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Nurses’ mental ill health is pushing up sickness absence, yet many staff struggle into work because of insensitive workplace policy
NHS sickness absence rates are rising, with mental ill health a leading cause. The NHS needs to have policies and procedures in place to function effectively but do these policies function as they should, especially in relation to mental health?
Nursing Standard. 39, 1, 27-27. doi: 10.7748/ns.39.1.27.s14
Published: 03 January 2024
The Once for Scotland policies cover all of Scotland’s health boards. The attendance policy standardises staff absence processes. But is a blanket approach appropriate for all sickness absences?
At least NHS policies offer some protection and benefit – some private sector employers offer even less to their sick staff. Yet despite these policies, it is still common for nurses in the NHS to carry on working when they should be off.
Some of them fear the sickness policy and its implications, with dismissal being the most extreme. When sick nurses come to work they are putting themselves, colleagues and patients at risk.
NHS Employers states staff should be symptom-free for 48 hours before returning to work when they have had sickness and/or diarrhoea. However, it does not advise a timeframe to return after, for example, a cold or flu. In such situations, nurses may carry on working possibly making themselves worse, through fear of letting people down. And the same is surely true of mental health issues.
We have a professional obligation to prioritise our patients, but we also have an obligation to ourselves to ensure we stay well enough to practise safely and effectively. But nurses often put their patients’ health ahead of their own mental health and well-being, which can lead to burnout. Some may worry about stigma or believe a decline in mental health and well-being does not warrant absence.
NHS Employers recognises that mental health can fluctuate in the same way physical health can. It offers recommendations to encourage positive well-being, including the use of reasonable adjustments. But it is not explicit about entitlement to time off.
Certain physical conditions, such as a sickness bug, have a quick recovery time. Analgesia or medication can be prescribed for pain. But it is not as easy and can take much longer to get our mental health and well-being back to where it should be.
At the RCN’s 2023 congress, members voted to lobby for an integrated suicide prevention programme for UK nurses. Yet recently, mental health leaders have raised concerns over the loss of mental health hubs to support nursing staff. Mental health sick days and suicide among nurses continue to rise, but where is the investment to tackle this? And are workplace policies doing enough?
Everyone’s mental health is different and this means their recovery and recuperation from a decline or change is also different. Some nurses return to work too soon or do not take time off because they believe they do not deserve it. Others feel they cannot take time off sick because this adds to the pressures already faced by the NHS.
Is a ‘one size fits all’ policy appropriate? Workplace policies that are explicit in their treatment and prioritisation of mental health would be a good start, but there needs to be a culture shift too. A change in policy has limited relevance when nurses continue to work when sick regardless.
NHS England sickness statistics show anxiety, depression and other mental health conditions were the most reported reason for absence in March 2023, accounting for 507,100 full-time-equivalent days lost. What causes NHS staff to be absent for these reasons? And is there more the NHS can do?
There has been talk of the NHS considering a four-day working week in a bid to try to increase productivity, reduce sickness and improve retention while increasing recruitment, and making the NHS a more attractive workplace. However, nurses have been quick to question the feasibility of this, given the ongoing staff crisis.
The NHS England Long Term Workforce Plan is a long-overdue commitment to address the many crises in the health service, including staffing. The plan promises a big recruitment drive and a programme of strategic workforce planning.
With more nurses than ever leaving the profession, care, compassion, understanding, empathy and leadership need to be shown and practised in relation to nurses’ health and sick leave. Nurses deserve to be supported, valued and able to take time off sick when they need it.
Nurses’ well-being: ‘burnout’ too gentle a term for mental distress rcni.com/burnout-distress
