EXTERNAL EVIDENCE AND RESEARCH

Our Pilot and General Programs are based on the following evidence, and combined with empathy and touch.

Numerous research papers have been commissioned to study the effect massage has on staff in a healthcare setting, and we have collated them below. The list is growing as more research comes into our field of vision.

Are we missing a section, key concern of yours, major research paper or any contra-opinion? Please let us know!

For information on how we use the evidence to back-up our case, visit our Why Your Facility Needs MFHPA.

GENERAL POSITIVES

Positives

SPECIFIC

MENTAL HEALTH of STAFF

ANXIETY: decrease
  1. “Given the significant reduction in anxiety it would be useful to look at providing a massage therapist for access onsite for massages at a cost. […] This research has demonstrated that aromatherapy massage with music significantly reduces the anxiety levels of emergency nurses thereby enhancing their comfort and over-all well-being. […] It is clear that massage was effective in reducing anxiety in most cases. There were no occasions when anxiety was worse after massage but, in contrast, there were 157 (86%) occasions where anxiety was improved after massage.” Massage Studies for Stress Management/Reducing Anxiety, and the Treatment of Back/Neck Pain. The effect of aromatherapy massage with music on the stress and anxiety levels of emergency nurses: comparison between summer and winter
  2. “Carers considered their stress levels to be medium to high before the treatments and reported that the aromatherapy massage helped to significantly reduce their stress and anxiety levels.” Caring for the carers
  3. ‘A study suggested that staff who received 20 min of massage twice a week for 8 weeks reported lower levels of anxiety and sleep disturbance, and decreased blood pressure and heart rate.’ The effect of massage therapy on occupational stress of Intensive Care Unit nurses

FULL CITATIONS

Massage Studies for Stress Management/Reducing Anxiety, and the Treatment of Back/Neck Pain. The effect of aromatherapy massage with music on the stress and anxiety levels of emergency nurses: comparison between summer and winter; Journal of Clin Nursing, 16(9), 695-1703.; Cooke, M., et al; 2007   🇦🇺

Caring for the carers; Mod Midwife; Lewis L.; 1995 Feb;5(2):7-10  🇺🇸

The effect of massage therapy on occupational stress of Intensive Care Unit nurses; Nurs Midwifery Res.; Fateme Nazari,1 Mojtaba Mirzamohamadi,2 and Hojatollah Yousefi;  2015 Jul-Aug; 20(4): 508–515 🇮🇷🇺🇸

BURNOUT or BREAKDOWN: decrease
  1. “In Canada, Leiter and Maslach found that burnout or exhaustion mediated the occurrence of turnover.” Nursing churn and turnover in Australian hospitals
  2. “Burnout and work stress were reduced when administrators created work environments that provided staff with access to opportunity, information, resources, and support—the features of empowerment.” Chapter 26 Work Stress and Burnout Among Nurses: Role of the Work Environment and Working Conditions; Patient Safety and Quality: An Evidence-Based Handbook for Nurses
  3. “Typically, there are four stages to burnout: Physical and mental exhaustion. Shame and doubt. Cynicism and callousness. Failure. One of the most severe types of burnout is compassion fatigue. Nurses can feel emotionally and physically drained when they deal with traumatic situations on a daily basis […] may feel despair, hopelessness, apathy and anxiety. Some […] may even fall into depression. They may suffer from insomnia, become accident-prone and lose interest in work. Nurses who suspect they are suffering from compassion fatigue should seek help from a mental health professional.” The High Cost of Nurse Turnover
  4. “Burnout Syndrome in nurses has been shown to increase about 23% for each additional patient added to the nurse’s shift workload (Blakeney, 2003).” Burnout syndrome in hospital nurses
  5. “I am burnt out due to the huge workload that I am expected to achieve which is far beyond normal working hours. I currently do at least 15 hours unpaid work per week. There is no work life balance and as a result I am currently being treated for anxiety and depression.” What Nurses Want: Analysis of the First National Survey on Nurses’ Attitudes to Work and Work Conditions in Australia
  6. “Nursing studies have firmly established that excessive exposure to psychosocial stressors produces considerable job stress, resulting in various problematic short- and long-term outcomes.” Alleviating Job Stress in Nurses
  7. “Studies have shown that nurses have very high rates of burnout. Aiken and colleagues found that more than 40% of hospital staff nurses scored in the high range for burnout, with 43.2% of nurses reporting high levels of emotional exhaustion […] In addition, nurses experiencing burnout have been found to be more likely to eat poorly, smoke cigarettes, and abuse alcohol and other drugs, all of which can lead to negative health conditions and diminished well-being.” Alleviating Job Stress in Nurses

 FULL CITATIONS

Nursing churn and turnover in Australian hospitals; BMC Nursing; Angela J Dawson, Helen Stasa, Michael A Roche, Caroline S E Homer and Christine Duffield; 8 April 2014, 13:11 🇦🇺

Chapter 26 Work Stress and Burnout Among Nurses: Role of the Work Environment and Working Conditions; Patient Safety and Quality: An Evidence-Based Handbook for Nurses; Bonnie M. Jennings 🇺🇸

The High Cost of Nurse Turnover; University of New Mexico; 30 November 2016  🇺🇸

Burnout syndrome in hospital nurses; Marshall University Digital Scholar; Priscilla Holdren and Alberto Coustasse; Spring 3 – 2015 🇺🇸

What Nurses Want: Analysis of the First National Survey on Nurses’ Attitudes to Work and Work Conditions in Australia; Monash University, Department of Management; Associate Professor Peter Holland, Dr Belinda C Allen and Dr Brian K Cooper; February 2012 🇦🇺

Alleviating Job Stress in Nurses; Medscape; Rashaun Roberts, PhD; Paula L. Grubb, PhD; James W. Grosch, MBA, PhD; 25 June 2012 🇺🇸

EMOTIONAL DISTRESS or COMPASSION FATIGUE: decrease
  1. “School, medical, psychiatric and social service social workers reported the best job conditions and significantly better physical health and lower levels of psychological distress.” Variations in job strain across nursing and social work specialities
  2. the most stressful situations were those dealing with patients’ pain, the presence of the patient’s family and a heavy workload.” Massage Studies for Stress Management/Reducing Anxiety, and the Treatment of Back/Neck Pain. The effect of aromatherapy massage with music on the stress and anxiety levels of emergency nurses: comparison between summer and winter
  3. “Moral distress and compassion fatigue are consequences of nursing stress that have received special attention from researchers in recent years […] Moral distress can arise from issues surrounding end-of-life care, depersonalising patients on an institutional level, policy constraints, and other situations that nurses believe may affect their ability to provide quality patient care.” Alleviating Job Stress in Nurses
  4. “Compassion fatigue occurs when a nurse psychologically withdraws and becomes disengaged from the caring nature of the job. Both moral distress and compassion fatigue have serious effects in terms of dissatisfaction, feelings of powerlessness, and poor physical and mental health outcomes.” Alleviating Job Stress in Nurses

 FULL CITATIONS

Variations in job strain across nursing and social work specialities. Journal of Community and Applied Social Psychology 1993;3:261-271 🇺🇸

Massage Studies for Stress Management/Reducing Anxiety, and the Treatment of Back/Neck Pain. The effect of aromatherapy massage with music on the stress and anxiety levels of emergency nurses: comparison between summer and winter; Journal of Clin Nursing, 16(9), 695-1703.; Cooke, M., et al; 2007 🇦🇺

Alleviating Job Stress in Nurses; Medscape; Rashaun Roberts, PhD; Paula L. Grubb, PhD; James W. Grosch, MBA, PhD; 25 June 2012 🇺🇸

DEPERSONALISATION: decrease
  1. “Depersonalisation is an increased mental distance from one’s job that results in an unfeeling or impersonal response toward recipients of one’s service, care, treatment, or instruction.”  Alleviating Job Stress in Nurses
  2. “On a review of the literature, Halbesleben and colleagues found a significant relationship between higher levels of emotional exhaustion and depersonalisation in nursing staff and lower patient satisfaction.” Alleviating Job Stress in Nurses

Alleviating Job Stress in Nurses; Medscape; Rashaun Roberts, PhD; Paula L. Grubb, PhD; James W. Grosch, MBA, PhD; 25 June 2012 🇺🇸

HYPERFATIGUE or SLEEP DISRUPTION: help decrease
  1.  “A randomised controlled trial was conducted in one 200 bed campus of a 650 bed regional hospital in South East Queensland. Approximately 350 full-time and part-time nurses were employed on the campus. […] Almost half (47.3%-41.8%) the participants identified that they suffered from fatigue […] Weekly sessions of massage therapy, over a five week period, provided to all staff may reduce psychological stress levels […] appear to decrease levels of anxiety in nurses employed in an acute care facility, compared to controls. […] The hospital used as the setting for this study, massage is now offered to staff at a discounted rate within the workplace.” The effectiveness of a 15 minute weekly massage in reducing physical and psychological stress in nurses
  2. “Carers generally reported that their sleeping patterns had improved over the course of the sessions and that their energy levels had increased.” Caring for the carers
  3. “A study suggested that staff who received 20 min of massage twice a week for 8 weeks reported lower levels of anxiety and sleep disturbance, and decreased blood pressure and heart rate.” The effect of massage therapy on occupational stress of Intensive Care Unit nurses

FULL CITATIONS

The effectiveness of a 15 minute weekly massage in reducing physical and psychological stress in nurses; Aust J Adv Nurs.; Bost N, Wallis M.; 2006 Jun-Aug;23(4):28-33  🇦🇺

