1. Stress in Nurses Starting Work Andy Smith

2. Healthy Minds at Work: An ESF funded project

3. Importance of studying stress in those starting work Most of our knowledge of stress at work is based on cross- sectional studies of people who have been in work for some time. It is difficult to separate out current influences and those from past working situations. It may be possible to give appropriate pre-work guidance or training to prevent stress occurring in the first place. Our previous studies of teachers and doctors on work placements suggest that this is a very stressful time.

4. Nurses on work placement Baseline measures taken prior to starting work Measures of stress at work and mental health taken after the placement Over 130 nurses completed the study

5. Results Perceived stress was found to be associated with established risk factors (e.g. job demands and interpersonal stressors). Stress was associated with mental health problems. The best predictor of stress at work was prior mental health problems. Levels of stress at work were generally low which may reflect some nurses observing work rather than having a hands on role. Future studies will examine the start of the actual job rather than job placements.

6. The role of a case manager in improving job retention for those with mental health problems.

7. Healthy Minds at Work: An ESF funded project

8. Stress and job retention Stress and mental health problems often threaten job retention, both in those starting work and those in established jobs. Approaches are needed to address this. Initial work in the Healthy Minds at Work project has shown that a case manager can recommend appropriate support services (e.g. counselling) that improve job retention.

9. A proposed approach to improving job retention in those who are stressed at work Initial assessment of work factors, personal factors and nature of illness and level of functioning. Development of an action plan with the client to aid job retention/return to work. This is considered along with the organisational perspective. Other information may be obtained from relevant sources (e.g. medical information requested). Workplace assessments may be arranged. Reasonable adjustments may be explored with the employer.

10. Proposed approach (contd) Support in the workplace may be arranged Individual therapies (e.g. counselling, stress management, CBT) may be arranged. Lifestyle changes may be discussed. This approach can be tailored to fit the individuals needs. Similarly, evaluation can occur at all stages and modifications made accordingly.