New guide calls on NHS leaders to promote nurse wellbeing

The quick guide, published yesterday by the University of Surrey, aims to help nurses, midwives and paramedics to thrive at work and deliver high-quality care to patients, often in challenging and emotionally taxing circumstances.

“We want it to be used, we want it to get out there and we want to change practice”

Jill Maben

It has made six recommendations targeted at NHS wellbeing guardians, trust executive boards, senior staff, team managers and anyone else looking to improve the psychological health of nurses, midwives and paramedics.

Its publication comes as a result of a study that was conducted in 2020-22 and sought to understand why psychological ill-health persists despite interventions to prevent it.

The final version of this study, which was funded by the National Institute for Health and Care Research (NIHR), is due to be published at the start of 2024.

Professor Jill Maben, co-lead author of the guide and professor of health services research and nursing at Surrey, said the guide was intended to “shift the dial” on who was responsible for looking after nurses’ psychological wellbeing.

“I think we already knew that a lot of the responsibility for keeping oneself well, and looking after oneself, has lain with individuals,” she told Nursing Times.

“Of course there’s a place for that, but it cannot only be the responsibility of individuals,” said Professor Maben.

One of the recommendations in the guide is a call for a systems approach to staff support, in order to make sure that the psychological health of staff is “a collective endeavour”.

Professor Maben said: “We need a whole systems approach and a whole organisational approach – this is everybody’s business.

“This has to be front and centre at everybody’s thinking at board level, about how we are going to retain staff, how we are going to give good care and how we are going to make staff thrive at work.”

The guide also recommended that psychological health management should be “normalised and anticipated”, so that strategies and early interventions can be put in place to mitigate risks of psychological ill-health.

Professor Maben said: “If we think about the intensity and the emotional labour of the work that we do, where we have moral distress [and] you can’t always give the care you want to give, that’s going to take its toll.”

She said nursing, midwifery and paramedics were sometimes “stressful [and] difficult professions” and, therefore, psychological health needed to be “planned from the minute students walk in the door”.

The guide also recommended that trust leaders prioritise the essential needs of staff, to ensure that access to food, rest areas and appropriate resources were met.

Jill Maben

Professor Maben highlighted this priority and said she wanted the guide to show that it was “okay to put your needs first” and “look after yourself”.

“It’s not always easy to take a break, to go and get a drink or get some food, or even go and have a bathroom break because you’re so busy and understaffed,” she said.

“But if you don’t look after yourself, you can’t look after others,” she noted.

Other recommendations in the guide include giving equal emphasis to psychological and physical harm, investing in future leaders with a focus on compassionate, inclusive leadership and fostering a learning culture over a blame culture.

The guide was launched on Thursday at an online event with over 150 attendees from a variety of trusts and professions.

Professor Maben said senior leaders attending the event had been “tasked with disseminating the guide and getting it out into the system”.

She added: “A lot of work has gone into making this accessible, user-friendly and useful – that’s what we want. We want it to be used, we want it to get out there and we want to change practice.”

This is the third project that Professor Maben’s has launched this autumn around nurse wellbeing.

Earlier this year, her University of Surrey team published a guide to address bullying in the health service, as well as research about the impact that the Covid-19 pandemic had on the nursing workforce.