Introduction
Strikes by its nursing staff in 2022 and 2023 presented a new challenge for the National Health Service (NHS) in the United Kingdom, known for its dedication to providing high-quality healthcare. These walkouts were representative of the growing dissatisfaction and fatigue among nurses across the country, and they prompted an in-depth analysis of the causes of this unrest. Last year was a watershed moment in the history of the National Health Service (NHS) when the Royal College of Nursing (RCN) coordinated the first UK-wide strike in over a century. It was not a hasty choice to go on strike; rather, it was a group reaction to a perfect storm of factors, including exhaustion, poor working conditions, and financial hardships. The backbone of the healthcare system, nurses, struggled under the weight of their obligations in an unsupportive work environment. The health of the healthcare workforce is crucial to the success of the healthcare system as a whole. Nurses’ emotional and physical well-being is put at risk by burnout, substandard working conditions, and financial stress, which in turn negatively affects patient care.
Causes of the NHS Nurses’ Strikes
Burnout and Working Conditions
Dall’Ora et al.’s (2023) cross-sectional study provides insight into the complex connection between shift work features and burnout among nurses, which is crucial for elucidating the reasons for the NHS nurses’ strikes. The results show that nurses who perform long shifts, especially those lasting longer than 12 hours, are at a far higher risk of burnout. Notably, the research extends beyond simply examining shift length to include other important factors, including the frequency with which workers rotate through the night shift, the number of hours they work each week, and the frequency with which they are given time off. It’s intriguing because it suggests that choice may moderate the link between lengthy shifts and increased burnout; not having a say in how long a shift lasts appears to amplify burnout (Dall’Ora et al., 2023). This nuanced approach challenges common thinking, advocating a deeper investigation of the fundamental relationship between choice, shift length, and burnout.
The personal stories of nurses, as shown in the included articles, bring home the human cost of burnout on healthcare personnel in a very tangible way. According to Collins (2022), these testimonies detail the difficulties of balancing job and personal life, having trouble sleeping, and losing weight due to burnout. When doctors and nurses, motivated by a feeling of duty, are prevented from doing their jobs by flaws in the healthcare system, it takes an emotional toll on them. The accounts highlight how burnout is a systemic problem with far-reaching effects on patient care, not just an individual one. While most nurses enter the field because they are passionate about helping others, challenges such as lengthy hours, insufficient staffing levels, and a lack of breaks may have a devastating effect on nurses’ health and, in turn, the quality of healthcare provided to patients. Several factors contribute to burnout, which is measured by the Maslach Burnout Inventory (MBI) (Kalocsányiová et al., 2023), such as emotional weariness, depersonalisation, and diminished personal accomplishment. Emotional exhaustion, or the depletion of emotional resources, was highlighted in the study as a result of lengthy hours and insufficient personnel. Depersonalisation, when nurses become cynical about their patients and the healthcare system, is made worse when they are unable to take breaks. The idea emphasises that burnout is a systemic problem that arises when professionals are unable to properly manage their emotional and physical resources.
Pay and Working Conditions
The financial challenges faced by nurses in the National Health Service (NHS), namely the contrast between inadequate salaries and rising living expenses, constitute a pivotal intersection in comprehending the underlying reasons for the recent strikes. The essay authored by Collins (2022) highlights the perspective of nurses who articulate the inherent contradiction between their dedication to providing quality patient care and the financial obstacles they encounter. The increasing cost of living contributes to a reduction in the purchasing power of nurses’ income, hence exacerbating financial burdens. The economic challenges have implications that transcend beyond individual financial circumstances, impacting the professional domain as well. Nurses who face financial burdens encounter growing difficulties in reconciling their commitment to a demanding profession with the economic circumstances that pose a threat to their welfare. The dissatisfaction of nurses in the National Health Service (NHS) is compounded by the significant disparity between the suggested salary increases and the tangible proposals put out by the government. The Royal College of Nursing (RCN) advocated for a 5% increment beyond the inflation rate as measured by the Retail Price Index (RPI), which was recorded at a level exceeding 12% (Dall’Ora et al., 2023).
