NMC finds over half of nurses satisfied but stress and harassment levels high

More than half of nursing and midwifery professionals report satisfaction with their day-to-day work, but most have experienced harassment, bullying or abuse and nearly a quarter are at high risk of burnout, according to the largest ever survey conducted by the Nursing and Midwifery Council (NMC).

The findings, based on responses from 37,961 nurses, midwives and nursing associates – representing 5% of the NMC register at the time of the research – revealed that 58% were satisfied in their roles, primarily motivated by making a difference to people’s lives and positive interactions with patients and colleagues.

However, 71% of respondents reported experiencing harassment, bullying or abuse in the past year, most commonly from members of the public (58%) but also from managers (35%) and colleagues (41%).

Four in 10 (40%) said they had experienced discrimination – particularly concerning given that the NMC register is now more ethnically diverse than ever, with 286,058 Black, Asian and minority ethnic nurses, midwives and nursing associates, representing 33.2% of the total workforce.

Of those who experienced discrimination, 47% said their ethnic background was the reason. Internationally educated professionals reported discrimination more frequently, with 53% experiencing it compared with 35% of UK-educated staff.

High risk of burnout

Some 23% were classified as at high risk of burnout – higher than the 18% of doctors identified in the 2024 GMC barometer survey. Around a third (33%) had taken a leave of absence due to stress in the past year, compared with 23% of doctors.

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Nearly a third (31%) of respondents said they found it hard to manage the expectations of people in their care at least once a week, while a similar number (32%) reported difficulty providing sufficient levels of care at least weekly.

GP practices and other primary care settings were identified among the workplaces where these pressures were more commonly reported, alongside hospitals, maternity units, prisons and telephone or e-health services.

Workload pressure and capacity constraints were also cited as key barriers to delivering safe, effective and kind care in these settings.

Over a third (36%) reported that pressure on workload and capacity had led them to consider or take steps towards leaving the profession. Around a fifth had taken concrete steps such as contacting recruiters or applying for roles outside the profession.

Despite satisfaction with core aspects of their work, only 12% of respondents said they would recommend nursing or midwifery as a career.

Almost a third (32%) of respondents reported witnessing situations where patient safety or care was compromised, often linked to inadequate staffing and pressure on workloads.

The NMC’s annual Spotlight report shows that while the register has continued to grow and is now the largest it has ever been, the rate of growth is slowing.

The report found fewer internationally educated professionals joining the register – the first time this has happened since 2020-21 – with declining numbers taking and passing the tests required to join from overseas.

At the same time, applications for certificates of current professional status (CCPS) – required by professionals wanting to work abroad – have increased fourfold since 2018-19, from 3,353 to 14,024 in 2024-25.

Around half of professionals (46%) said they felt involved in decisions affecting their work, and 41% said they could influence change in their workplace.

‘Urgent need to tackle unacceptable behaviours’

Emma Westcott, executive director of strategy and insight at the NMC, said it was encouraging that professionals remained ‘energised by the most positive aspects of nursing and midwifery practice’, including making a difference to people’s lives and forming relationships with patients and colleagues.

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However, she added: ‘Our findings are a stark reminder of the urgent need to tackle unacceptable behaviours that drive people out of work they love.

‘A zero-tolerance approach to discrimination, bullying and harassment is needed across the sector.’

Ms Westcott said the NMC’s current review of its code would strengthen expectations around equity and anti-racism in the professions, and that employers who took their duty of care seriously were more likely to retain nursing and midwifery staff.

The survey was conducted in March last year when the NMC register stood at 842,460 professionals.

Royal College of Nursing chief nursing officer Lynn Woolsey said the findings shows ‘the dashboard is flashing red for a workforce drowning under unmanageable workloads’ and ‘unsafe staffing levels within toxic environments’.

‘When almost a third say patient safety is being compromised and almost a quarter feel at risk of burnout, it is little wonder so few would now recommend nursing as a career. This is a perfect storm for patient care now and in the future,’ added Ms Woolsey.

‘It is extremely troubling to see so many staff reporting bullying and harassment as well as discrimination at work, with so much of it directed at those from a minority ethnic background,’ she said.

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‘We have repeatedly raised the alarm on this appalling treatment and this report shows we need leadership and action from politicians and service leaders now.’

The RCN urged the government to ‘listen to their largest workforce’.

‘Investment to boost nurse numbers, alongside strategies to improve retention are crucial to easing workload pressures and freeing up staff to deliver care they are proud of,’ added Ms Woolsey.