Prescription for Reducing Work Absences Among Nurses

Health care workers have a high rate of lost-time claims and work absence. This
is especially true for nurses who experience high rates of prolonged absences.
A recent study from the Canadian Institute for Work and Health (IWH) suggests
that creating non-violent and supportive health care workplaces may help reduce
prolonged work absences among nurses.

Health-related worker absence is a costly problem that creates a financial
burden in compensation costs and lost productivity, in addition to the impact
it represents to worker health. And it is on the rise. In the last ten years
the length and costs of absences have increased and, with an aging workforce
likely to experience evermore chronic conditions, will continue to do so.

The study

The study, Examining the Impact of Worker and Workplace Factors on Prolonged
Work Absences Among Canadian Nurses, was published in the August 2011 issue of
the Journal of Occupational and Environmental Medicine. It collected
information on 11,762 female, direct-care Canadian nurses from Statistics
Canada's 2005 National Survey of the Work and Health of Nurses. Factors related
to nurses' personal health and their workplaces were examined relative to three
categories of work absences: none, short-term (one to 10 work days) and
prolonged (11 or more work days).

The impact of the following worker health factors were considered in the study:

  • pain-related multimorbidity (concurrent chronic conditions)

  • depression

  • work-related and non-work-related pain severity

  • pain-related work interference

Seven workplace factors were considered:

  • organizational culture, autonomy at work

  • respect and support at work

  • physical assault or emotional abuse by a co-worker, patient or visitor

  • job insecurity

  • unionization status

  • facility type

  • employment status


The IWH study shows that the biggest effect on the length of nurses' work
absences are worker health factors such as pain that interfered with the
ability to work, more severe pain, depression and having a higher number of
chronic health conditions (such as arthritis, migraine and back pain). Although
workplace-related factors have a smaller effect overall, emotional or physical
abuse at work by co-workers or patients/visitors, and disrespectful and
unsupportive work environments contribute to prolonged absences.

The study not only looked at the impact that worker and workplace factors had
on absenteeism among nurses; it examined the relationship between the two. The
combined effect of worker and workplace factors is the most distinctive finding
in this study. For example, pain-related work interference, the factor most
strongly associated with prolonged absences among nurses, appears to be a
result of both worker and workplace factors. The degree to which pain
interferes with work may depend not only on a nurse's pain level, but also on
the demands, both physical and social, of the work environment. Respect and
support at work also serve as connections between the worker and workplace
factors. Nurses who perceived more respect and support from their co-workers or
supervisors reported lower levels of work-related pain severity and were less
likely to report depression, and therefore less likely to have prolonged work

What employers can do to help reduce long absences

The study's findings and IWH Adjunct Scientist Dr. Renée-Louise Franche, a
clinical psychologist at Vancouver General Hospital who led the study, suggest
a number of ways in which health care organizations can help decrease
health-related work absence among nurses:

  • Implement or augment violence prevention programs. Among those in the 2005 Statistics Canada nurses' survey that were included in this study, 57 per cent reported being emotionally abused at work and 31 per cent reported being physically assaulted at work during the previous year.

  • Address respect, support and organizational culture. This includes nurses' feelings of control over their practice and autonomy at work, as well as their relationships with doctors and co-workers.

  • Focus disability management practices on workers who are still on the job but struggling with multiple physical and mental health conditions.

  • Offer pain management and programs that address depression, focusing on the work environment. Although the workplace doesn't have full control of workers' pain and depression, it can help deal with issues by offering self-management approaches. For example, more workplaces are offering relaxation and meditation courses, and these could be extended to include strategies on how to manage symptoms and episodes at work.

Further Information - Source: Canadian Centre for Occupational Health and Safety