The proposals presented, however, were much below this standard. Nurses already feel unappreciated and economically mistreated, and this disparity just makes their situation worse. According to the psychological contract, an idea from the field of organisational psychology, employees and employers have mutual obligations. A sense of betrayal and the erosion of trust necessary for a successful employer-employee relationship result from the breaking of this contract, which is represented in the gap between expectations and reality about wage hikes. Pay stagnation has far-reaching effects on NHS nurses’ morale and wellbeing beyond the monetary. According to the work satisfaction hypothesis (Evans et al., 2023), a person’s level of happiness on the job is proportional to the amount of money they make. Low morale and a feeling of unimportance result from what nurses consider to be inadequate pay. Burnout is accelerated by the deterioration of morale, which in turn is fueled by the stressful working circumstances and emotional toll. As nurses battle with the simultaneous demands of financial distress and professional responsibility, the impact reverberates across the healthcare system, hurting not just individual well-being but also the quality of patient care.
Underfunding and Staff Shortages
The National Health Service (NHS) is currently facing a severe crisis characterised by an unprecedented number of job openings and operational interruptions, which have contributed to the recent strikes among nurses. Bryant (2023) asserts that the current healthcare workforce is in a state of permanent tension due to the substantial number of vacant posts. The strain is evident via the manifestation of augmented workloads, compromised quality of patient care, and elevated levels of stress experienced by healthcare personnel. The current circumstances have reached a pivotal point when regular services, such as scheduled surgeries and mental health assistance, are experiencing significant disruptions. The systemic issue at hand not only poses a threat to the welfare of nurses but also leaves the larger healthcare system in a precarious state of instability. The current dilemma in the NHS may be traced back to underfunding and inadequate planning in the past. The actual growth rate of government spending on health and social care slowed dramatically during the austerity era. These difficulties are compounded by the fact that the healthcare system cannot keep up with the expanding needs of a population that is living longer. As head of research at the Health Foundation, Anita Charlesworth’s observation highlights the consequences of underfunding, including increasing bed occupancy rates and a significant decrease in social care availability (Clarke-Ezzidio, 2023) [citation needed]. As a result of years of ignoring the importance in favour of the urgent, the National Health Service is unprepared to deal with the current crisis.
The NHS crisis is exacerbated by a lack of qualified medical personnel, which in turn causes overburdening of doctors and nurses and subpar care for patients. By emphasising the “urgent undermining the important,” Charlesworth highlights a systemic issue in which hospitalisations take precedence over preventative and basic care. This prioritisation, Freedman and Wolf (2023) argue, is contributing to a cycle of resource shortages and increased reliance on outsourcing. With fewer healthcare workers available, the pressure on those who are currently employed in the field to do more with less results in a vicious cycle of burnout and turnover. Patients suffer from subpar treatment, and medical staff, especially nurses, face tremendous obstacles as a result.
Solutions to Address the Causes
Increasing the number of nurses on staff is crucial to reducing the stress experienced by nurses and preventing burnout in the National Health Service. Staffing levels that allow healthcare workers to do their duties without becoming emotionally or physically exhausted are essential. It is critical to implement measures that encourage breaks and deal with understaffing. Policies that demand adequate break periods and solve staffing gaps assist in the restoration of work-life balance and enable nurses to have the necessary leisure to recharge (Collinson, 2023). These measures promote a more positive atmosphere in the workplace while also improving care delivery. Last but not least, it is crucial to advocate for more study into the link between shift duration and choice in order to guide future legislation. Tailoring methods to reduce the negative impacts of lengthy shifts require an understanding of how nurses’ control over shift length intersects with burnout. For a healthcare system to be long-lasting and secure, researchers need to learn how to improve both the health of healthcare providers and the standard of treatment they provide their patients.
Advocating for competitive salaries that keep up with the growing cost of living is an important step towards fixing the NHS’s pay and working conditions problems. Recognising the financial burdens nurses experience, it is crucial to offer a competitive compensation structure in order to recruit and retain qualified nurses. This entails making frequent modifications in response to changes in the economy. Davies et al. (2023) stress the need to set up open systems for salary discussions and suggestions. Transparent procedures guarantee that discussions are just, inclusive, and representative of healthcare professionals’ genuine needs and contributions. This openness increases confidence and reduces conflicts over perceived unfairness. Finally, it is crucial to negotiate with and have open conversations with NHS personnel to resolve their issues. Identifying problems, fostering mutual understanding, and cooperatively developing solutions all need healthcare professionals, government authorities, and relevant stakeholders to actively engage with one another. Healthy workplaces are built on open and honest communication, which in turn may lead to policies that are more in line with the hopes and dreams of the hardworking people who make up the NHS.
