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Professional

Mental health and wellbeing

Workforce

Research

Impact of stress on nurses working in the district nursing service

02 November 2020

Professional

02 November 2020

Volume 25 · Issue 11

ISSN (print): 1462-4753

ISSN (online): 2052-2215

Abstract

This literature review aimed to identify the consequences of working in a highly stressful environment within district nursing teams and the implications this has on nursing practice and the welfare of nurses. The review analysed 10 primary research studies, resulting in three emerging themes that formed the foundation of a discussion; burnout and compassion fatigue; reduced job satisfaction and retention; and emotional injury. The results identified that healthy behaviours, emotional intelligence and effective caseload and staffing management can reduce the negative impact that stress can have on nurses. Organisations need to promote healthy behaviours through support and training and need to reassess how caseloads are managed in correlation with staffing levels. Coaching in emotional intelligence skills is vital and should be provided to all nurses within the DN service.

District nursing (DN) is a field of nursing that specialises in providing care to individuals living in the community (NHS, 2019). DN teams are led by district nurses who have completed the Specialist Practitioner Qualification in district nursing and supported by registered general nurses and healthcare assistants. DN has had to develop in order to accommodate an ageing population with increasingly complex health needs (NHS, 2019). Staff working within these teams are often a lifeline for patients, helping them to maintain independence (King's Fund, 2016a; 2016b). Nurses working in DN services are central in providing empowerment and high-quality, holistic care to people living in the community while reducing costs in the long term within the NHS (Queen's Nursing Institute (QNI), 2015). The NHS (2019) Long Term Plan identifies the importance of DN services as well as the challenges faced due to insufficient staffing levels, leading to lack of capacity to meet the rising patient need and complexity within the community setting. The QNI and Royal College of Nursing (RCN) (2019) undertook a report that provided an overview of DN, in order to identify the elements that are required to deliver an excellent DN service. The report found that the number of district nurses working within the NHS in England has reduced by 43%. Challenges within district nursing are often not recognised, with media attention focusing on care within hospitals (QNI, 2016a). Middleton (2016) described DN as an overlooked field of nursing, an invisible glue that is holding the health service together.

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District nursing

Stress

Burnout

Compassion fatigue

Retention

Emotional injury