What are the effects of stress on nurses?

Nurses are the backbone of the healthcare system, providing essential patient care and support. However, the demanding nature of the nursing profession can take a toll on nurses’ well-being and mental health. In fact, stress is a significant concern for nursing staff across the UK’s healthcare systems. According to The King’s Fund, an independent healthcare think-tank:

• 40% of nurses feel burnt out because of their work.
• 52% feel unwell as a result of work-related stress.
• 34% often think about leaving their jobs.

And research suggests that this trend is worsening. According to a 2023 survey by the Nursing Times, two in five nursing staff say their mental health is worse now than it was during the peaks of the coronavirus pandemic:

“A stark 61% of respondents said their mental health had deteriorated since the outbreak of the Covid-19 pandemic,” says the Nursing Times in an article about the results of its questionnaire. “Perhaps more alarming still, 40% said their mental health and well-being was ‘worse’ or ‘much worse’ now than compared with the peaks of the pandemic in 2020 and 2021. Furthermore, 62% of respondents described their colleagues’ morale as ‘poor’ or ‘very poor’.”

To mitigate the effects of stress on nursing staff, it is crucial to first identify the determinants of stress and to then implement effective interventions. Doing so benefits both nurses and the broader healthcare profession – and addressing nursing stress is essential for maintaining a high standard of healthcare for everyone.

Understanding the main causes of stress for nurses

Nursing is a rewarding profession but a challenging one, too, exposing its professionals to various stressors. These can include:

• The work environment. Working conditions in healthcare settings can be fast-paced, chaotic, and emotionally charged. Nurses often face long shifts, heavy workloads, and limited resources, and they are required to navigate extraordinarily stressful situations. For example, hospital nurses providing nursing care in intensive care units routinely have to cope with demanding and even traumatic situations. All of this, unsurprisingly, can lead to increased workplace stress levels.
• High job demands. Nurses are responsible for providing quality patient care and social support, critical care decision-making, and managing complex medical cases. This pressure to perform at a high standard can often lead to stress and burnout.
• Shift work. Irregular and overnight shifts disrupt nurses' circadian rhythms, leading to sleep disturbances and even physical health concerns. Shift work can also impact nurses’ work-life balance, which can have a negative effect on nurses’ quality of life.
• Emotional exhaustion. Nurses frequently deal with emotionally distressing situations and behaviours, such as patient suffering and loss. Constant exposure to these situations can lead to emotional exhaustion and compassion fatigue.
• Staffing issues. Shortages of nursing staff and other healthcare workers can result in higher workloads for those on duty, increasing stress levels. And inadequate staffing affects nurses' ability to provide quality patient care.
• Interpersonal conflicts. Conflicts with co-workers or patients can be an additional source of stress. 

Why is it important to understand the impact of stress on nursing staff?

Stress can have a significantly detrimental impact on nurses’ own health and well-being. It can also have several knock-on consequences within the wider healthcare profession, including:

• Greater strain on the healthcare system. High levels of stress is often associated with higher levels of absenteeism and turnover rates in nursing staff, as well as poorer job performance, all of which can greatly strain health services. The recruitment and retention of nurses also becomes more challenging in this kind of environment, further straining nursing care and healthcare resources – particularly when replacing experienced nurses. 
• Deteriorating quality of patient care. There are clear links between greater strain on healthcare systems and a lower quality of care. And as care quality declines, so do patient outcomes, and patient safety can also be compromised. For example, errors in medication administration or patient assessments can occur when nurses are overwhelmed.
• Wider public health issues. The healthcare system's ability to respond to public health crises, such as the COVID-19 pandemic, relies heavily on the well-being of its nursing staff – and stressed and burned-out nurses are likely to be less effective in times of crisis.

How to reduce nurses’ stress levels

It’s clear that reducing job stress among nursing staff is essential for improving nurses’ job satisfaction and well-being as well as patient care and the effectiveness of the overall healthcare system.

Strategies for reducing stress for nurses include:

• Offering stress management programmes. Hospitals and healthcare facilities can implement stress management programmes that teach nurses coping effective strategies for managing occupational stress, as well as techniques for personal resilience-building.
• Creating a supportive work environment. Promoting a culture of support and open communication is crucial for creating a better work experience for nurses and other health professionals. It should encourage nurses to seek help when it’s needed and ideally provide access to counselling services.
• Ensuring adequate staffing. Addressing staffing shortages to reduce workloads and prevent burnout is key and can make a significant difference to nurses’ stress scores. 
• Providing relevant education and training. Healthcare providers routinely offer ongoing education and training to nurses to help them deliver the best possible care, but nursing studies should also focus on nurses’ own care, with a focus on self-care and emotional resilience.
• Promoting a healthy work-life balance. It’s essential to encourage a good work-life balance. For example, this might include providing flexible scheduling options or encouraging staff to use their annual leave. 
• Establishing peer support networks. Peer support can be hugely beneficial for the nursing demographic, offering nurses a safe space to discuss their experiences and share coping strategies with their colleagues.
• Developing strong leadership support. Nursing management should be supportive and empathetic towards the challenges nurses face, understanding the predictors of stress and other related factors that influence nurses’ well-being. 

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