Caring for the carers; Mod Midwife; Lewis L.; 1995 Feb;5(2):7-10 🇺🇸

The effect of massage therapy on occupational stress of Intensive Care Unit nurses; Nurs Midwifery Res.; Fateme Nazari,1 Mojtaba Mirzamohamadi,2 and Hojatollah Yousefi;  2015 Jul-Aug; 20(4): 508–515🇮🇷🇺🇸

SUICIDE: contribute to decrease
  1.  “Women working in health professions have a rate of suicide which is three times higher than those in other occupations […] male nurses and midwives had close to double the rate of suicide compared with men in other professions” Female doctors and nurses at least three times more likely to commit suicide: study
  2. “As a group, nurses tend to have higher rates of mortality and disproportionately high rates of general illness, stress-related disease, psychiatric outpatient consultation, and psychiatric admissions.” Alleviating Job Stress in Nurses
  3. “The research revealed that female doctors take their own lives at nearly three times the rate of the general population. Female nurses had a suicide risk almost four times greater than women in other jobs […] Dr Milner worked with two other authors from the University of Melbourne to analyse almost 10,000 suicide cases from 2001 to 2012. They found that about 3.8 per cent of those deaths were of health professionals.” Female doctors and nurses at least three times more likely to commit suicide: study

 FULL CITATIONS

Female doctors and nurses at least three times more likely to commit suicide: study; The World Today, Radio National, Australian Broadcasting Corporation; Bridget Brennan; 19 September 2016  🇦🇺

Alleviating Job Stress in Nurses; Medscape; Rashaun Roberts, PhD; Paula L. Grubb, PhD; James W. Grosch, MBA, PhD; 25 June 2012 🇺🇸

CYNICISM AND JADEDNESS: decrease
WORK STRESS: decrease

Massage lowers stress immediately upon touching the participant’s body. Massage in the workplace brings a greater satisfaction with workplace environment, and due to an emotionally healthier environment, take less sick days.

  1. “Work stress in nursing was first assessed in 1960 when Menzies identified four sources of anxiety among nurses: patient care, decision making, taking responsibility, and change.” Chapter 26 Work Stress and Burnout Among Nurses: Role of the Work Environment and Working Conditions; Patient Safety and Quality: An Evidence-Based Handbook for Nurses
  2. “Staff found the massages extremely beneficial and indicated that they would be interested in paying for them if they were available and regular massages may improve stress levels. […] Introducing stress reduction strategies in the workplace may lower the stress levels of nursing staff in the ED, thereby increasing their job satisfaction and decreasing the number of sick leave.” Massage Studies for Stress Management/Reducing Anxiety, and the Treatment of Back/Neck Pain. The effect of aromatherapy massage with music on the stress and anxiety levels of emergency nurses: comparison between summer and winter
  3. “These skill-mix issues were said to increase workload, and meant nurses were not able to complete shifts on time and increased stress (by placing unrealistic expectations and demands on qualified staff)” Nursing churn and turnover in Australian hospitals
  4. “Burnout and work stress were reduced when administrators created work environments that provided staff with access to opportunity, information, resources, and support—the features of empowerment.” Chapter 26 Work Stress and Burnout Among Nurses: Role of the Work Environment and Working Conditions; Patient Safety and Quality: An Evidence-Based Handbook for Nurses
  5. “The results of this study suggest that massage therapy is a beneficial tool for the health of nurses as it may reduce psychological stress levels.” The effectiveness of a 15 minute weekly massage in reducing physical and psychological stress in nurses
  6. “Participants were offered a 20-minute massage, and all felt this helped reduce stress.” Caring for the carers
  7. “Carers considered their stress levels to be medium to high before the treatments and reported that the aromatherapy massage helped to significantly reduce their stress and anxiety levels.” Caring for the carers
  8. “Stress perception was significantly lower in the massage group after the chair massage, and not significantly changed in the control group […] Massage therapy is one technique that has been found to be effective in reducing anxiety and job stress (Field, Quintino, Henteleff, Wells-Keife, & Delvecchio-Feinberg, 1997).” The effect of chair massage on stress perception of hospital bedside nurses
  9. “The rate of occupational stress is higher among health professionals compared to other professionals. The results of a study on a large sample of Swedish nurses indicated that more than 80% of nurses reported higher levels of stress than other professional groups […] Immediately after and 2 weeks after the intervention, the mean score of occupational stress in the experimental group was significantly lower than that in the control group […] In the experiment group, the mean score of occupational stress after the intervention compared to before the intervention had significantly decreased. Moreover, this reduction had remained for 2 weeks; thus, it can be concluded that the intervention of massage therapy can be effective in reducing occupational stress.” The effect of massage therapy on occupational stress of Intensive Care Unit nurses

 FULL CITATIONS

Chapter 26 Work Stress and Burnout Among Nurses: Role of the Work Environment and Working Conditions; Patient Safety and Quality: An Evidence-Based Handbook for Nurses; Bonnie M. Jennings 🇺🇸

Massage Studies for Stress Management/Reducing Anxiety, and the Treatment of Back/Neck Pain. The effect of aromatherapy massage with music on the stress and anxiety levels of emergency nurses: comparison between summer and winter; Journal of Clin Nursing, 16(9), 695-1703.; Cooke, M., et al; 2007

Nursing churn and turnover in Australian hospitals; BMC Nursing; Angela J Dawson, Helen Stasa, Michael A Roche, Caroline S E Homer and Christine Duffield; 8 April 2014, 13:11 🇦🇺

The effectiveness of a 15 minute weekly massage in reducing physical and psychological stress in nurses; Aust J Adv Nurs.; Bost N, Wallis M.; 2006 Jun-Aug;23(4):28-33  🇦🇺

Caring for the carers; Mod Midwife; Lewis L.; 1995 Feb;5(2):7-10 🇺🇸

The effect of chair massage on stress perception of hospital bedside nurses‘; Canadian Touch Research Centre; MARY KAY BRENNAN, MS, RN, LMBT and RITA DeBATE, PhD, MPH, CHES 🇨🇦

The effect of massage therapy on occupational stress of Intensive Care Unit nurses; Nurs Midwifery Res.; Fateme Nazari,1 Mojtaba Mirzamohamadi,2 and Hojatollah Yousefi;  2015 Jul-Aug; 20(4): 508–515🇮🇷🇺🇸

FINANCIAL and ORGANISATIONAL

COSTS or EXPENSES: reduce
  1.  “Leaders of health care organisations can no longer ignore these findings. Just as institutional leaders need to understand their financial standing, they also need to assess how environmental stress is affecting patients and staff and take action to alter unhealthy situations.” Chapter 26 Work Stress and Burnout Among Nurses: Role of the Work Environment and Working Conditions; Patient Safety and Quality: An Evidence-Based Handbook for Nurses
  2. “The states pay for more than half of all public hospital services and Mr Duckett said the rising costs are a key reason their budgets are under pressure […] Hospitals that cut their costs would be able to perform more surgery and help cut the waiting lists for public hospital care which can stretch to 12 months for some procedures.” The most expensive hospitals in Australia revealed in NHPA report

FULL CITATIONS

Chapter 26 Work Stress and Burnout Among Nurses: Role of the Work Environment and Working Conditions; Patient Safety and Quality: An Evidence-Based Handbook for Nurses; Bonnie M. Jennings 🇺🇸

The most expensive hospitals in Australia revealed in NHPA report; news.com.au; Sue Dunlevy; 29 April 2015 🇦🇺

INTERVENTIONS or SMPs: choose

Out of the many Stress Management Programs that exist, which is the cheapest, most effective and most accepted and attended by staff. Nurses and management staff can work with job stress practitioners to diagnose organisational and work-unit conditions that contribute to stress.

  1.  “The challenge for managers is to find interventions that support nurses individually and organisationally and reduce levels of stress.” The effectiveness of a 15 minute weekly massage in reducing physical and psychological stress in nurses
  2. “A stress management program (SMP) is an example of a person-focused intervention. […] These programs improve the ability of workers to cope with difficult work situations by educating them about the nature and sources of stress and the effects of stress on health, and build skills to reduce stress (e.g., time management or relaxation skills). SMPs can rapidly reduce the symptoms of stress, such as anxiety and sleep disturbance, and have the advantage of being inexpensive and easy to implement. […] SMP content that is directly relevant and applicable to the specific work environment, interpersonal issues, and job characteristics or tasks encountered by nurses can be developed, implemented, and evaluated. Customised nurse SMPs that are practical for use on and off the job may have the best potential for positively influencing the health and well-being of nurses […] Interventions involve identifying the stressful aspects of the job (e.g., excessive workload, conflicting expectations) and then designing strategies to reduce or eliminate these stressors. The advantage of this approach is that it directly addresses the root causes of work-related stress.” Alleviating Job Stress in Nurses
  3. “Similar to SMPs, organization-focused interventions should be customised according to work setting […] Establishing the technical capacity to conduct the program (e.g., specialised training for in-house staff or use of job stress consultants) […] If well-planned and implemented, integrated programs potentially can be effective in reducing or eliminating job stress for nurses. Each approach has unique advantages: Person-focused interventions have a more positive effect on individual outcomes, and organization-focused interventions have a more positive effect on organisational outcomes.” Alleviating Job Stress in Nurses
  4. “Relaxation techniques, training in behavioural techniques, stress management workshops and training in therapeutic skills were effective stress management techniques for mental health nurses.” A systematic review of stress and stress management interventions for mental health nurses
  5. “[…] supports  staff  wellness and compassionate care. Why are we piloting this program? As Nurses’ and Midwives we recognise that caring for patients is very rewarding work. However, at times it can be really challenging and stressful. There are some days when we feel that we have given our all and yet we wish that we could have done more for our patients and their families. Research  has  found  that  focusing  on  staff  wellness,  supporting resilience and helping staff develop effective coping strategies can be some of the most meaningful ways to ensure a compassionate environment for both patients their families and staff. […] supports  staff  wellness and compassionate care and developed to support staff to generate and maintain personal resources that will help support wellness and compassionate care.Heart of Health Program

