Nurses and midwives are the foundation of the health-care system, playing a key role in ensuring the continuity and quality of healthcare. Despite their role in ensuring the health of the population, their own physical and mental health often remains neglected. Scientific literature shows the special role of shift work (night work) as one of the factors determining the health of healthcare workers. In addition to night shifts, long shifts, the need to make quick decisions, and exposure to patient suffering also pose a significant mental and physical burden. A meta-analysis from 2022 found that shift workers had more than twice the risk of metabolic syndrome compared to day workers [1]. In a review of 24 studies examining the impact of shift work on nurses’ health [2], the authors demonstrated that shift work is associated with disruption of psychophysical homeostasis and, consequently, decreased productivity. It poses a barrier to social and family relationships, as well as a risk factor for stress, sleep disorders, metabolic disorders, diabetes, cardiovascular disease, and breast cancer. Similarly, a 2024 review found an association between shift/night work and health problems such as cardiometabolic risk, glucose intolerance, breast cancer and a weakened immune system [3].

Available data indicate disturbing trends in the health of this professional group in Poland, including an increased risk of chronic diseases, mental disorders, and a shortened life expectancy compared to the general population. According to the 2022 Report of the Supreme Council of Nurses and Midwives, the average age of death for nurses and midwives in Poland between 2016 and 2021 was just over 62 years [4]. It is important to remember that the life expectancy of women in Poland is almost 82 years [5]. These data are alarming and therefore require a separate, in-depth epidemiological analysis and explanation. However, research indicates that the population of nurses and midwives in Poland is characterized by an increased incidence of risky health behaviors. A study conducted in 2017-2018 among 1,080 nurses and midwives working in Lower Silesia, for example, found that nearly 20% smoked, 35% were at increased risk of alcohol addiction, 45% were overweight, and 95% reported poor diets [6]. There is a lack of nationwide information on nurses’ participation in primary and secondary prevention programs, such as influenza and COVID vaccinations, in this population.

Nursing is associated with numerous health risks. Among the most frequently reported problems are back pain, sleep disorders, chronic fatigue, burnout, depression, and anxiety. Long shifts, night shifts, the need to make quick decisions, and exposure to patient suffering pose a significant psychological and physical burden. Also, multiple employment or working across more than one healthcare setting may further increase fatigue and burnout, with potential consequences for health status and quality of life. According to reports from the Supreme Chamber of Nurses and Midwives, nearly 60% of nurses in Poland experience symptoms of burnout, and 70% complain of somatic complaints related to their profession. Another issue warranting further investigation is the increasing age of the nursing workforce in Poland. A recent report showed that the average age of Polish nurses is over 54 years, while the average age of midwifes is 51.4. In just 15 years, the average age of nurses has increased by almost 10 years, while the average age of midwives has increased by over 8 years during this period [7]. Among approximately 277 thousand employed nurses, around 100 thousand remain professionally active after reaching retirement age, which may represent an additional factor influencing the health status and occupational burden of this professional group.

In Poland, where the number of nurses and midwives per 1,000 inhabitants is among the lowest in the European Union [8], this problem is strategic in nature and requires in-depth research and, based on this, immediate strategic intervention programs. In light of the growing demand for care and the aging nursing workforce, it is necessary to consider implementing strategies to improve their health. Furthermore, the staffing crisis in Polish healthcare and the need to retain experienced staff within the system demonstrate that investing in research on the health of nurses and midwives is not only an ethical requirement but also a strategic element in ensuring the long-term sustainability of the healthcare system.

Given the recently published study showing that only 53% of those who used primary care in the last 12 months received any advice on a healthy lifestyle, the crucial role of nurses in health promotion, patient education, and chronic disease prevention in primary care becomes increasingly important. The study results indicate a significant societal demand for expanded preventive care provided by nursing staff, particularly in the area of healthy lifestyles and individualized prevention plans. However, developing these competencies requires appropriate organizational support, additional training, and improved working conditions for nurses and midwives [9].

At the same time, research shows that nurses who practice health-promoting behaviors themselves (e.g., phy-
sical activity, proper nutrition, avoiding stimulants) are more likely to see themselves as role models for patients and are more willing to provide health education. A study examining nurses’ attitudes toward health promotion found that healthy staff behaviors were significantly associated with a more positive attitude toward the educational role and health promotion. The publication indicates that nurses’ healthy habits can foster greater engagement in health promotion activities, particularly in the areas of physical activity and smoking prevention [10].

Evidence from the literature suggests that developing nurses’ health competencies through targeted education and training can increase their readiness to undertake health promotion and disease prevention activities. Programs addressing healthy lifestyle behaviors and health communication skills have been associated with greater engagement in patient education [11]. Furthermore, researchers highlight that nurses’ competence, self-efficacy, and adequate preparation for health counseling are essential prerequisites for effective educational practice [12, 13]. Therefore, fostering healthy lifestyles and strengthening health-related competencies among nursing personnel may contribute to more effective patient education and health promotion outcomes.

Given the above, urgent consideration should be given to implementing strategies aimed at improving health and establishing a program for continuous health screening and developing health competencies for nurses and midwives in Poland. Establishing a research program on the health of nurses and midwives in Poland will enable, among other things, the identification of key health risk factors, the assessment of the impact of working conditions on health and longevity, the development of prevention and health promotion strategies tailored to professional realities, and the formulation of recommendations for decision-makers in the areas of health and employment policy.

The best example of such a program seems to be the multi-year program modeled on the American Nurses Health Study (NHS), one of the most influential cohort studies in public health research. The study began in 1976 with 121,700 American nurses and has been providing crucial knowledge about women’s health and chronic disease prevention for over 40 years. The inclusion of nurses as a study population was particularly valuable due to their professional knowledge and ability to provide detailed health-related information over time. Through longitudinal follow-up, regular surveys, and self-collection of biological samples, the study has created a comprehensive database, with a participant retention rate of over 94%. Over time, the scope of the NHS expanded from studies on contraception to include diet, lifestyle, and other risk factors. Subsequent editions were developed (NHS II, NHS3), a study of participants’ children, and similar projects for men and in other countries. The NHS results had a significant impact on public health recommendations, including in the field of nutrition, physical activity, and the elimination of trans fats from food [14].

Although there are some studies on nurses’ health in Poland, systematic monitoring and comprehensive analyses are still lacking. Epidemiological, qualitative, and interventional studies are needed to better understand the scale of the problem, identify key risk factors, and propose effective solutions. The health status of nurses in Poland reflects the condition of the entire healthcare system. Ignoring the problems of this professional group threatens not only the nurses themselves but also patient safety and the stability of healthcare. Urgent legislative, organizational, and research measures are needed to improve nurses’ working conditions and ensure their improved health, which will have implications for the health of the entire Polish population.

Disclosures

1. Institutional review board statement: Not applicable.

2. Assistance with the article: None.

3. Financial support and sponsorship: None.

4. Conflicts of interest: None.

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