staff. Issues arise when demand becomes unsustainable.
Staff shouldn't assume they're powerless to change anything
“Work-related stress is real,” says Leona Cameron, RCN Head of Health, Safety and Wellbeing.
“The busier winter season may highlight more general workplace issues that exacerbate stress, so nursing staff shouldn’t assume they’re powerless to change anything as it could be a wider issue.”
Leona says managers should plan rotas to allow for the busier season with extra bank staff and ensuring teams have clear expectations.
There should be information on where staff can access support if stressed.
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“Nursing staff might expect some stress during work, especially if they’re going through a busy shift, or if there’s a shortage of staff,” says Leona. “Issues arise when demand becomes unsustainable, with employers not fulfilling their duty leading to moral distress for staff.”
What’s my employer's responsibility?
NHS data from winter 2024 showed record-breaking patient numbers in hospitals meant nursing staff were “pushed to the edge” as a surge of winter viruses meant more than 95% of adult beds were occupied.
Employers have a duty of care to ensure the risk of work-related stress is minimal – this includes throughout the winter season.
Check if work-related stress is on your employer’s risk register and whether there’s a risk assessment tool in place.
“If there’s no risk assessment for stress, refer them to the HSE website for guidance or raise it with your manager or rep,” says Leona. “Make sure you record unsustainable demand on your employer's own reporting system if you’re feeling overwhelmed.”
Employers aren't putting the tools in place to support staff
The HSE/HSENI Management of Stress Standards state employers should address the causes of work-related stress, while supporting individuals experiencing difficulties as a result.
The six key areas identified by HSE/HSENI that can be causes of work-related stress include demand, control and manager support. During winter, these areas can be particularly relevant for nursing staff.
How can managers support staff?
Leona reiterates the importance of reducing the stigma of reporting sickness absence due to stress, and building a culture where staff can speak up if feeling the strain through regular meetings.
“Work-related stress is one of the biggest reasons for staff sickness within the health sector and many employers aren’t putting the tools in place to support staff.”
Leona suggests simple solutions, such as managers listening to staff concerns and working with them to find solutions. In some workplaces, it could be a change of culture that’s needed.
“Many people feel unable to ask for flexible working for example, which, if granted, could relieve stress and reduce the number of days a person might be off sick,” says Leona.
Leona’s workplace stress tips
- Legal duty: your employer has a duty of care to keep you safe at work; this includes work-related stress. Check if your employer has a work-related stress risk assessment in place, if not, make sure you raise it with your manager or speak to your RCN rep.
- Resilience and stigma: while you should ensure you’re eating well, staying hydrated and resting for overall wellbeing, work-related stress isn’t yours to manage alone. Your employer needs to support you.
- Reporting and data: if you’re feeling stressed at work – record it. Tell your manager and rep. If there’s a pattern or trend for colleagues taking sick leave for stress-related reasons, the employer should be using the data to put measures in place to reduce it.
More information
- For more support around managing stress, speak to someone in the RCN advice team or check our guides.
- The RCN has a work-related stress guide specifically for managers covering all aspects of HSE guidance.
- The RCN’s Nursing Workforce Standards can be used to challenge issues in the workplace and have guidance on safe and effective care.
- General advice around managing stress as nursing staff.