Immediate steps should be taken to raise funding and devote greater resources to the NHS in order to solve the continuing difficulties of underfunding and personnel shortages within the NHS. Specific investments in personnel, machinery, and infrastructure are also part of this plan. The recruitment of new healthcare workers, the maintenance of the current workforce, and the improvement of overall patient care all require sufficient money (Evans et al., 2023). Second, if you want to fix the problems that lead to a lack of employees, you need a long-term strategic strategy. Efforts in this direction include expanding healthcare training opportunities, developing career ladders, and enhancing the hiring process. Improving working conditions, cultivating a positive work culture, and enacting retention techniques should all be the central goals of any comprehensive workforce strategy. Long-term viability requires proactive steps to bring the healthcare system’s capacity in line with the public’s changing demands. The National Health Service (NHS) hopes to create a healthcare system that can keep up with the needs of its hardworking employees and the people they serve by combining short-term budgetary interventions with long-term strategic planning.
Conclusion
Strikes by nurses in the NHS in 2022 and 2023 brought attention to the urgent need for systemic changes to the healthcare industry, such as the elimination of burnout, the improvement of working conditions, the increase of financing, and the reduction of financial and human resource difficulties. The strikes, which have involved nurses from all around the UK and the Royal College of Nursing, have drawn attention to systemic problems within the nursing profession. Nurses’ mental health and the quality of patient care are at risk due to burnout and poor working circumstances. Consistently low wages contribute to a depressing atmosphere at work. Inadequate resources and a lack of qualified personnel threaten the future of the healthcare system as a whole. In order to tackle these obstacles, a comprehensive strategy is required, which consists of augmenting personnel levels, advocating for equitable compensation, instituting transparent procedures for wage negotiations, and executing strategic initiatives to rectify insufficient funding and personnel deficiencies, in addition to advocating for policies that remediate breaks and inadequate staffing. Nurses in the NHS are some of the hardest working people in the world, and they deserve a healthcare system that puts them first. Developing a healthcare system that is long-lasting, helpful, and patient-centred requires teamwork among medical experts, government officials, and other interested parties.
References
Bryant, M. (2023). ‘It’s soul destroying’: why so many NHS staff are off sick with burnout. The Observer. [online] 5 Feb. Available at: https://www.theguardian.com/society/2023/feb/05/why-so-many-nhs-staff-are-off-sick-with-burnout.
Clarke-Ezzidio, H. (2023). How can NHS strikes be resolved? [online] New Statesman. Available at: https://www.newstatesman.com/spotlight/healthcare/2023/02/how-resolve-nhs-strikes.
Collins, R. (2022). Nurses’ strike: The young NHS workers who voted yes. BBC News. [online] 8 Nov. Available at: https://www.bbc.com/news/newsbeat-63542551 [Accessed 15 Nov. 2023].
Dall’Ora, C., Ejebu, O.-Z., Ball, J. and Griffiths, P. (2023). Shift work characteristics and burnout among nurses: cross-sectional survey. Occupational Medicine, 73(4). doi: https://doi.org/10.1093/occmed/kqad046.
Collinson, D. (2023). From pandemic solidarity to industrial action hostility: British media representations of workers during Covid-19 and the 2022-23 strikes. repositori.upf.edu. [online] Available at: https://repositori.upf.edu/handle/10230/57970 [Accessed 15 Nov. 2023].
Davies, N., Hoddinott, S., Fright, M., Nye, P., Shepley, P. and Richards, G. (2023). Spring update. [online] Available at: https://www.instituteforgovernment.org.uk/sites/default/files/2023-02/Performance%20Tracker%202022-23%20Spring%20Update.pdf.
Evans, J., Jung, C., Parkes, H. and Narayanan, P. (2023). THE PUBLIC SECTOR NEEDS A REAL PAY RISE. [online] Available at: http://files.localgov.co.uk/ippr_638252741725837491.pdf.
Freedman, S. and Wolf, R. (2023). The NHS productivity puzzle. [online] Available at: https://www.instituteforgovernment.org.uk/sites/default/files/2023-06/nhs-productivity-puzzle.pdf.
Kalocsányiová, E., Essex, R., Brophy, S.A. and Sriram, V. (2023). Social media opposition to the 2022/2023 UK nurse strikes. Nursing Inquiry. Doi: https://doi.org/10.1111/nin.12600.
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