FULL CITATIONS

The effectiveness of a 15 minute weekly massage in reducing physical and psychological stress in nurses; Aust J Adv Nurs.; Bost N, Wallis M.; 2006 Jun-Aug;23(4):28-33  🇦🇺

Alleviating Job Stress in Nurses; Medscape; Rashaun Roberts, PhD; Paula L. Grubb, PhD; James W. Grosch, MBA, PhD; 25 June 2012 🇺🇸

A systematic review of stress and stress management interventions for mental health nurses; J Adv Nurs; Edwards D, Burnard P.; 2003;42:169-200″] Reference [/tooltip] 🇺🇸

Heart of Health Program; Sydney Local Health District; 2017 🇦🇺

MEDIA and PUBLIC RELATIONS: improve image
  1.  “A FORMER Cairns Hospital nurse, who claims her bosses made life hellish while working in the maternity unit, has spoken out about a culture of bullying within the troubled ward […] The maternity ward has since been gripped by a shortage of midwives, that hospital insiders say is a direct result of a hostile work environment.” Bullied nurse claims she was forced to resign from Cairns Hospital’s troubled maternity ward

FULL CITATIONS

Bullied nurse claims she was forced to resign from Cairns Hospital’s troubled maternity ward‘; Cairns Post; Daniel Bateman; 18 February 2017🇦🇺

ADMINISTRATION: decrease bureaucratic hassles and paperwork
  1.  “Stress not only adversely affects the health, safety, and well-being of nurses at the individual level, it also negatively affects healthcare organisations. Research indicates that the stress fostered by workplace bullying, psychological aggression, incivility, and disruptive behaviour affects healthcare costs, turnover, retention, and formal grievances and lawsuits.” Alleviating Job Stress in Nurses

 FULL CITATIONS

Alleviating Job Stress in Nurses; Medscape; Rashaun Roberts, PhD; Paula L. Grubb, PhD; James W. Grosch, MBA, PhD; 25 June 2012 🇺🇸

PRODUCTIVITY: increase
  1.  “Indirect costs of lost productivity account for 79% of total costs.” The rate and cost of nurse turnover in Australia
  2. “Turnover affects the roles, morale and stress levels of remaining staff, impacting upon nurse productivity.” Nursing churn and turnover in Australian hospitals

 FULL CITATIONS

The rate and cost of nurse turnover in Australia; Collegian Journal, Michael A. Roche,  Duffield, Homer, Buchan, Dimitrelis; Volume 22, Issue 4, Pages 353–358; December 2015 🇦🇺

Nursing churn and turnover in Australian hospitals; BMC Nursing; Angela J Dawson, Helen Stasa, Michael A Roche, Caroline S E Homer and Christine Duffield; 8 April 2014, 13:11 🇦🇺

WORKERS COMPENSATION: decrease
  1.  “40.7% decrease in workers compensation costs” Proof Positive. An Analysis of the Cost Effectiveness of Worksite Wellness

 FULL CITATIONS

Proof Positive. An Analysis of the Cost Effectiveness of Worksite Wellness. ; Seattle, WA: Chapman Institute.; Workplace Health Association Australia; Chapman, L.S. (2007)”] Reference [/tooltip] 🇺🇸🇦🇺

ADMINISTRATION ISSUES RESULTING FROM MEDICAL ERRORS: reduce
  1. “The Director of Nursing at Warwick Hospital […] resigned. Claims that staff shortages have put patient safety at risk are among a number of worrying allegations aimed at the hospital administration.” Nursing director quits: cites bullying and lack of staff

FULL CITATIONS

Nursing director quits: cites bullying and lack of staff; Warwick Daily News; Michael Cormack; 13 March 2015 🇦🇺

PATIENTS

AGGRESSION FROM PATIENTS AND FAMILIES: lower
  1.  Patients constantly complain about poor service.” Nursing churn and turnover in Australian hospitals

FULL CITATIONS

Nursing churn and turnover in Australian hospitals; BMC Nursing; Angela J Dawson, Helen Stasa, Michael A Roche, Caroline S E Homer and Christine Duffield; 8 April 2014, 13:11 🇦🇺

COMMUNICATION WITH PATIENTS: better
MEDICOLEGAL ISSUES: reduce

18,000 individuals die from errors, of which a significant number proceed to litigation. This is partly due to the stress, fatigue and mental health issues that lead to lack of focus, and are not due to inexperience.

Additional costs and energy is borne from covering up mistakes, when using interventions such as massage for HCPs, reduce the amount of mistakes from fatigue or stress, and paperwork and hassles for administration.

Massage can center HCPs, help clear the mind, reduce physical problems, and allow the HCP to focus on their job.

  1. “By some estimates, as many as 18,000 people die every year as a result of medical error, while 50,000 people suffer a permanent injury.” Medical mistakes: a silent epidemic in Australian hospitals
  2. “Medical Error Action Group almost 20 years ago. Between 70 and 100 complaints come to her each day, half of which she says can reasonably be classified as medical error. […] I don’t see a reduction in medical error at all. I still see cover-ups, I still see the lengths health departments will go to smother things and destroy records. But the errors are just the same, I’m not seeing a reduction.” Medical mistakes: a silent epidemic in Australian hospitals
  3. “Stress induced anxiety can lead to poor performance and increased nursing errors and studies have identified job stress as a major cause of nurses leaving the health care workforce.” The effectiveness of a 15 minute weekly massage in reducing physical and psychological stress in nurses
  4. “Increased workgroup learning led to fewer occurrences of severe medication errors.” Impact of nursing unit turnover on patient outcomes in hospitals
  5. “It’s natural to think that the more stressed you are, the more errors [you make], but until now we haven’t had any substantive scientific evidence of this,” The study focuses on the particularly stressful experiences of staff in a newly opened emergency department, dealing with all the pressures of initiating new cooperation structures both internally and with other hospital departments. “If we hadn’t found a link between stress and patient [health] here–where [staff] were under so much psychological pressure–we probably wouldn’t be able to find it anywhere else.” Stressed doctors make more mistakes

FULL CITATIONS

Medical mistakes: a silent epidemic in Australian hospitals; Australian Broadcasting Corporation; Eleanor Hall; 10 June 2013 🇦🇺

The effectiveness of a 15 minute weekly massage in reducing physical and psychological stress in nurses; Aust J Adv Nurs.; Bost N, Wallis M.; 2006 Jun-Aug;23(4):28-33  🇦🇺

Stressed doctors make more mistakes; ScienceNordic/American Journal of Emergency Medicine; Anders Boas; 11 February 2016″] Reference [/tooltip] 🇺🇸🇩🇰

PATIENT CARE AND SAFETY: improve quality of (incl. help lessen patient falls)
  1.  “Finally, turnover impacts on patient safety and outcomes with registered nurse (RN) turnover found to be related to both increased infection and subsequent hospitalisation; an increased likelihood of medical error; and reduced patient satisfaction.” Nursing churn and turnover in Australian hospitals
  2. “Nursing units with low levels of turnover were likely to have fewer patient falls than nursing units with no turnover.” Impact of nursing unit turnover on patient outcomes in hospitals
  3. “Lateral workplace violence has been shown to jeopardise patient safety, satisfaction, and health outcomes […] Studies have found that stress and burnout are strongly linked to sub-optimal patient care as reported by nurses and other studies have found that stress and burnout in nurses negatively affect patients’ perception of the quality of their care.” Alleviating Job Stress in Nurses
  4. “They explained that burned-out nurses may not be as alert or mentally aware, which compromises their ability to provide high-quality patient care […] Lack of mental alertness due to burnout also contributed to a higher likelihood of medical errors.” Alleviating Job Stress in Nurses

FULL CITATION

Nursing churn and turnover in Australian hospitals; BMC Nursing; Angela J Dawson, Helen Stasa, Michael A Roche, Caroline S E Homer and Christine Duffield; 8 April 2014, 13:11 🇦🇺

Impact of nursing unit turnover on patient outcomes in hospitals; J Nurs Scholarsh. 2010 Mar;42(1):40-9. doi: 10.1111/j.1547-5069.2009.01319.x.; Mar 2010 🇺🇸

Alleviating Job Stress in Nurses; Medscape; Rashaun Roberts, PhD; Paula L. Grubb, PhD; James W. Grosch, MBA, PhD; 25 June 2012 🇺🇸

PATIENT DEATHS: help decrease

A strong health care system includes sustainable management of human resources. Massage contributes to this management, and this results in less deaths. Massage can centre HCPs, help clear the mind, reduce physical problems, and allow the HCP to focus on their job.

