More than 18 000 nurses have answered questions about how they experience their daily work, with particular emphasis on the psychosocial work environment.

“The survey shows that municipalities in Norway are underfunded. The staffing is not proportionate to the tasks to be performed,” says Solveig Osborg Ose.

Ose is a senior research scientist and has led the work with the large nursing cohort that SINTEF established on behalf of the Norwegian Nurses’ Association (NSF).

The report concludes that many nurses have experienced increased workloads in the past year, especially in municipal nursing homes, home care services and residential and care facilities.

“Many nurses are experiencing great pressure, and the workload is greatest in the municipalities. At the same time, half of the nurse managers say that they have experienced staffing cuts in the past year,” says Ose.

More than 60 percent of nursing managers state that they have unfilled nursing positions in municipal nursing homes and home care services. This leads to great pressure on the nurses working in these services. Ose is clear that the staffing in the municipalities must be strengthened.

“Many municipalities are struggling to recruit nurses. Some end up choosing to hire people with lower qualifications. But that only exacerbates the problem for the nurses who are already there. We have to stop thinking that this is about getting more hands into service. What we need are heads and brains, nurses with expertise,” says the SINTEF researcher.

To make recruitment easier, municipalities should offer better working conditions. Staffing plans and shifts have to take into account expected absences, and employers should avoid minimum staffing that overloads employees. Employers must avoid strain that causes health problems and leads to sick leave, such scheduling shifts with only short rest periods in between.

Ose also points to increased wages as a means of intervention.

“This is about simple market mechanisms. Many nurses would also prefer a reduced workload. Increased staffing and better weekend allowances could also make working on weekends more attractive.

In addition to filling vacant nursing positions, priority should be given to attracting more support staff into the services. Many nurses report that they perform tasks that they believe should be done by others, such as cleaning, working in the kitchen and administrative tasks. In public specialist health services, for example, over half respond that they perform tasks daily or weekly that cleaning personnel should have done.

The report reveals major shortcomings in HSE work among nurses. Employers are required to regularly review working environment conditions and assess the risk of health problems as a result of the work. However, almost 60 percent of nurses state that this does not happen. Over half of nurses respond that they do not have procedures in place for handling offensive behaviours in the workplace.

“Employees need protection to avoid overload and health problems that result. This is what HSE and internal control are supposed to take care of. We find that this work has fallen quite short in the public sector as compared to the private sector,” says Ose.

The report concludes that many nurses and employees experience inadequate protection.

“What we see is that in professions where you work with people, HSE work has not been adapted to the actual loads,” says Ose.

The survey shows that cooperation between parties in the workplace must be strengthened. This could contribute to more effective preventive HSE work. Ose also believes that employees must be better trained in technological developments.

“Many nurses are only minimally involved when new technology or new solutions are being developed and implemented. Better cooperation between parties can help employees participate more in technological developments in various workplaces. This could provide better solutions and increase the likelihood that their implementation will be successful,” says Ose.

The survey forms the basis for a long-term study of working conditions in the health services.

“We will now follow this sampling over ten years. This first survey included a certain predominance of older nurses among those who responded, and we’ll introduce ways to also include more younger employees in our further work,” says Ose.