Nurses more likely to call in sick during staffing shortages

By Stephen Beech

Nurses are more likely to take time off work sick when their NHS ward is understaffed, suggests a new study.

Researchers found that not having enough registered nurses on a ward leads to higher rates of illness among the nursing staff group.

The University of Southampton study shows that the higher the proportion of registered nurses on a ward, compared to nursing support staff, the fewer incidents there are of registered nurse sickness.

The findings, published in the journal JAMA Network, also reveal that nurses working long shifts over a period of several days are more prone to being off sick than those on shorter shifts.

The research team analyzed data from four acute care hospitals in England over a four year period from April 2015 to February 2020, covering more than 18,000 registered nurses and nursing support staff.

They looked at factors including the nursing team skill-mix, understaffing, and shift length.

For more than 2.5 million shifts worked, there were just over 43,000 sickness episodes.

The researchers found that when moving from a staffing mix where just over half are registered nurses, to a mix of three-quarters, there was a 4% reduction in the chances of registered nurses being off unwell.

For every 10% increase in the proportion of registered nurses working on a ward, there was a 2% reduction in incidents of sickness.

The study also showed that when full-time registered nurses experienced more understaffing during a working week, sickness absence rose in the following week.

But understaffing among nursing support workers didn’t contribute to sickness rates across either staff groups.

The researchers also found a 26% increase in the odds of a registered nurse reporting in sick when their shifts are all long ones - 12 hours or more - in the preceding seven days, when compared to nurses working no long shifts at all.

Study lead investigator Dr. Chiara Dall’ora said: “Our findings are significant because the nursing workforce is under increasing pressure, with not enough nurses entering the profession, and many leaving their jobs due to stress-related sickness and burnout.

"We hope our work can help inform those in charge of planning workforce strategy and scheduling.”

Co-author Dr. Peter Griffiths added: “Increasing registered nurse staffing levels has been associated with improved outcomes for patients and could be a cost-effective strategy for improving the quality and safety of care.

"Our study adds to this body of evidence by shining a light on the additional impact on nurses’ health and well-being.”

The research team concluded that although increasing the registered nurse skill mix and reducing their understaffing may lead to what appear, at first glance, to be modest gains, the effects of even small improvements in working conditions could actually go a long way to improving productivity.

They say it may also reduce staff turnover.