  1. “Evidence demonstrates that those health systems with strong primary health care are more efficient, have lower rates of hospitalisation, fewer health inequalities and better health outcomes including lower mortality.” Australia’s Future Health Workforce – Nurses, Detailed Report
  2. “Aiken and colleagues found that each additional patient per nurse resulted in a 7% increase in the likelihood of a patient dying within 30 days of hospital admission.” Alleviating Job Stress in Nurses

 FULL CITATIONS

Australia’s Future Health Workforce – Nurses, Detailed Report; Health Workforce Australia; August 2014 🇦🇺

Alleviating Job Stress in Nurses; Medscape; Rashaun Roberts, PhD; Paula L. Grubb, PhD; James W. Grosch, MBA, PhD; 25 June 2012 🇺🇸

PATIENT SATISFACTION: help improve
  1.  “Workgroup cohesion and relational coordination had a positive impact on patient satisfaction.” Impact of nursing unit turnover on patient outcomes in hospitals

FULL CITATIONS

Impact of nursing unit turnover on patient outcomes in hospitals; J Nurs Scholarsh. 2010 Mar;42(1):40-9. doi: 10.1111/j.1547-5069.2009.01319.x.; Mar 2010 🇺🇸

PHYSICAL HEALTH of STAFF

BLOOD PRESSURE: help stabilise and reduce
  1. “The researchers found a significant reduction in systolic and diastolic blood pressure post intervention.” Massage Studies for Stress Management/Reducing Anxiety, and the Treatment of Back/Neck Pain. The effect of aromatherapy massage with music on the stress and anxiety levels of emergency nurses: comparison between summer and winter
  2. “Massage therapy has beneficial physiological effects such as dilation of blood vessels […] a study suggested that staff who received 20 min of massage twice a week for 8 weeks reported lower levels of anxiety and sleep disturbance, and decreased blood pressure and heart rate.” The effect of massage therapy on occupational stress of Intensive Care Unit nurses

 

 FULL CITATIONS

 

Massage Studies for Stress Management/Reducing Anxiety, and the Treatment of Back/Neck Pain. The effect of aromatherapy massage with music on the stress and anxiety levels of emergency nurses: comparison between summer and winter; Journal of Clin Nursing, 16(9), 695-1703.; Cooke, M., et al; 2007 🇦🇺

 

The effect of massage therapy on occupational stress of Intensive Care Unit nurses; Nurs Midwifery Res.; Fateme Nazari,1 Mojtaba Mirzamohamadi,2 and Hojatollah Yousefi;  2015 Jul-Aug; 20(4): 508–515 🇮🇷🇺🇸

 

HEART RATE: help calm
  1. “The average pulse rate of participants dropped by 12 beats per minute during massage.” Caring for the carers

FULL CITATIONS

Caring for the carers; Mod Midwife; Lewis L.; 1995 Feb;5(2):7-10 🇺🇸

INJURIES: reduce

With a decrease in physical discomfort, nurses will take less shortcuts at work (to avoid using painful body areas such as lower back pain), take less sick days and be absent less (due to less headaches).

  1. Nurses leave this job stressed and burnt out and likely physically injured. RN, 32 years, Part time, Female.” Nursing churn and turnover in Australian hospitals

 FULL CITATIONS

Nursing churn and turnover in Australian hospitals; BMC Nursing; Angela J Dawson, Helen Stasa, Michael A Roche, Caroline S E Homer and Christine Duffield; 8 April 2014, 13:11 🇦🇺

PHYSICAL AND MUSCULAR PAIN LEVELS: decrease

With a decrease in physical discomfort, nurses will take less shortcuts at work (to avoid using painful body areas such as lower back pain), take less sick days and be absent less (due to less headaches).

  1. Pain intensity and tension levels significantly reduced; self-reported levels of relaxation increased significantly.” Massage Studies for Stress Management/Reducing Anxiety, and the Treatment of Back/Neck Pain. The effect of aromatherapy massage with music on the stress and anxiety levels of emergency nurses: comparison between summer and winter
  2. I plan on leaving nursing within the next year. Nursing has become physically heavy.Nursing churn and turnover in Australian hospitals
  3. “A randomised controlled trial was conducted in one 200 bed campus of a 650 bed regional hospital in South East Queensland. Approximately 350 full-time and part-time nurses were employed on the campus. […] Almost half (47.3%-41.8%) the participants identified that they suffered from muscle or joint pain […] Weekly sessions of massage therapy, over a five week period, provided to all staff may reduce psychological stress levels […] appear to decrease levels of anxiety in nurses employed in an acute care facility, compared to controls. […] The hospital used as the setting for this study, massage is now offered to staff at a discounted rate within the workplace.” The effectiveness of a 15 minute weekly massage in reducing physical and psychological stress in nurses
  4. “Others reported reduced tension and tightness in the neck and shoulder area - parts of the body where we traditionally carry stress.” Caring for the carers
  5. “Other studies have found associations between low nurse staffing levels and hospital-acquired pneumonia, urinary tract infections, sepsis, nosocomial infections, pressure ulcers, upper gastrointestinal bleeding, shock and cardiac arrest, medication errors, falls, and longer-than-expected lengths of stay.” Alleviating Job Stress in Nurses

FULL CITATIONS

Massage Studies for Stress Management/Reducing Anxiety, and the Treatment of Back/Neck Pain. The effect of aromatherapy massage with music on the stress and anxiety levels of emergency nurses: comparison between summer and winter; Journal of Clin Nursing, 16(9), 695-1703.; Cooke, M., et al; 2007  🇦🇺

Nursing churn and turnover in Australian hospitals; BMC Nursing; Angela J Dawson, Helen Stasa, Michael A Roche, Caroline S E Homer and Christine Duffield; 8 April 2014, 13:11 🇦🇺

The effectiveness of a 15 minute weekly massage in reducing physical and psychological stress in nurses; Aust J Adv Nurs.; Bost N, Wallis M.; 2006 Jun-Aug;23(4):28-33  🇦🇺

Caring for the carers; Mod Midwife; Lewis L.; 1995 Feb;5(2):7-10 🇺🇸

Alleviating Job Stress in Nurses; Medscape; Rashaun Roberts, PhD; Paula L. Grubb, PhD; James W. Grosch, MBA, PhD; 25 June 2012 🇺🇸

HEADACHES: help decrease
  1. “A randomised controlled trial was conducted in one 200 bed campus of a 650 bed regional hospital in South East Queensland. Approximately 350 full-time and part-time nurses were employed on the campus. […] Almost half (47.3%-41.8%) the participants identified that they suffered from headaches […] Weekly sessions of massage therapy, over a five week period, provided to all staff may reduce psychological stress levels […] appear to decrease levels of anxiety in nurses employed in an acute care facility, compared to controls. […] The hospital used as the setting for this study, massage is now offered to staff at a discounted rate within the workplace.” The effectiveness of a 15 minute weekly massage in reducing physical and psychological stress in nurses

FULL CITATIONS

The effectiveness of a 15 minute weekly massage in reducing physical and psychological stress in nurses; Aust J Adv Nurs.; Bost N, Wallis M.; 2006 Jun-Aug;23(4):28-33  🇦🇺

STAFFING

HIGH QUALITY STAFF: attract
  1. “A fourth method used to attract candidates is to develop and communicate an effective employment brand to potential applicants. This requires investing resources into defining and marketing the unique cultural characteristics and career opportunities that make the organisation a particularly attractive place to work.” Nursing Turnover: Costs, Causes, & Solutions

FULL CITATIONS

Nursing Turnover: Costs, Causes, & Solutions; Success Factors, 2009 🇺🇸

RECRUITMENT: create attractive benefits

Massage works side by side with general organisational improvement of working conditions. Those hospitals giving the benefit of massage are more attractive places to work.

  1. “Comparable to the previous year, the average time to recruit an experienced RN ranged from 54 to 109 days, pending speciality.” 2016 National Healthcare Retention & RN Staffing Report
  2. “Finally, improved working conditions for nurse administrators might make the role more appealing and help correct the serious dearth of individuals interested in pursuing administrative positions.” Chapter 26 Work Stress and Burnout Among Nurses: Role of the Work Environment and Working Conditions; Patient Safety and Quality: An Evidence-Based Handbook for Nurses
  3. But the success of employment branding efforts is predicated on the assumption that an organisation truly is a great place to work” Nursing Turnover: Costs, Causes, & Solutions
  4. “Taken together these findings are cause for serious concern and unless steps are taken to improve the work conditions of nurses it is likely that existing problems in relation to the recruitment and retention of this critical workforce will only worsen.” What Nurses Want: Analysis of the First National Survey on Nurses’ Attitudes to Work and Work Conditions in Australia
  5. “With the nursing shortage predicted to increase over the next decade as baby boomer nurses retire and this age group population predicted to require greater healthcare services, it seems that measures to support nurses would be beneficial.” The effect of chair massage on stress perception of hospital bedside nurses

FULL CITATIONS

2016 National Healthcare Retention & RN Staffing Report; Nursing Solutions Inc. (NSi); March 2016 🇺🇸

hapter 26 Work Stress and Burnout Among Nurses: Role of the Work Environment and Working Conditions; Patient Safety and Quality: An Evidence-Based Handbook for Nurses; Bonnie M. Jennings 🇺🇸

Nursing Turnover: Costs, Causes, & Solutions; Success Factors, 2009 🇺🇸

What Nurses Want: Analysis of the First National Survey on Nurses’ Attitudes to Work and Work Conditions in Australia; Monash University, Department of Management; Associate Professor Peter Holland, Dr Belinda C Allen and Dr Brian K Cooper; February 2012 🇦🇺

The effect of chair massage on stress perception of hospital bedside nurses‘; Canadian Touch Research Centre; MARY KAY BRENNAN, MS, RN, LMBT and RITA DeBATE, PhD, MPH, CHES 🇨🇦

RETENTION: stabilise and increase

With some regions in Australia finding it hard to attract any quality staff, benefits they may not get in other facilities, such as massage, can be used to attract new staff.

