[Nurses] feel that management imperatives and targets are imposed on them with insufficient consultation...

Professor Isobel Allen, of the PSI

Report author Professor Isobel Allen said: "[Nurses] have big problems related to the infrastructure of the organisation - unreliable support services, old and poorly maintained equipment and inadequate IT and administrative support.

"They feel that management imperatives and targets are imposed on them with insufficient consultation or consideration of how they are to be implemented.

"Ward sisters and charge nurses in particular find it very difficult to get their voices heard."

The report found nurses were being stressed by:

• Concerns on how to staff busy wards
• Worries about competency levels among agency nurses
• Long hours
• Recruitment and retention problems
• Cleanliness of wards
• Stress from other medics
• Disenfranchisement from their workplace

While staffing shortages remain a central problem for the NHS it is difficult to see how this sort of stress among ward sisters can be reduced

Sheelagh Brewer of the RCN

Professor Charles Easmon, director of Workforce Development at the NHS Executive, London, which commissioned the research said it clearly highlighted areas of concern.

"This is not easy or palatable reading, but we hope it will provide the basis for work at all levels to address a largely hidden problem which does have an impact on recruitment and retention and on clinical governance and staff performance."

'Central problem'

The Royal College of Nursing (RCN) welcomed the report, but called for better staffing levels to relieve stress on staff.

Sheelagh Brewer of the RCN said: "While staffing shortages remain a central problem for the NHS it is difficult to see how this sort of stress among ward sisters can be reduced.

"They are often caught between advocating staff concerns and tackling these issues with management.

"Ward sisters need the autonomy and authority to use their knowledge and skills in implementing employee friendly practices in their own area."