Staff wellbeing

The wellbeing of nursing and midwifery staff has a significant impact on the healthcare system and the quality of the care that patients receive. Healthcare professionals who report high scores on wellbeing measures tend to stay in their jobs longer, describe more resiliency, and demonstrate more caring behaviours towards patients (53). Staff that describe high resiliency tend to exhibit less of these negative symptoms of mental distress and utilise positive coping skills to manage workplace stress, with resilience playing a mediating role between the impacts of the job demands of nursing and mental ill-health (64). Thus, the EiC framework prioritises the wellbeing of healthcare staff and includes measures within the CAIR dashboard that concern workforce and ward capacity, and strives to build resiliency through leadership, learning and culture. By creating an environment that supports staff wellbeing, we aim to empower staff to provide compassionate, person-centred care consistently for every patient.

Healthcare professionals’ workloads continue to increase as the healthcare system’s capacity changes due to fiscal changes, ageing population, inadequate staffing, and more (68). These increasing pressures have been associated with poorer staff wellbeing. Nurses and midwives’ physical and mental wellbeing may suffer as a result of their occupation, from increased risk of communicable disease to high rates of adverse mental health problems (depression, anxiety, etc) (57). Rates of psychological ill-health (such as: depression, burnout, and anxiety) have been on the rise in British nursing populations for the last two decades, with some studies reporting rates of mental health symptoms as high as 80 %(64). Mental wellbeing has been additionally tested by the COVID-19 pandemic, challenging an already stretched healthcare system (71).

These high levels of psychological distress are associated with wide-ranging adverse outcomes for patients, the healthcare system and staff themselves. Nurses and midwives’ wellbeing is associated with patient satisfaction, safety, and outcomes, and has been conceptualised as the ‘working conditions-patient outcomes’ relationship (53, 63, 68, 72). In addition to the impact on patient care, staff who report poor mental wellbeing have higher rates of medical leave and increased attrition, with high numbers of healthcare professionals expressing their intentions to leave their current employment or the field of care altogether (53, 56, 63). This attrition increases work burden for the remaining staff and impacts nurse-to-patient ratios, contributing to a negative feedback loop that has implications for patient safety (55, 64). Given the association between staff wellbeing and the quality of care, EiC is coordinating with the Healthcare Staffing Programme, ensuring that its objectives aligned with the Health and Care (Staffing) (Scotland) Act 2019.