  1. “While an overwhelming majority (8 4.8%) of organisations view retention as a “key strategic imperative” it is not evident in operational practice/planning. Although viewed in such a strong light, only half or 51.5% have a formal retention strategy. This is a dramatic increase from the previous survey signifying that more and more hospitals are focusing on protecting their human capital” 2016 National Healthcare Retention & RN Staffing Report
  2. “Northern Territory and Queensland, as both regions have reported problems attracting and retaining nurses in rural and remote areas.” The rate and cost of nurse turnover in Australia
  3. “In Taiwan, Chen and co-workers found that distributive justice, workload, resource adequacy, supervisory/kinship support, and job satisfaction were strongly associated with intention to stay or leave one’s job.” Nursing churn and turnover in Australian hospitals
  4. Gess and colleagues found that changing organisational processes, so that the nursing staff had additional autonomy and were offered rewards and recognition for their work improved organisational commitment, and decreased turnover.” Nursing churn and turnover in Australian hospitals
  5. To eliminate nurse turnover, healthcare organisations must create programs and incentives that increase retention. They can do this by offering monetary incentives such as competitive salaries and benefits, profit sharing, scholarships and tuition reimbursement.” The High Cost of Nurse Turnover
  6. “Taken together these findings are cause for serious concern and unless steps are taken to improve the work conditions of nurses it is likely that existing problems in relation to the recruitment and retention of this critical workforce will only worsen.”  What Nurses Want: Analysis of the First National Survey on Nurses’ Attitudes to Work and Work Conditions in Australia

FULL CITATIONS

2016 National Healthcare Retention & RN Staffing Report; Nursing Solutions Inc. (NSi); March 2016 🇺🇸

The rate and cost of nurse turnover in Australia; Collegian Journal, Michael A. Roche,  Duffield, Homer, Buchan, Dimitrelis; Volume 22, Issue 4, Pages 353–358; December 2015 🇦🇺

Nursing churn and turnover in Australian hospitals; BMC Nursing; Angela J Dawson, Helen Stasa, Michael A Roche, Caroline S E Homer and Christine Duffield; 8 April 2014, 13:11 🇦🇺

The High Cost of Nurse Turnover; University of New Mexico; 30 November 2016  🇺🇸

What Nurses Want: Analysis of the First National Survey on Nurses’ Attitudes to Work and Work Conditions in Australia; Monash University, Department of Management; Associate Professor Peter Holland, Dr Belinda C Allen and Dr Brian K Cooper; February 2012 🇦🇺

STAFF REPLACEMENT COSTS: decrease
TURNOVER: we help decrease

A number of factors contribute towards burnout, and we want to, initially, intervene with those staff members who are close to dysfunctional burnout. Many reason burnout happens can be mitigated by massage to a large degree, however, not eliminated. These include low morale, management issues, poor support and negative staff attitudes.

This is hitting hospitals on a regular basis, with an average cost of staff replacement of $5million p.a., and with little investment, can recoup costs within weeks and go onto save a large percentage of that cost.

As each nurse costs an average of $49,255 to replace, and turnover rates hovering around 18>24%, $5 to $8million is a cost currently borne per facility. Massage intervention can mitigate a substantial part of this turnover.

  • Over the entire sample, the average total cost of turnover was calculated as $49,255 per FTE. However, costs ranged from $17,728 to $104,686 across the hospitals.” The rate and cost of nurse turnover in Australia
  • “Nursing turnover is a serious issue that can compromise patient safety, increase health care costs and impact on staff morale.” Nursing churn and turnover in Australian hospitals
  • “Minimising turnover rates is an important priority for health service managers for a number of reasons. Firstly, turnover is costly for health care organisations […] Positive solutions must be found if we wish to decrease clinical nursing staff turnover.” Nursing churn and turnover in Australian hospitals
  • “To eliminate nurse turnover, healthcare organisations must create programs and incentives that increase retention. They can do this by offering monetary incentives such as competitive salaries and benefits, profit sharing, scholarships and tuition reimbursement.” The High Cost of Nurse Turnover
  • “These causes for turnover massage directly improves: Feeling overworked; not being able to manage workload
    Not receiving recognition or rewards for accomplishments
    Not feeling respected and valued for contributions and capabilities
    Work is too physically demanding. These causes for turnover massage directly results in: Making jobs more attractive to nursing candidates, Increasing compensation and benefits, Improving the organisations’ employment brand” Nursing Turnover: Costs, Causes, & Solutions
  • “Implementing these findings will reduce the national shortage of nurses caused at least in part by burnout, saving hospitals money in recruiting new and retaining existing nursing staff.” Burnout syndrome in hospital nurses

FINANCIAL

  1. “Direct costs are defined as those which relate to recruitment, temporary replacement and hiring of a new employee. […] Indirect costs relate to time spent administering the turnover process relating to termination and separation, as well as the costs associated with orientation and training and productivity of new employees ” The rate and cost of nurse turnover in Australia;
  2. “Estimates of turnover costs also vary widely, ranging from roughly USD$25,000 up to $88,000. This is largely due to conceptual differences relating to cost categories included in the calculation, and methodological differences relating to study design.” The rate and cost of nurse turnover in Australia;
  3. “The cost of turnover can have a profound impact on the already diminishing hospital margin and needs to be managed. According to the survey, the average cost of turnover for a bedside RN ranges from $37,700 to $58,400 resulting in the average hospital losing $5.2M – $8.1M. Each % change in RN turnover will cost/save the average hospital an additional $373,200.” 2016 National Healthcare Retention & RN Staffing Report
  4. “Figures from the Northern Territory show a turnover rate of 38% and a mean turnover cost of $10,734 (Australian dollars) per commencing nurse […] The total cost of turnover was highest in the ACT ($68,621), followed by WA ($58,260) and NSW ($26,199)” The rate and cost of nurse turnover in Australia;
  5. A pilot study in Australia estimating turnover costs at $A16,634 per nurse.” Nursing churn and turnover in Australian hospitals
  6. “Recent studies of the costs of nurse turnover have reported results ranging from about $22,000 to over $64,000 (U.S.) per nurse turnover (Advisory Board, 1999; Jones, 2005; OBrien-Pallas et al., 2006; Stone et al., 2003; Waldman et al., 2004). The reasons for this variability can be attributed to a variety of factors, but principally emanate from conceptual differences, such as defining nurse turnover cost categories, as well as methodological differences, such as study designs and samples. Two of the studies cited above that reported the highest costs (Advisory Board; Jones) defined and measured more extensive turnover-related productivity losses (e.g., pre-turnover productivity of the departing nurse), while the other studies acknowledged but did not capture these productivity losses at the same level of detail.The Costs and Benefits of Nurse Turnover: A Business Case for Nurse Retention
  7. “The average hospital is estimated to lose about $300,000 per year for each%age increase in annual nurse turnover […] One 9000 person healthcare organisation estimated that nursing turnover was contributing to a loss of over $15 million per year” Nursing Turnover: Costs, Causes, & Solutions
  8. “Estimated a total cost of between $62,100 and $67,100 to replace a single RN.” Burnout syndrome in hospital nurses

STATISTICS

  1. “About 17.5% of newly licensed registered nurses leave their first job within a year—and 33.5% leave within two years. [..] Organisational costs associated with RN turnover can be as much as $6.4 million for a large acute care hospital” Nurse turnover is high, but is that a problem?
  2. “The current national rate is 17.1%, slightly below 2014. Unlike hospital turnover, RN turnover continued to rise and, for the first time since conducting this survey, has exceeded the national hospital turnover rate. In 2015, the turnover rate for bedside RNs increased to 17.2%, up from 16.4% in 2014.” 2016 National Healthcare Retention & RN Staffing Report
  3. “In a recent Canadian study […] with an estimated mean turnover rate of 19.9% per year. In Jordan, the turnover rate has been estimated as high as 36.6%, with the authors using a broad definition as the total number of leavers in England a turnover rate of roughly 10% has been reported” The rate and cost of nurse turnover in Australia
  4. “Queensland has previously reported an annual turnover rate of 20.2% in the 1990s (Queensland Health, 1999), a figure not dissimilar to the recently reported rates of between 12% and 31.9% from that state, which varied according to nurses’ age […] The annual turnover rate per ward was 15.1% overall, ranging from 12.6% in NSW to 16.7% in WA” The rate and cost of nurse turnover in Australia;
  5. “Recent reports indicate a turnover rate in one state (New South Wales) of 1% to 1.4% per month.” Nursing churn and turnover in Australian hospitals
  6. “As of March 2016, Streamline Verify ranked healthcare third of the top three industries with high turnover rates. […] also found that 43% of newly licensed nurses who work in hospitals leave their jobs within three years. 33.5% resign after two years and 17.5% work for only one year.” The High Cost of Nurse Turnover
  7. “Nurses who work more than 12 hours in a single shift and more than 40 hours a week are likely to leave the nursing workforce within a year.” The High Cost of Nurse Turnover
  8. “Turnover costs, in general, have been estimated to range between 0.75 to 2.0 times the salary of the departing individual (McConnell, 1999), while nurse turnover costs have been estimated at 1.3 times the salary of a departing nurse (Jones).” The Costs and Benefits of Nurse Turnover: A Business Case for Nurse Retention
  9. “Annual turnover rates for registered nurses are estimated by the Joint Commission to range from 18%-26%, with cost estimates for each turnover ranging from $62,100-$67,000.” Alleviating Job Stress in Nurses

REGIONAL

  1. “With remote communities experiencing an even higher turnover of nursing staff” Losing the rural nursing workforce: Lessons learnt from resigning nurses

