Silent Killers: Stress, Fatigue and understaffing

Stress, fatigue and understaffing are silent killers in healthcare.

We know from our own research, from independent third-party research and from research conducted by the Victorian government that there is a crisis with under-staffing across all of our key clinical disciplines. While much of that research has focused on pathology services, we know the findings equally apply to all areas of the healthcare system and to our disciplines.

It is alarming that our surveys, conducted over a number of years, confirm an entrenched workplace culture of staff feeling pressured into doing unpaid work, and not necessarily because they’ve been asked by their supervisor. It is also very concerning that there remains such a heavy reliance on unpaid work in order for the clinical workload to be completed.

When asked about the reasons for doing unpaid work, approximately 85% of respondents say being unable to complete tasks within ordinary hours; 68% indicated it was because of the department being understaffed; 65% are doing unpaid work for patient care reasons; and approximately 58% indicated the unpaid work was due to urgent requests. These figures are strongly suggestive of a workplace culture which has ‘normalised’ unpaid work, unsustainable workloads and ‘the negative health impacts on the workforce.

Our research showed that when asked if there were sufficient staff to cover the workload when staff take annual leave or sick leave, approximately 87% of respondents indicated there are not enough staff and more than 50% of respondents indicating they had been refused leave because of understaffing. This sort of situation creates more stress and contributes to the fatigue members feel.

One of the issues highlighted from a 2018 survey is the rise of management’s use of on-call and re-call to cover understaffing. Understaffing and an increasing need to use recall compounds high workload stress and is emerging as one of the leading causes of stress related injuries. This kind of approach to managing clinical services in public health appears to stem from the failure of health services to guarantee the appropriate mix of staff needed; under-resourced and understaffed services.

When asked about whether there is an adverse impact on their general health and well-being from high workloads, 80% of respondents indicated there is an adverse impact. Of those who indicated there is an adverse impact on their health and well-being, nearly 85% of respondents indicated that the impact has worsened in the past 4 years. Many respondents identified increases in stress and exhaustion as some of the major impacts on their health and well-being.

It is clear that there are increasing health and well-being risks as more staff across a range of disciplines are highlighting ever increasing workloads that cause stress and fatigue. The level and regularity of stress leading to adverse health and well-being impacts being reported is of major concern. As members noted in their comments the workloads are increasing stress which results in greater anxiety and exhaustion. Under such circumstances people’s health and well-being is being put at risk by huge workloads; and in such circumstances puts patient safety at risk as errors are more likely to be made.

Here’s a small sample of what our members say about this very serious issue:

  • “Headaches on a weekly basis”
  • “Chronically tired, sore legs and feet, many people with hand problems from capping samples, back problems”
  • “Anxiety from constant stressful environment. Also physically tiring as more workloads added to your shift and expected to complete.”
  • “I experience more stress, I have shorter lunch breaks (or attend meetings during them), I am very tired by the end of the week.”
  • “Feeling of not coping taking more sick days”
  • “I plan to quit very soon. I’m so sick of being taken advantage of. If I don’t do the unpaid work my patients suffer and treatment is delayed.”
  • “Generally negativity and expectations that non-patient related duties can be performed to the detriment of patient-related duties.”
  • “Pressure at work leads to it carrying over into time after work. Constantly thinking of everything that needs to be done”
  • “Not sleeping properly, reliance on alcohol to wind down, stress and anger management issues”
  • “Exhausted and less likely to have a life! Repetitive strain aches and pains”

Unless the chronic understaffing is seriously addressed by the government, members and patients will be exposed to greater risks to their health and well-being; and it will only be a matter of time before patients and members are being injured. Addressing high workloads and the welfare and safety of members remains the highest priority issue that we will continue to pursue.

Paul Elliott

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