Page 146 - GHES-2-3

Global Health Economics and
Sustainability
Nurses’ perceived affective well-being at work

Appendices

Appendix A1. Experiential statement 1: “Negative feelings about self” and associated personal experiential themes
Personal Experiential Themes
• Burden of work
“The continuing care is now so difficult to get; it makes you feel inadequate in a lot of ways, but it’s not your fault because the services and the way
they are organized it’s not fair anymore. I think there is an unrealistic portrayal of what care is available. Like all the advertising about people being
able to die at home and you will be able to see a nurse every day. All those things when, in reality, it doesn’t happen. There isn’t the funding really for
it.” Group A
“…I find that things are moving so fast…especially in secondary care pushing patients out, you know, without perhaps sometimes spending, you
know, taking time to make sure that the discharge is proper. But it all falls, you know, insufficient resources to give, you know, to organize the care,
and they end up back in the hospital because it wasn’t properly sorted out..this idea that everything must be out, out, out in the community..because
there is a culture now that everything should be straight out of the hospital.” Group A
“Too much work is put upon them (nurses) because we have so many tasks on board like cannulation and all these extra tasks, and you have your
paperwork. To do all the proper things you need for a discharge to work takes a lot of time. It’s a system’s failure, really. You are putting more and
more jobs and more and more tasks on the nurses and fewer people (to do the job) with no extra resources, you know. You are doing a junior
doctor’s role.” Group B.
“ …We have been short for ages, and I think it’s more bureaucracy because some people who are in terms of requirements, they don’t meet the
requirements; I mean, I’ve seen one of them has not taken the mentorship course that’s right, some people are qualified to do…but they can’t be
shortlisted because they haven’t done the mentorship course….” Group B
“There is more paperwork. The risk of legislation is always there now. Documentation, documentation, documentation, and that’s on top of the physical
care, the more senior staff get roped into paperwork instead of providing physical care, which is what we want to instead of filling bits of paper.” Group C
“If you have a conversation, if you don’t record it doesn’t count or you are open to complain or disciplinary if there is a problem in the future. You
get some nurses who are far better at doing the paperwork than actually looking after the patients.” Group C
“..you can’t absorb emotions forevermore; you have to have an outlet, and if you don’t have…find an outlet that works for you, then you’re gonna
pop…you’re gonna get chest pains or your hair’s going to fall out..50% it’s a hell of a lot and organizing social services, MDTs you know getting all
these people together just takes up tons of your time probably it takes up possibly more than 50% of your time.” Group C
• Exhausted
“When I wake up the following day, I feel so exhausted and you know I feel all tight before I start the following day. I don’t really have a way to solve
the stress situation personally; I lay down there in no lights. I use this one to solve my stress situation definitely.” Group A
“… for me, my first line of enquiry and support would be my mentor. From there, I have my line manager and my link lecturers and personal tutors…
you have to be forceful to get anywhere and take the bull by the horns and tell them I’m going to do some revision, please. I got an allocated mentor
who is always away from me, and if I approach to ask about something, they say, ‘Oh, didn’t she tell you this? Ask her, stop asking me!’” Group B
“When I have a bad day, I carry that bad mood from the workplace to my house, and then I’ll have a sleepless night.” Group B
“There was a time I thought about opting out from nursing and doing another thing but on a second thought, I said, I have been in this (nursing)
all the time; all that I know is nursing, you know? So, I can’t opt out and start all over again. If only I knew I would have started before going into
nursing.” Group B
“I was thinking about changing my career but it never came. It was just a dream, really I don’t know, just needed a change maybe.” Group C
“You can’t keep carrying being a nurse with that day job when you are 50 or whatever. It’s so physical and emotional.” Group C
“..I get really mad toward the doctors…if you are unsure, you send somebody for a CT scan or something… or even a plain spine neck tray would have
shown the compression…but the worst thing was that straight away, all fingers went out. And we all of us nurses had to write statements, and we wanted to
know what was going on here…but that was the consultant. I actually told the registrar on the ward round to F** off in the middle of the ward….” Group C
• Frustrated
“You can’t say anything because then they say you have been unreasonable, so you don’t say anything, so you feel frustrated because things are
happening, and you don’t say much because you never know when the cards are going to turn on you and the issue is not going to be about what
they are doing but about you are saying something.” Group A
“I don’t think that nurses are ever truly autonomous because they were always looking at the guidelines; they always regard the job autonomous to
a degree, but not truly in the full sense of the word in that we can work totally independent of anyone. Doctors are truly autonomous, but I don’t
think nurses are.” Group A
“I think if you go against the system, if you start speaking out against it. (You are told by your manager) you don’t understand; you are old-
fashioned. So, you have to toe the line. If you don’t toe the line you do not understand you are old fashioned.” Group B
“She (another nurse) keeps pushing me away, and while three, four times I asked and feel somehow embarrassed to keep asking about something
which is not your personal issue, it’s something to do with the job, and it’s a professional matter! Then you give up and you take a step back and
feel isolated, you feel ignored, and then you lose your confidence, you lose the wish to do something, and you feel low. And sometimes I feel
disappointed that I have ever started this I shouldn’t.” Group B
“They (other nurses) would ask for the help, but they are not happy to return the help back; they may say to a colleague, Well, they can’t do it (help),
and you will be stuck going solo with your patients. Many, many times I have experienced that.” Group C
“They (medical teams) don’t treat you with respect and not realizing that you’ve got some expertise and they are just dismissive… this team had
a patient admitted with fluid in his lung, and they said he is going to go down for a scan because they are going to do a pleural tap on him. And I
took one look, and I thought, ‘My god, if they take him off the ward, he is going to be arrested,’ and I said, ‘he is not safe to go downstairs,’ but they
insisted on taking him down there without the crash trolley.” Group C
Cont’d...

Volume 2 Issue 3 (2024) 11 https://doi.org/10.36922/ghes.3012