Who looks after the nurses?

Nurses, the major part of the workforce charged with caring for the state’s health, are affected by chronic disease, back pain, obesity or overweight, mental illness and extreme fatigue – but still see themselves as in good health.
Fiona McGill reports that a study of 5000 NSW nurses presents a good news-bad news story for health managers and governments grappling with the policy challenges of caring for an ageing population.
Frontline nurses reported a high level of job satisfaction, an important indicator of quality of care and intention to remain in the workforce. But they also reported a host of health symptoms and diseases.
Nearly two-thirds of nurses surveyed had at least one chronic illness – particularly anxiety and depression, arthritis, cardiovascular disease and respiratory disease such as asthma; almost half suffered from back pain; and almost half described themselves as “severely tired”. Headaches and poor sleep were among other symptoms commonly reported.
Nurses make up the oldest sector of the Australian health workforce, with an average age significantly higher than that of medical, pharmacy and therapy staff. The World Health Organisation acknowledges the nursing industry worldwide is on the brink of a staffing crisis. In Australia, workforce projections indicate a shortfall of more than 120,000 registered nurses by 2025.
“The first thing we looked at was what influenced intention to leave because maintenance of the workforce is a key consideration,” says study leader Lin Perry, who is professor of nursing research at the University of Technology Sydney (UTS). Older nurses were more likely to stay, the study found, but only if they were in good health.
“We have a workforce that works very hard, and that comes out in the low levels of vitality [reported in the survey], in the tiredness, the number and range of symptoms they suffer.”
Professor Perry’s research project, “Fit for the future”, was conducted in partnership with the NSW Nurses and Midwives’ Association, which has more than 60,000 members. It canvassed registered nurses and midwives and enrolled nurses in NSW. Most respondents were women, reflecting the demographic profile of the workforce, with a mean age of 48.
It followed pilot studies at two Sydney hospitals which “showed us some things [about nurses’ mental and physical health] that were potentially concerning”, she says.
Those anonymous studies also showed the extent of nurses’ sensitivity about revealing personal health information, says Professor Perry. “I had a couple of people text me saying – particularly around mental health and bullying – these are my answers to your questions. I’m not going to put it on paper. Don’t try to track this phone number – I’m using a friend’s phone.”
Professor Perry says other important findings include:

• Very poor workplace access to fresh food and nutritious cooked meals, especially for shift workers; many nurses do not have access to a fridge or kettle and rely on vending machines and takeaway food


• Take-up of health screening, such as mammogram, pap smear and bowel cancer screening, above the general population average but still inadequate


• Rates of depression and anxiety higher than the general population – a high level of stigma attached to reporting mental illness.

“There’s a lot of stress and strain that is intrinsic to looking after people and their families, often at what is the worst, most stressful point in their lives … in a system that is creaking under the increasing weight of chronic disease,” says Professor Perry.
“It’s recognised that this is a stressful occupation, but it’s not adequate just to accept that.

“What we don’t do particularly well is support the workforce … as health professionals. We’re not expected to have problems ourselves.”

Mark Kearin, member organising manager for the NSW Nurses and Midwives’ Association, says members have been raising concerns about proposed changes to the retirement age, given how physically demanding their job can be. He says nurses and midwives frequently report that their workloads mean they miss meals and breaks or seek food that is easily and quickly accessible.
He says the association hopes this “vitally important research” will be used in the development of strategies to support this health workforce.
Kearin points to data from the Australian Institute of Health and Welfare that shows there are more employed nurses and midwives aged 50 to 54 than in any other age group.
“Older nurses and midwives have a wealth of knowledge that can be shared with junior nurses and midwives,” he says.
Professor Perry says: “We pay a lot of attention to the fact that our population is ageing and the prevalence of chronic disease is increasing – and the implications of that. Yet we pay very little attention to the fact that our nursing workforce is ageing.
“Our ageing nurses have got the same problems as our ageing population, plus the problems caused by stressful, hard, physical work.
“We have opportunities here that at the moment we’re not taking advantage of … to help and support this important workforce to remain healthy.”
This article was originally published by the University of Technology Sydney.