Rostering patterns for the nursing workforce will take into account best practice on safe shift working. Rostering patterns should be agreed in consultation with staff and their representatives.
a) Longer shifts are preferred by some individuals, such as those with caring responsibilities or those who travel long distances to work. However, fatigue at the end of a long shift can result in clinical error. Cumulative fatigue can result in health problems for staff and even ‘burnout’. Careful rostering and internal rotation are strategies that are supportive and clear policies and procedures need to be in place.
b) Where staff work long shifts, employers should offer appropriate support with respect to their health and wellbeing, and their ability to provide safe and effective patient care. Opportunities should be offered to move to shorter shift times where this is preferred. Other options for wellbeing include self-rostering and team rostering.
c) The Health and Safety Executive recommend the avoidance of shifts that are longer than eight hours where the work is safety critical and physically demanding. They recommend that where 12-hour shifts are implemented there should be adequate rest breaks and that 12-hour night shifts should be limited to two or a maximum of three in a row to ensure compliance with working time regulations.
The nursing workforce should be treated with dignity, respect, and enabled to raise concerns without fear of detriment, and to have these concerns responded to.
a) The nursing workforce is a highly differentiated body of practitioners who bring their own unique skills and qualities to make up a diverse workforce. Employment policies, practices, processes and cultures as well as leadership styles must intentionally support and nurture inclusion and psychological safety as well as create environments that are free from discrimination, bullying and health inequalities.
b) To treat someone with dignity is to treat them as being of worth, in a way that is respectful to their diversity. Treating people who use services with dignity is essential in nursing practice, but in order to do this effectively, nursing staff must themselves be treated with dignity by their employers, managers and colleagues.
c) Encouraging and valuing diversity within the workforce is shown to have positive effects for a more motivated, harmonious, willing and loyal workforce.
d) Encouraging staff to report near misses and incidents and ensuring appropriate follow up by accountable managers creates psychologically safe environments and a learning culture.
The nursing workforce is entitled to work in healthy and safe environments.
a) Risks to health and safety should be properly controlled and all legal requirements complied with. This includes robust procedures for prevention of and dealing with:
- violence and aggression
- back and musculoskeletal disorders
- work-related stress
b)There is a legal requirement for the provision of adequate welfare and safety facilities, for example, breaks, changing facilities and personal lockers, access to sufficient, well maintained and high-quality resources (eg PPE, moving and handling equipment) and utilising the working environment as a place for promoting health and wellbeing is vital to enable a healthy and safe workforce.
c) Members of the nursing workforce working in people’s homes or community settings should carry out dynamic risk assessments. For staff who are lone workers, there must be clear access to advice, supervision, and means of raising the alarm and support at all times and individual risk assessment.
d)Health, safety and wellbeing is more than just the absence of work-related disease or injury rather, an emphasis on achieving good physical and mental health amongst the nursing workforce. As well as complying with the legal requirements of health and safety laws, nursing leaders have a professional responsibility to create healthy environments that improve the health and wellbeing of others.
The nursing workforce is supported to practice self-care and given opportunities at work to look after themselves.
a) The health and wellbeing of nurses is fundamental to the quality of care they can provide. Supporting the nursing workforce to practice self-care will help improve recruitment to the profession as well as support retention of the current workforce. Inherent within the Nursing & Midwifery Council Code is the need for individual practitioners to look after their own health and wellbeing in order to care effectively for others and employers must ensure they are able to do this.
b) Access to healthy eating options at work, opportunities to participate in wellbeing initiatives and access to proactive sessions on promoting physical and mental health all support employee health and wellbeing. This is alongside providing access to occupational health support and all recommended occupational health vaccines.
Workforce Standards case studies
The Nursing Workforce Standards are being used by RCN reps to support members working in a range of health care settings across the UK.Find out more