ORGANISATIONAL

  1. “Nurse turnover has recently gained greater attention due to strong correlations with patient outcomes (e.g. patient falls, infections), low staff morale, poorer job satisfaction and quality of patient care” The rate and cost of nurse turnover in Australia;
  2. “A high rate of turnover at a hospital, if it’s voluntary, could be problematic, but if it’s involuntary or if nurses are moving within the hospital to another unit or position, that tells a very different story. Researchers say there are different kinds of turnover, […] RN turnover can actually be helpful. In cases of functional turnover, a poorly functioning employee leaves, as opposed to dysfunctional turnover, when well-performing employees leave.” Nurse turnover is high, but is that a problem?
  3. “Comparison scenario results for the other nursing sector. A workforce undersupply is projected across the projection period, reaching an undersupply of approximately 38,000 in 2030 (an 88% gap). Factors contributing to this are high exit rates and low numbers of workforce entrants.” Australia’s Future Health Workforce – Nurses, Detailed Report
  4. “Higher rates of turnover also place considerable demands on hospital budgets.” The rate and cost of nurse turnover in Australia;
  5. “Direct Costs (Pre-hires): Advertising and training; Vacancy/Unfilled positions; Hiring. Indirect costs (Post-hire): Orientation and training; Decreased new nurse productivity; Decreased pre-turnover productivity; Termination” The rate and cost of nurse turnover in Australia;
  6. “Key factors affecting nursing turnover were limited career opportunities; poor support; a lack of recognition; and negative staff attitudes. […] low morale, management issues, workload, and the amount of time spent on non-nursing tasks all contributed to turnover […] Another study by Rhéaume and colleagues found […] foundations for quality nursing care, was the top predictor of the variance in turnover.” Nursing churn and turnover in Australian hospitals
  7. “Stress induced anxiety can lead to poor performance and increased nursing errors and studies have identified job stress as a major cause of nurses leaving the health care workforce.” The effectiveness of a 15 minute weekly massage in reducing physical and psychological stress in nurses

FULL CITATIONS

The effectiveness of a 15 minute weekly massage in reducing physical and psychological stress in nurses; Aust J Adv Nurs.; Bost N, Wallis M.; 2006 Jun-Aug;23(4):28-33  🇦🇺

Nursing churn and turnover in Australian hospitals; BMC Nursing; Angela J Dawson, Helen Stasa, Michael A Roche, Caroline S E Homer and Christine Duffield; 8 April 2014, 13:11 🇦🇺

The rate and cost of nurse turnover in Australia; Collegian Journal, Michael A. Roche,  Duffield, Homer, Buchan, Dimitrelis; Volume 22, Issue 4, Pages 353–358; December 2015 🇦🇺

The High Cost of Nurse Turnover; University of New Mexico; 30 November 2016  🇺🇸

Nursing Turnover: Costs, Causes, & Solutions; Success Factors, 2009 🇺🇸

Burnout syndrome in hospital nurses; Marshall University Digital Scholar; Priscilla Holdren and Alberto Coustasse; Spring 3 - 2015 🇺🇸

Alleviating Job Stress in Nurses; Medscape; Rashaun Roberts, PhD; Paula L. Grubb, PhD; James W. Grosch, MBA, PhD; 25 June 2012 🇺🇸

The Costs and Benefits of Nurse Turnover: A Business Case for Nurse Retention; Nursing World; Vol.12 - 2007 No3 Sept 2007 🇺🇸

2016 National Healthcare Retention & RN Staffing Report; Nursing Solutions Inc. (NSi); March 2016 🇺🇸

Nurse turnover is high, but is that a problem?; New York University, 11 September 2014 🇺🇸

Nursing Turnover: Costs, Causes, & Solutions; Success Factors, 2009 🇺🇸

Losing the rural nursing workforce: Lessons learnt from resigning nurses; QUT e-Prints; Bragg, Susan & Bonner, Ann; 23(6), pp. 366-370; 2015 🇦🇺

Australia’s Future Health Workforce – Nurses, Detailed Report; Health Workforce Australia; August 2014 🇦🇺

WORKPLACE ISSUES

ABSENTEEISM: decrease
  1. “A large survey published by the Australian Industry Group (AIG) in 2015 estimated that absenteeism directly costs organisations $578 per employee per day of absence. In direct costs alone, the loss to economy is said to be in excess of $44 billion per annum.” Absenteeism and sick leave policy in Australia
  2. “Absenteeism levels (sick and carers leave) rose to 8.93 days per employee per annum” 2013 Absence Management Survey Summary
  3. “The survey found employees were most likely to be absent on a Tuesday and least likely on a Friday.” Entitlement mentality’: Sickies costing employers $33b a year, survey finds
  4. “Staff shortages were said to lead to low levels of job satisfaction and increase nurse workloads, absenteeism and workplace injuries. In addition, staff shortages were reported to delay patient treatment and increase health care costs.” Nursing churn and turnover in Australian hospitals
  5. “In the health care organisation, work stress may contribute to absenteeism and turnover, both of which detract from the quality of care.” Chapter 26 Work Stress and Burnout Among Nurses: Role of the Work Environment and Working Conditions; Patient Safety and Quality: An Evidence-Based Handbook for Nurses
  6. “Job stress is believed to account for approximately 50% of all workplace absences and for as much as 40% of employee turnover.” Alleviating Job Stress in Nurses
  7. “According to previous research, 7.4% of nurses are absent per week due to corrosion or disability caused by stress, which is 80% higher than other professional groups.” The effect of massage therapy on occupational stress of Intensive Care Unit nurses
  8. “25.3% decrease in sick leave absenteeism […] $5.81 saving for every $1 invested in employee wellbeing” Proof Positive. An Analysis of the Cost Effectiveness of Worksite Wellness

 FULL CITATIONS

Absenteeism and sick leave policy in Australia; Dr Sick Note; 2 May 2016 🇦🇺

2013 Absence Management Survey Summary; Direct Health Solutions; 2 May 2016🇦🇺

Entitlement mentality’: Sickies costing employers $33b a year, survey finds; Sydney Morning Herald; 17 November 2014

Nursing churn and turnover in Australian hospitals; BMC Nursing; Angela J Dawson, Helen Stasa, Michael A Roche, Caroline S E Homer and Christine Duffield; 8 April 2014, 13:11 🇦🇺

hapter 26 Work Stress and Burnout Among Nurses: Role of the Work Environment and Working Conditions; Patient Safety and Quality: An Evidence-Based Handbook for Nurses; Bonnie M. Jennings 🇺🇸

Alleviating Job Stress in Nurses; Medscape; Rashaun Roberts, PhD; Paula L. Grubb, PhD; James W. Grosch, MBA, PhD; 25 June 2012

The effect of massage therapy on occupational stress of Intensive Care Unit nurses; Nurs Midwifery Res.; Fateme Nazari,1 Mojtaba Mirzamohamadi,2 and Hojatollah Yousefi;  2015 Jul-Aug; 20(4): 508–515🇮🇷🇺🇸

Proof Positive. An Analysis of the Cost Effectiveness of Worksite Wellness. Seattle, WA: Chapman Institute; Workplace Health Association Australia; Chapman, L.S. (2007)

NO BREAKS: manage state of self
  1. “Respondents also commented on often having to go without breaks on long shifts because of a lack of staff” What Nurses Want: Analysis of the First National Survey on Nurses’ Attitudes to Work and Work Conditions in Australia

FULL CITATIONS

What Nurses Want: Analysis of the First National Survey on Nurses’ Attitudes to Work and Work Conditions in Australia; Monash University, Department of Management; Associate Professor Peter Holland, Dr Belinda C Allen and Dr Brian K Cooper; February 2012 🇦🇺

JOB DISSATISFACTION: decrease

When an employee is taken care of, their job satisfaction stays high and so do their retention rates. When a facility takes on or MSMIP, job satisfaction rises as employees feel they are recognised for their effort, their working environment is more comfortable and they can balance their life and work. Massage cannot fix problems directly (such as fair pay or job security), but massage gives HCPs the ability to be more resilient and cope better with other satisfaction indicators.

  1. “Organisational costs associated with RN turnover can be as much as $6.4 million for a large acute care hospital.” Nurse turnover is high, but is that a problem?
  2. “Employee’s satisfaction is measured by employees indicating their agreement or disagreement to the following set of indicator questions:
    Opportunities for career development, fair pay, job security, relationship with members of your workgroup, relationship with manager, regular feedback, ability to work on own initiative, Interesting/challenging work provided, comfortable working environment, Work-life balance, Level of satisfaction with your present job overall,  recognition for effort” Sick Leave in the Victorian Public Sector Research Report 2006-2007 and 2011-2012
  3. “The Public Service is an exception where an increase in sick leave recorded for the public service over 2010-11 and 2011-12 coincides with a significant fall in employees satisfaction levels.” Sick Leave in the Victorian Public Sector Research Report 2006-2007 and 2011-2012
  4. “Rates of job dissatisfaction are extraordinarily high in nurses.” Alleviating Job Stress in Nurses

FULL CITATIONS

Nurse turnover is high, but is that a problem?‘; New York University, 11 September 2014 🇺🇸

SIck Leave in the Victorian Public Sector Research Report 2006-2007 and 2011-2012; Victorian Public Sector Commission; June 2012 🇦🇺

 lleviating Job Stress in Nurses; Medscape; Rashaun Roberts, PhD; Paula L. Grubb, PhD; James W. Grosch, MBA, PhD; 25 June 2012 🇺🇸

CO-WORKER, CO-OPERATION AND LEARNING: increase

Massage for a critical number of employees within one ward or department lowers stress amongst those who received and secondary effects. Massage encourages connection, and that connection allows greater improvements co-worker relations.

  1. “Nursing units with moderate levels of turnover were likely to have lower levels of workgroup learning compared to those with no turnover.” Impact of nursing unit turnover on patient outcomes in hospitals

FULL CITATIONS

Impact of nursing unit turnover on patient outcomes in hospitals; J Nurs Scholarsh. 2010 Mar;42(1):40-9. doi: 10.1111/j.1547-5069.2009.01319.x.; Mar 2010 🇺🇸

MANAGING FIRST LINE SERVICES: help stabilise efficiencies
HIGH-INTENSITY WORKLOADS: provide resiliance to deal with

Chronic overwork, with all its organisational problems, results in exhaustion and sometimes, burnout. Massage cannot fix internal organisational problems, like staff shortages, but it can help deal with how the staff member lives with effects. No matter where the stress comes from, the effect is the same.

