Health care settings across the UK are facing a staffing crisis so severe that nursing staff are continuing to work while unwell, according to new findings from the Royal College of Nursing.
Stress has emerged as the leading cause of illness among nurses, hitting an eight-year high.
The RCN’s landmark employment survey – due for full release next month – asked more than 20,000 nursing staff about their working conditions. It found that two-thirds (66%) admit to working when they should be on sick leave, up from 49% in 2017. Stress was cited as the biggest cause of illness by 65.1% of respondents, compared to 50% eight years ago.
The survey also highlights unsustainable pressures across all health and care settings. Seven in ten nurses (70.4%) work beyond their contracted hours weekly, with over half (52.1%) doing so unpaid. The RCN says this is unacceptable and warns that unsafe staffing levels are harming both patients and staff.
Calls to the RCN advice line reveal the human impact: nurses report panic attacks, nightmares, exhaustion, and burnout, often unable to take breaks or annual leave. The advice line is on track to receive 2,175 calls about staffing issues this year, up from 2,026 in 2024 and 1,837 in 2023.
Professor Nicola Ranger, Chief Executive and General Secretary of the Royal College of Nursing, said:
“Nursing staff are being driven to ill health from working in understaffed and under-resourced services. And what’s worse, many feel they cannot take time off for fear of leaving their colleagues at the mercy of brutal pressures. This simply isn’t sustainable.
“Nursing staff strive to do their best for every patient on every shift, but they are left with the impossible task of caring for dozens and sometimes over a hundred at a time. This is hugely detrimental to patient outcomes, but there also needs to be action to address the devastating impact on staff themselves. The reality is they’re not breaking; many are already broken.
“These findings are yet more cold, hard evidence that there are simply too few nursing staff to meet growing demand. New and urgent investment is desperately needed to grow the nursing workforce, ensuring staff are able to work in a safe environment and that patients get the best care. This must be accompanied by the introduction of safety-critical nurse-to-patient ratios in all health and care settings."
There are currently over 29,000 registered nursing vacancies in the NHS alone, leaving staff with what the RCN calls an “impossible task” of keeping patients safe under extreme pressure.
The RCN is demanding urgent action, including:
- New investment to grow the nursing workforce
- Minimum, safety-critical nurse-to-patient ratios across all health and care settings
The findings underscore the need for systemic change to protect patient safety and the mental and physical health of nursing staff.
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