Every year on 28 April, International Workers’ Memorial Day (IWMD) is a time when trade unions around the world come together to “remember the dead and fight for the living.”

While emotive to some, this phrase reflects a stark reality: people still die because of their work, or are exposed to conditions that damage their health and shorten lives. That is why trades unions continue to speak out against harm that is predictable and preventable.

Each year, the International Trade Union Confederation (ITUC) sets a theme for IWMD. This year’s focus is psychosocial risks, with a clear message: work-related stress must be treated as seriously as physical danger.

In the UK, the scale of the issue is undeniable. Health and Safety Executive (HSE) figures show that in 2024/25, 964,000 workers suffered from work-related stress, depression or anxiety, accounting for 52% of all work-related ill health cases.

Within the NHS, staff experience reflects these figures. The NHS Workforce Survey consistently shows high levels of stress, with staff reporting that work negatively affects their wellbeing. Nursing staff frequently describe burnout, emotional exhaustion and an inability to provide the standard of care they believe patients deserve. Unsafe workloads, inadequate rest and relentless pressure affect both professional performance and personal lives.

Crucially, this stress is not an individual failing - it is systemic. Nursing staff are not leaving because they “can’t cope”; they are leaving because the system repeatedly demands more with less. This is reinforced by the RCN 2025 Employment Survey, where 62.8% of respondents agreed that they feel under too much pressure at work.

One nurse’s testimony illustrates this lived reality:

“My own health needs and disabilities are used against me. They don’t understand the correlation between work stress and how this impacts staff on a personal, emotional, physical and socio-economic level. Holistic care is preached, yet when it comes to staff nobody cares. I have experienced micromanagement, bullying that is hard to prove, unfair and unprofessional treatment and want to leave my career due to this. I have chronic physical and mental health issues and when off sick I get ‘reminded’ of how my absence affects the service and my team - I stress about this enough and don’t need it.”

Clinical Nurse Specialist, NHS community setting, West Midlands

Nursing is fundamental to our health and care system. Every day, nursing staff support patients, service users and families. Yet some of the greatest threats to nursing staff's wellbeing are less visible, under-recognised, and long-lasting.

Psychosocial risks arise from how work is designed, organised, managed, and experienced. For nurses, these risks are embedded in daily practice: chronic understaffing, excessive workloads, long shifts, moral distress, exposure to trauma, violence and abuse, insufficient rest, and a culture where an individual’s ability to “cope” is somehow a reflection of their failure and a need for them to become more “resilient”. Work-related stress is not about being resilient. It is a known hazard which employers must proactively manage and mitigate against potential harm occurring.

Unlike physical hazards, psychosocial risks rarely cause immediate injury. Instead, harm accumulates over time, contributing to stress, burnout, anxiety and depression - and in some cases long-term sickness absence or suicide. When we talk about workers dying because of work, we must include those whose mental health has been eroded by relentless occupational stress.

This was starkly highlighted in the RCN’s 2024 report Understanding the factors underpinning suicidal ideation amongst the UK nursing workforce (2022–2024). The report demonstrates how unmanaged psychosocial risks can severely damage mental health and contribute to suicidal thoughts. Doing a job you love should never cost you your wellbeing - or your life.

On International Workers’ Memorial Day, this evidence should serve as a warning. Stress is not about morale alone; it is a workplace health and safety issue.

There is also a clear link between staff wellbeing and patient safety. Exhausted nursing staff face a greater risk of error, injury, compassion fatigue and moral injury. Unsafe staffing increases psychosocial risk, leading to sickness absence and retention problems - which in turn place even greater pressure on remaining staff.

The HSE recognises work-related stress as preventable and provides Management Standards to help employers control risk. These align closely with the RCN Nursing Workforce Standards, which set out what is needed for safe and sustainable practice, including:

• Safe and effective staffing levels
• Appropriate skill mix
• Manageable workloads
• Access to rest breaks and support
• A culture that values wellbeing
• Leadership that listens and acts

These are not aspirational ideals; they are preventative controls. Where they are ignored, harm increases. Where they are implemented, stress reduces, retention improves, and patient care is safer.

International Workers’ Memorial Day reminds us that prevention saves lives. The day is not only about remembrance, but commitment - to safer work, stronger protections and learning from harm. For nursing, this means recognising that work-related stress is predictable, psychosocial risks are identifiable and harm is preventable.

Risk assessments must properly consider psychosocial hazards. Staffing decisions must be evidence based. Wellbeing policies must be backed by real action, not posters or resilience training alone.

Nursing staff advocate every day for our patients. IWMD asks us to turn that advocacy inward: to insist the workforce is valued, protected and kept safe.

We remember colleagues who have died due to their work, including those lost to stress-related illness. We stand with affected families and communities. And we call for meaningful change.

Honouring workers means safe staffing, psychological safety and working conditions that do not damage lives. If we want a safer NHS, psychosocial risk must be treated with the same seriousness as any other occupational hazard, today and every day.

The RCN has a range of resources on work-related stress. If you need support, contact the Samaritans on 116 123, access the RCN Counselling Service, or speak to your Employee Assistance Programme. In an emergency, call 999.