  1. “SECRET government reports show Queensland emergency departments are so overstretched that patients are dying before seeing a doctor. […] revealing the problems leading to patient deaths including misdiagnosis, lack of staff and beds, failure to see a doctor in time, and inadequate treatment, the Courier-Mail reported.” Patients dying in Queensland hospital emergency departments waiting for treatment
  2. “The role of the nursing workforce varies with increasing remoteness. In the most remote communities, nurses can often be the only health professional providing regular face-to-face health services within the community. The distribution in this publication does not take this differing role into account.” Australia’s Future Health Workforce – Nurses, Detailed Report
  3. “Nurses in the mental health sector work the longest average hours per week of the nursing sectors.” Australia’s Future Health Workforce – Nurses, Detailed Report
  4. “These issues impacted upon heavy workloads and stress levels with nurses feeling undervalued and disempowered. Nurses described supportive strategies: improving performance appraisals, responsive preceptorship and flexible employment options. […] Poor skill-mix was commonly cited as a serious problem at work.” Nursing churn and turnover in Australian hospitals
  5. Admissions, whether we have adequate nurses on or not. We are expected to ‘special’ (provide one to one care) patients, whether we are given the staff to do this or not. “Absorb” them we are told- how do you this? EN, 50 years, Part time Female. […] Staff shortages were said to lead to low levels of job satisfaction and increase nurse workloads, absenteeism and workplace injuries. In addition, staff shortages were reported to delay patient treatment and increase health care costs.” Nursing churn and turnover in Australian hospitals

FULL CITATIONS

Nursing churn and turnover in Australian hospitals; BMC Nursing; Angela J Dawson, Helen Stasa, Michael A Roche, Caroline S E Homer and Christine Duffield; 8 April 2014, 13:11 🇦🇺

Australia’s Future Health Workforce – Nurses, Detailed Report; Health Workforce Australia; August 2014🇦🇺

Patients dying in Queensland hospital emergency departments waiting for treatment; The Australian; 7 April 2011🇦🇺

OCCUPATIONAL VIOLENCE: help decrease bullying, abuse and/or assualt

We give space and touch to nurses, doctors, surgeons and others on the receiving end of aggression from patients and other co-workers, to help them through these times. This care help decrease the risk of incidences having the effect they have on those we massage.

  1. “Johnson and Rea found that workplace bullying was associated with turnover from both the organisation and the nursing profession Nursing churn and turnover in Australian hospitals: nurses perceptions and suggestions for supportive strategies
  2. “Verbal abuse from physicians was noted to be stressful for staff nurses. In a study of 260 RNs, conflict with physicians was found to be more psychologically damaging than conflict within the nursing profession. However, a study exploring verbal abuse among 213 nursing personnel (95% RNs) found the most frequent source of abuse was other nurses (27%). Families were the second most frequent source of abuse (25%), while physicians ranked third (22%).” Chapter 26 Work Stress and Burnout Among Nurses: Role of the Work Environment and Working Conditions
  3. “The maternity ward has since been gripped by a shortage of midwives, that hospital insiders say is a direct result of a hostile work environment. […] ‘I was made to feel worthless and always that I shouldn’t have advocated for my patient as my complaint involved a senior doctor,” she said. i always felt intimidated by certain staff and most days were a battle. Instead of loving my job I ended up hating going to work and would breathe a sigh of ­relief if certain staff were not on duty […] These bullies need to be prosecuted for their continuous and wanton destruction of good nurses and their careers.”’ Bullied nurse claims she was forced to resign from Cairns Hospital’s troubled maternity ward
  4. “The American Nurses Association found that 17% of surveyed nurses reported that they had been physically assaulted at work in the past year and 56.9% had been threatened or verbally abused […] Physical violence against nurses is typically perpetrated by patients, patients’ family members, or strangers (e.g., in emergency departments), whereas non-physical, or “lateral,” violence in the form of incivility, disruptive behaviour, verbal aggression, and bullying tend to be perpetrated by other nurses, nurse managers, physicians, and other co-workers” Alleviating Job Stress in Nurses
  5. “Nurses reported a lack of support for flexible work arrangements and a failure of management to properly handle cases of physical, verbal and sexual harassment and intense workloads. “Such negative perceptions were most prevalent in New South Wales and in the areas of mental health, critical care and emergency, maternity care and aged care.” A third of Australia’s nurses are thinking of leaving the profession
  6. “Episodes of occupational violence is increasing” from interviews with healthcare professionals

FULL CITATIONS

Nursing churn and turnover in Australian hospitals: nurses perceptions and suggestions for supportive strategies; BMC Nursing; Angela J Dawson, Helen Stasa, Michael A Roche, Caroline S E Homer and Christine Duffield, 8 April 2014, 13:11 🇦🇺🇺🇸

Chapter 26 Work Stress and Burnout Among Nurses: Role of the Work Environment and Working Conditions; Patient Safety and Quality: An Evidence-Based Handbook for Nurses; Bonnie M. Jennings 🇺🇸

Bullied nurse claims she was forced to resign from Cairns Hospital’s troubled maternity ward‘; Cairns Post; Daniel Bateman; 18 February 2017🇦🇺

Alleviating Job Stress in Nurses; Medscape; Rashaun Roberts, PhD; Paula L. Grubb, PhD; James W. Grosch, MBA, PhD; 25 June 2012 🇺🇸

A third of Australia’s nurses are thinking of leaving the profession; Sydney Morning Herald online; 28 September 2016 🇦🇺

PRESENTEEISM: decrease
  1. “Experts say so-called “presenteeism” costs businesses money through lost productivity, and because sick staff can infect their colleagues.” Presenteeism costs economy $34 billion a year through lost productivity, report shows

FULL CITATIONS

Presenteeism costs economy $34 billion a year through lost productivity, report shows; Australian Broadcasting Corporation; Lucy Carter; 12 April 2016

NEGATIVE WORK ENVIRONMENT: decrease
  1. “Respondents wrote about issues that led them to contemplate leaving the workplace. These included […] a poor workplace culture and negative staff attitudes. […] Poor staff attitudes were said to affect workplace culture leading to a break down in relationships. The negative workplace culture prompted some staff to leave and seek other jobs” Nursing churn and turnover in Australian hospitals
  2. “By turning toxic work environments into healthy workplaces, researchers and nurse leaders believe that improvements can be realised in recruitment and retention of nurses, job satisfaction for all health care staff, and patient outcomes—particularly those related patient safety.” Chapter 26 Work Stress and Burnout Among Nurses: Role of the Work Environment and Working Conditions; Patient Safety and Quality: An Evidence-Based Handbook for Nurses

FULL CITATIONS

Chapter 26 Work Stress and Burnout Among Nurses: Role of the Work Environment and Working Conditions; Patient Safety and Quality: An Evidence-Based Handbook for Nurses; Bonnie M. Jennings 🇺🇸

Nursing churn and turnover in Australian hospitals; BMC Nursing; Angela J Dawson, Helen Stasa, Michael A Roche, Caroline S E Homer and Christine Duffield; 8 April 2014, 13:11 🇦🇺

QUALITY OF WORK ENVIRONMENT: increase
  1. “According to the results of this study, it is suggested that massage therapy can be used as a method suitable for nurses working in ICUs in order to reduce stress, promote mental health, and prevent a reduction in quality of nursing work life.” The effect of massage therapy on occupational stress of Intensive Care Unit nurses

FULL CITATIONS

The effect of massage therapy on occupational stress of Intensive Care Unit nurses; Nurs Midwifery Res.; Fateme Nazari,1 Mojtaba Mirzamohamadi,2 and Hojatollah Yousefi;  2015 Jul-Aug; 20(4): 508–515 🇮🇷🇺🇸

LONG SHIFTS: decrease stress
  1. “Although the type of nursing personnel involved was unclear, the nurses on 12-hour shifts experienced significantly more chronic fatigue, cognitive anxiety, and emotional exhaustion.” Chapter 26 Work Stress and Burnout Among Nurses: Role of the Work Environment and Working Conditions; Patient Safety and Quality: An Evidence-Based Handbook for Nurses

FULL CITATIONS

Chapter 26 Work Stress and Burnout Among Nurses: Role of the Work Environment and Working Conditions; Patient Safety and Quality: An Evidence-Based Handbook for Nurses; Bonnie M. Jennings 🇺🇸

SICK LEAVE: decrease

As the average age of HCP staff in a hospital is growing towards older age, part time work is a majority of work, and a majority of HCP nurses are women, sick leave is becoming an increasing expense facilities need to bare. It also doesn’t matter if the workers are first-line or work in administration away from public contact.

As massage can decrease sick leave, it is easy to calculate. If levels of sick leave are high, it may indicate that a facility has organisational problems, for which massage can play a part in decreasing stress levels and the ongoing benefits from massage session.

