The Mental Health and Wellbeing of Nurses and Midwives …

1 The Mental Health and Wellbeing of Nurses and Midwives in the united KingdomProfessor Gail Kinman, Dr Kevin Teoh and Professor Anne HarrissJuly 2020In association with2 THE Mental Health AND Wellbeing OF Nurses AND Midwives IN THE united KINGDOMAUTHORSP rofessor Gail Kinman, Dr Kevin Teoh and Professor Anne HarrissACKNOWLEDGMENTS We would like to express our gratitude to The Society of Occupational Medicine (SOM) for supporting this project from inception to fruition. We are also grateful to the members of the Steering Group for their invaluable guidance and suggestions throughout the course of this project.

2 Thanks are also due to the members of the Advisory Group who participated in the Delphi Study. We also wish to thank Chris Robus of the University of Bedfordshire for his help in managing the Delphi study and Ann Caluori of the SOM for proofreading the final report. COVID-19 will have further detracted from the Mental Health of Nurses and Midwives , as detailed in this report. 2020 is the International Year of the nurse and Midwife, and this must now be a priority. Professor Anne Harriss President, The Society of Occupational Medicine This report is very timely and clearly shows that the stress of work leads to long term and widespread Mental Health problems and burnout among Nurses and Midwives .

3 While the report was written before the COVID-19 pandemic, the situation has further highlighted how essential it is for Nurses and Midwives to have supportive work environments. It is really important that policy makers and workforce planning take into consideration the recommendations in this report. Helen Donovan Professional Lead for Public Health , Royal College of Nurses3 Executive summary 4 Urgent action required: what this report means for different stakeholders 6 Introduction 11 Section I.

4 The current state of Mental Wellbeing among Nurses and Midwives in the UK 12 Section II: Factors that influence the Mental Health and Wellbeing of Nurses and Midwives 18 Section III: The wider implications of Mental Health and Wellbeing in Nurses and Midwives 28 Section IV: Interventions to improve the Mental Health and Wellbeing of Nurses and Midwives 32 Recommendations and conclusion 40 References 48 Appendix 1: Support services and resources for Nurses and Midwives 55 Appendix 2.

5 Methods 58 Appendix 3: Procedure for the Delphi Study 60 Appendix 4: Complete list of recommendations 614 THE Mental Health AND Wellbeing OF Nurses AND Midwives IN THE united KINGDOMEXECUTIVE SUMMARYThis report aims to summarise the research evidence on the Mental Health and Wellbeing of Nurses and Midwives working in the united kingdom . The review was conducted prior to the COVID-19 pandemic.

6 The high levels of work-related stress, burnout and Mental Health problems identified are likely to have risen further due to the exceptional pressure that many Nurses and Midwives are experiencing during the pandemic and will likely increase for some time to come. Many staff are at high risk of post-traumatic stress symptoms and are experiencing moral distress. The prevalence of presenteeism ( working while sick) is also likely to have risen in the sector. The challenges presented by the pandemic and the potential impact on Nurses and Midwives will be considered at various points in the report.

7 The report considers four questions:i. What is the current state and prevalence of Mental ill Health and Wellbeing among Nurses and Midwives ? ii. What are the factors that influence the Mental Health and Wellbeing of Nurses and Midwives ? iii. What impact does the Mental Health and Wellbeing of Nurses and Midwives have on the workforce and patient care? iv. What Mental Health and Wellbeing interventions have been conducted with Nurses and Midwives and how effective are they?A systematic review found 100 studies, published in the last ten years, that shed light on the occupational, organisational and individual factors that influence the Mental Health and Wellbeing of Nurses and Midwives and the implications for the workforce and the quality of patient care.

8 Interventions that have the potential to improve the Wellbeing of Nurses and Midwives are also considered. Key findings include: Nurses and Midwives are at considerable risk of work-related stress, burnout and Mental Health problems such as depression and anxiety. The risk, including the rate of suicide among female Nurses , is greater than that of the general working population. Rates of poor Mental Health appear to be increasing in response to rising demands, staffing shortages and diminishing resources. These pressures are often systemic in nature and require intervention at public policy and organisational levels.

9 Overall, Nurses and Midwives are deeply engaged in the work they do and strongly motivated to make a positive difference to the lives of patients and their families. Little is known, however, about how these positive aspects of Wellbeing can be increased in these professional groups. Nurses and Midwives strive hard to ensure that their working conditions and any stress they may experience does not adversely affect their patients. Nonetheless, there is strong evidence that poor Mental Health and Wellbeing among staff impairs the quality of patient care. Nurses and Midwives are at particularly high risk of moral distress if institutional pressures and constraints stop them from pursuing what they believe to be the most appropriate course of action for their patients.

10 Satisfaction with job demands, control, support and role clarity are lower among Nurses and Midwives than other professional groups in the UK and strongly linked to stress and burnout. Nurses and Midwives are at particularly high risk of harassment and bullying which is a key source of distress. Such experiences appear to have become more common over time, but a culture of silence surrounding this issue has been identified meaning that it is not openly or adequately addressed. Staff from Black and Minority Ethnic (BAME) backgrounds are at greater risk of bullying and harassment than other groups.