In 2022, it was reported that the NHS workforce sustained unprecedented levels of sickness rates in England than previously recorded (Nuffield Trust, 2023). Sickness absence relating to anxiety, stress and depression in the workforce has increased substantially (Palmer and Rolewicz, 2023).
In order to deliver high-quality care for patients, it is essential that community services prioritise the wellbeing of community nurses. This editorial discusses the importance of attending to the well-being of community nurses and emphasises the need for comprehensive support structures to foster a resilient and empowered community nursing service.
Over recent years, the unique challenges associated with working in a community nursing role have been highlighted by a number of authors. The challenges include heavy workloads, long hours, high levels of responsibility and community nurses frequently working in isolation (The King's Fund, 2021). These factors significantly impact upon the well-being of the nurse. The demanding nature of their work can lead to physical and emotional exhaustion, burnout, a decline in job satisfaction and can ultimately lead to nurses leaving community nursing altogether (Senek et al, 2023).
A review of the research exploring resilience identifies the complexities surrounding it in nursing and highlights the difficulties of identifying key characteristics of what constitutes the ‘resilient nurse’. Furthermore, most studies focus on building resilience within the individual. There is a lack of evidence investigating external factors that can impact upon wellbeing, such as excessive workload and working conditions, with these areas currently remaining under-researched (Cooper et al, 2021).
Building resilience cannot be the responsibility of individual community nurses alone. Adequate staffing and resources are key components in supporting community nurses to feel empowered and in control of their workload. NHS England (2017) acknowledges the complexities and lack of evidence for establishing safe caseload staffing levels in community nursing. Locally, the capacity and demand for the community nursing service must be urgently established, with a baseline agreed consensually by managers and district nurses, of what is acceptable in terms of workload. In order to establish safe staff levels, the workforce standards published by the Queen's Nursing Institute (2022) has provided a valuable benchmarking tool for managers and clinical teams in order to measure key matrixes that assure a safe and effective community nursing service.
Nurses who are physically and emotionally well are able to handle the demands of professional practice, make sound clinical decisions and build meaningful therapeutic relationships with their patients (McKinless, 2020). A positive and caring working environment that prioritises well-being can enhance staff retention, reduce sickness, absence and turnover rates that in turn ensures better provision and continuity of care for community nursing patients (NHS England, 2016).
The widespread acknowledgement of stress, burnout and other emotional challenges is required so that individuals are encouraged to seek appropriate emotional support when this is required (Glasper, 2019). In order to provide mental health support, local accessible and confidential support services are required to address these challenges. Community nurses can connect and support each other through peer networks and mentorship programmes as this will enhance resilience and provide a platform for sharing experiences and best practices. Promoting a healthy work-life balance through flexible working, regular breaks and adequate time off is crucial to prevent burnout and promote overall well-being. NHS England have developed a straightforward and useful guide for individuals to support this activity. The tool is available online.
The well-being of community nurses is crucial, and each of us share a responsibility to show kindness and compassion towards one another as part of our working day. Embedding informal checks and balances within each community nursing team into the daily routine will help individual team members to feel well supported. A move towards a culture where wellbeing is valued and recognised as an essential prerequisite for delivering patient care is vital. It is crucial for good team morale and will ensure high-quality nursing care provision within community nursing teams.