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First-hand accounts show newly registered nurses’ fear and anxiety

First-hand accounts show newly registered nurses’ fear and anxiety

A project by the Royal College of Nursing (RCN) Foundation and The King’s Fund has revealed first-hand accounts of newly registered nurses experiencing feelings of fear, anxiety and exhaustion through their work.

The project, called Follow Your Compassion, was set up last year to explore the ‘everyday lived experiences’ of newly registered nurses and midwives, who joined the workforce during Covid-19 and its immediate aftermath, across various healthcare settings in the UK.

Some 22 participants documented their working lives using words, audio, photographs and video, describing their thoughts and feelings at the end of each day.

Themes emerging from the personal accounts included heavy workload and perceptions of being unprepared.

One account read: ‘Staffing shortages are the main cause of problems for new nurses and our ability to adapt easily or not.

‘I wrote to my manager recently about my being the only nurse on duty when there are supposed to be two of us.’

Another revealed: ‘Lunch is usually marked by spinning our swivel chairs around so that we all face the centre of the room, and eating on our laps.’

A nurse working in community mental health services wrote that ‘staff shortages and no formal induction meant it was a rocky start’.

The nurse added: ‘The last six months have felt like a whirlwind crash course, a mixture of learning new skills and finding out I’m doing things wrong.’

Another participant recounted being ‘quite bad at switching off after work’, revealing: ‘I was always anxious or overthinking. Did I do everything right? Did I get everything done? Did I make the right decision about X, Y or Z?’

The positive aspects of the job were also explored within the journals, such as the mutual support offered by nursing staff.

One entry read: ‘There are a few newly qualified nurses on my ward with me, and we show compassion for each other. We check-in with each other and are always there for a little rant on the rough days. I don’t know where I’d be without them.’

However, one newly qualified nurse revealed: ‘The reason for leaving my first place of work was that I was not being supported. It is hard to put the situation down in writing because of the fear that the management may see it as an attack on them.’

Another said: ‘When you start out it can feel like trial by fire. It’s like an initiation not an induction.’

Deepa Korea, director of the RCN Foundation, commented: ‘This work highlights the enormous challenges facing newly qualified nurses and midwives, from chronic excessive workloads and under-staffed wards, to generally poor working environments.

‘It also describes their experiences of harmful workplace cultures full of anxiety, judgement, and exhaustion – environments in which compassion is at times, absent.’

According to Suzie Bailey, director of leadership and organisational development at The King’s Fund, the experiences shared by the newly qualified nurses and midwives show that ‘action must be taken quickly and consistently to make the NHS a more attractive employer’.

Ms Bailey added: ‘There must be a stronger focus on developing cultures where staff can flourish, including through compassionate, inclusive, and collective leadership which can be pivotal to the physical and mental health of staff.’

This Follow Your Compassion project is a companion piece to The Courage of Compassion (2020), an earlier report from The King’s Fund, commissioned by the RCN Foundation, on the core workplace needs of nurses and midwives.

A panel of primary care experts last year warned nurses and other staff working in general practice must be given time to prioritise their own health and wellbeing.

Meanwhile, a separate report from the Florence Nightingale Foundation said healthcare providers should prioritise staff wellbeing to ensure that staff are able to speak out and protect patients.

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