Highlighting some of the toxic elements of the critical care working environment

The recently published NHS workforce strategy is arguably ambitious and somewhat unrealistic in terms of increasing nurses' numbers.

As a critical care nurse and passionate researcher on the issue of nurses' retention, I also believe there is a lack of focus and robust plan in the strategy on retaining health care professionals, especially nurses. This is unfortunately a continuous theme and the worsening working conditions of nurses suggest that NHS leaders and the government have not learnt their lessons to develop strategies on retaining nurses and not just focus on recruitment.

Various factors have been identified to have been associated with critical care nurses' intentions to leave but in this blog, I would like to highlight some of the unpleasant aspects of the critical care working environment. My own research into the factors associated with critical care nurses' intentions to leave identified some of the toxic elements present in the critical care environment. These unpleasant aspects and misbehaviours include unprofessional and bullying behaviour especially towards junior colleagues, racial and judgmental attitudes and remarks, anti-intellectualism and devaluing other colleagues.

As a critical care nurse, I observed some of these elements myself in practice and similar toxic elements were reported by critical care nurses in not just one but in 2 to 3 different set of data that I collected. Considering that the NHS is currently relying heavily on international nurses with diverse backgrounds, it is even more important that we develop strategies to tackle these issues.

Critical care nurse leaders and managers, therefore, need to develop strategies to focus more on retention by specifically improving these unpleasant aspects of the critical care work environment. In my view, this will go a long way in improving the critical care working environment and thus critical care nurses’ retention.