SUMMARY

  1. “The greatest source of stress for employees is not actually work load, it is non-work factors, such as family responsibilities” 2013 Absence Management Survey Summary
  2. “The largest single factor influencing the increase in sick leave rates appears to be the increasing number of older employees in the public sector workforce and that older employees take more sick leave. […] Sick leave is increasing at a faster rate for women than for men.” Sick Leave in the Victorian Public Sector Research Report 2006-2007 and 2011-2012
  3. “In a 2008 report, the United States Merit Systems Protection Board identified that disengaged employees are more likely to take sick leave than engaged employees.” Sick Leave in the Victorian Public Sector Research Report 2006-2007 and 2011-2012

FINANCIAL

  1. “The simplest means of attaching a cost to sick leave is to calculate the salary cost of the time taken.” Sick Leave in the Victorian Public Sector Research Report 2006-2007 and 2011-2012
  2. “The $70,000-$89,999 salary cohort shows a relatively high rate of sick leave. Over half of all nurses and 87% of all teachers fall into this salary bracket so it is highly represented by employees in service delivery occupations that have close contact with people.” Sick Leave in the Victorian Public Sector Research Report 2006-2007 and 2011-2012
  3. “If sick leave usage decreased by one day per FTE per year, it would have resulted in a saving of over $58 million in 2011-12.” Sick Leave in the Victorian Public Sector Research Report 2006-2007 and 2011-2012
  4. “Organisations who responded to the survey reveal the cost to their business was $2741 per employee per annum.” 2013 Absence Management Survey Summary
  5. ‘The cost to businesses of sick leave is also rising, with the average cost of absence now at $375 from $370 in 2009.” Sick leave costs business $30 billion – here’s how to cut it back
  6. “The cost to businesses of sick leave is also rising, with the average cost of absence now at $375 from $370 in 2009. Over the year, that cost comes to $3,712, resulting in the Australian economy losing up to $30 billion a year – 3% of GDP. […] We’re a bit behind the eight ball in terms of how we’re supporting our employees in the workplace.” Sick leave costs business $30 billion – here’s how to cut it back
  7. “In 2015-16, NSW Health spent $90.4 million on locums to cover workforce shortages including those created by doctors being on sick leave or holidays.” Doctors working overtime to compensate for seasonal staff exodus
  8. “The cost to businesses of sick leave is also rising, with the average cost of absence now at $375 from $370 in 2009.” Sick leave costs business $30 billion – here’s how to cut it back

DAYS PER YEAR

  1. “Jobstrain and longer commuting time were associated with long sick leave, whereas long work hours were inversely associated with long sick leave” Occupational factors and sick leave in Australian employees
  2. “Average Sick leave per FTE, 2011-12, Public health care, 10.6” Sick Leave in the Victorian Public Sector Research Report 2006-2007 and 2011-2012
  3. “Healthcare absenteeism climbed to 9.0 days annually.” 2013 Absence Management Survey Summary

DEMOGRAPHICS

  1. “Sick leave rates for employees aged 50 or more were nearly double that for employees aged under 30 (12.2 days per FTE compared to 6.3 days per FTE)” Sick Leave in the Victorian Public Sector Research Report 2006-2007 and 2011-2012 🇦🇺
  2. “Previous studies conducted in Australia have shown that certain employees tend to take more sick leave than others. These include workers with primary school-aged children (sick leave rose 20% during school holidays), employees with one child, employees with carer responsibilities, younger employees, […] and shift workers.” Absenteeism and sick leave policy in Australia

ORGANISATIONAL

  1. “The three largest industries in the public sector (Public Health Care, Government Schools and the Victorian Public Service) show the largest growth in sick leave.” Sick Leave in the Victorian Public Sector Research Report 2006-2007 and 2011-2012 🇦🇺
  2. It is common to use sick leave rates as a measure of organisational health. There is a significant body of research that links poor organisational culture and lower levels of employees satisfaction and engagement with higher levels of sick leave.” Sick Leave in the Victorian Public Sector Research Report 2006-2007 and 2011-2012 🇦🇺
  3. “Public health care and Police and emergency services also show comparatively high sick leave rates in the other occupational categories for which they have significant numbers of employees (Managers, Technicians and trades, and Clerical and administrative workers). […] there are characteristics of the work and practises in the organisations in these sectors which influence sick leave rates. […] establish a culture around sick leave use that influences the sick leave usage of their colleagues working in other occupations.” Sick Leave in the Victorian Public Sector Research Report 2006-2007 and 2011-2012 🇦🇺
  4. “Experts say so-called “presenteeism” costs businesses money through lost productivity, and because sick staff can infect their colleagues. […] they risked infecting colleagues and lowering overall workplace productivity.” Presenteeism costs economy $34 billion a year through lost productivity, report shows
  5. “Over 83% of the part time workforce are employed in Public health care and Government schools, the sectors with higher rates of sick leave, while only 51% of the full time workforce work in these two industries. […] The proportion of part time employees in the public sector workforce is also increasing […] 79% of fixed term employees are employed in Public health care […] the sectors with higher rates of sick leave, while only 60% of the full time employees work in these […] industries […] The proportion of part time employees varies within each industry sector from around 60% in Public Health Care” Sick Leave in the Victorian Public Sector Research Report 2006-2007 and 2011-2012 🇦🇺

FULL CITATIONS

Sick Leave in the Victorian Public Sector Research Report 2006-2007 and 2011-2012; Victorian Public Sector Commission; June 2012 🇦🇺

Presenteeism costs economy $34 billion a year through lost productivity, report shows; Australian Broadcasting Corporation; Lucy Carter; 12 April 2016 🇦🇺

Absenteeism and sick leave policy in Australia; Dr Sick Note; 2 May 2016 🇦🇺

Occupational factors and sick leave in Australian employees; University of Wollongong Research Online, Faculty of Science, Medicine and Health’; 2011 🇦🇺

Sick leave costs business $30 billion – here’s how to cut it back; Smart Company; 7 December 2010 🇦🇺

2013 Absence Management Survey Summary; Direct Health Solutions; 2 May 2016  🇦🇺

Doctors working overtime to compensate for seasonal staff exodus; Sydney Morning Herald online;  27 December 2016 🇦🇺

UNSUPPORTED OR UNAPPRECIATED BY MANAGEMENT: help manage feelings

SUMMARY

  1. “Because nurse administrators are responsible for creating the environment in which nursing is practised and patient care is given, it is important to explore interventions that will reduce the stress and burnout experienced by nurse administrators.”  Chapter 26 Work Stress and Burnout Among Nurses: Role of the Work Environment and Working Conditions; Patient Safety and Quality: An Evidence-Based Handbook for Nurses
  2. “Lewis found that 80% of the participants felt stress at work and only 13% felt supported at work.” Massage Studies for Stress Management/Reducing Anxiety, and the Treatment of Back/Neck Pain. The effect of aromatherapy massage with music on the stress and anxiety levels of emergency nurses: comparison between summer and winter
  3. “Respondents wrote about issues that led them to contemplate leaving the workplace. These included perceiving that there were  poor management support and little recognition. […] “Improvements and much more encouragement is required […] Performance review was seen as a way to recognise high performance although more attention to recognise achievements, encourage staff and reward excellent service was needed. […] Interestingly, these focused on non-financial incentives emphasising the recognition of staff achievements” Nursing churn and turnover in Australian hospitals
  4. “Work empowerment showed a strong, negative association with job tension and a strong positive relationship with perceived work effectiveness. […] Psychological empowerment, in turn, had a strong positive effect on job satisfaction and a strong negative influence on job strain. […] structural empowerment in the workplace (e.g., opportunity, information, support, resources, power) contributed to improved psychological empowerment (e.g., meaning, confidence, autonomy, impact).” Chapter 26 Work Stress and Burnout Among Nurses: Role of the Work Environment and Working Conditions; Patient Safety and Quality: An Evidence-Based Handbook for Nurses
  5. “As perceptions of empowerment increased, staff nurses reported less emotional exhaustion and depersonalisation along with a greater sense of personal accomplishment—the three components of burnout. Empowerment was negatively associated with work stressors in another study as well […] Because empowerment is often viewed as a characteristic of how work environments are structured, it has strong implications for nurse managers’ behaviours.”  Chapter 26 Work Stress and Burnout Among Nurses: Role of the Work Environment and Working Conditions; Patient Safety and Quality: An Evidence-Based Handbook for Nurses
  6. “Managerial support and participative management helped to reduce stress […] Burnout and work stress were reduced when administrators created work environments that provided staff with access to opportunity, information, resources, and support—the features of empowerment.” Chapter 26 Work Stress and Burnout Among Nurses: Role of the Work Environment and Working Conditions; Patient Safety and Quality: An Evidence-Based Handbook for Nurses
  7. “I am sick to death of working short staffed and being underpaid and not appreciated. My children earn more money than me working at Coles! NOT FAIR!” What Nurses Want: Analysis of the First National Survey on Nurses’ Attitudes to Work and Work Conditions in Australia
  8. “Management has a lack of understanding of the nursing role and also lack a true understanding of holistic care. There is a lack of respect shown to nurses by management who treat us like school children instead of adult professionals” What Nurses Want: Analysis of the First National Survey on Nurses’ Attitudes to Work and Work Conditions in Australia

FULL CITATIONS

What Nurses Want: Analysis of the First National Survey on Nurses’ Attitudes to Work and Work Conditions in Australia; Monash University, Department of Management; Associate Professor Peter Holland, Dr Belinda C Allen and Dr Brian K Cooper; February 2012 🇦🇺

Chapter 26 Work Stress and Burnout Among Nurses: Role of the Work Environment and Working Conditions; Patient Safety and Quality: An Evidence-Based Handbook for Nurses; Bonnie M. Jennings 🇺🇸

Nursing churn and turnover in Australian hospitals; BMC Nursing; Angela J Dawson, Helen Stasa, Michael A Roche, Caroline S E Homer and Christine Duffield; 8 April 2014, 13:11 🇦🇺

Massage Studies for Stress Management/Reducing Anxiety, and the Treatment of Back/Neck Pain. The effect of aromatherapy massage with music on the stress and anxiety levels of emergency nurses: comparison between summer and winter; Journal of Clin Nursing, 16(9), 695-1703.; Cooke, M., et al; 2007 🇦🇺

WORKFLOW AND TIME MANAGEMENT SCHEDULING: make more efficient

As massage decreases stress and become more focused and clear-headed, staff spend less time spent sorting problems on the workfloor, and have less interference to performing daily tasks. Thus, massage increases efficiency.