Pressures on nursing staff in the UK have become “unsustainable,” according to the Royal College of Nursing (RCN). The RCN said its latest employment survey found a rise in nurses working while they are ill because services are so understaffed.

The survey of more than 20,000 nurses found:

• 66% worked while they should have been on sick leave at least twice in the past year, up from 49% in 2017.
• 65.1% cited stress as their main cause of illness, higher than the rate for cold or viral infections (52.5%).
• 70.4% worked beyond their contracted hours at least once a week, and more than half (52.1%) said this overtime was unpaid.

Staff ‘Broken’ by Chronic Understaffing

The RCN said that the numbers reporting working whilst sick and citing stress as the leading cause of illness both hit 8-year highs. 

The College said that the findings point to the “impossible task” of meeting rising demand with too few staff. Nurses reported feeling “broken” by feeling obliged to work through illness amid chronic understaffing.

The RCN advice line is now receiving an average of six calls a day from members seeking help over understaffing and workplace pressures. It said this is probably an underestimate of the scale of the problem.

Nurses described having panic attacks, nightmares, and exhaustion. Some felt unable to take meal or bathroom breaks, while others avoided annual leave because their departments were already overwhelmed. 

Impact on Care Quality and Staff Health

The RCN said the situation is harming both staff well-being and patient safety, noting that “unsustainable pressures on staff” are felt “across the UK and in all settings.”

Earlier this year, a separate RCN report found patient-to-nurse ratios in acute settings reaching as high as 50-to-1.

RCN general secretary and chief executive Professor Nicola Ranger, said, “Nursing staff are being driven to ill health from working in understaffed and underresourced services. And what’s worse, many feel they cannot take time off for fear of leaving their colleagues at the mercy of brutal pressures. This simply isn’t sustainable.” 

A Department of Health and Social Care (DHSC) spokesperson told Medscape News UK by email: “We hugely value the work of talented nurses, and through our 10-Year Health Plan, we are taking action to improve conditions for the overworked and demoralised workforce we inherited. 

“That includes rolling out high-quality occupational health support, introducing new staff standards to make sure flexible working is more widely available, and cracking down on violence, racism, and sexual harassment in the workplace.”

RCN Calls for Safety-Critical Nurse-Patient Ratios

The RCN reiterated its call for new investment to grow the nursing workforce and introduce “safety-critical nurse-patient ratios” across all settings.

There are currently more than 25,000 NHS nursing vacancies in England. 

The DHSC said its “graduate guarantee,” announced in August, will create “better job opportunities for qualified nurses and midwives” and ease pressure on existing staff.

Dr Sheena Meredith is an established medical writer, editor, and consultant in healthcare communications, with extensive experience writing for medical professionals and the general public. She is qualified in medicine and in law and medical ethics.