Nurses at crowded hospitals more likely depressed

NEW YORK (Reuters Health) -- Nurses who work in hospital wards that are usually filled to capacity may have a higher risk of depression than their counterparts in less-crowded hospitals, Finnish researchers suggest.

Their new study found that hospital staffers who worked in the most crowded wards were twice as likely to take sick leave for depression as staff who worked in wards with "optimal" numbers of patients. The large majority of workers in the study -- 93 percent -- were nurses.

The findings, published online May 4 in the Journal of Clinical Psychiatry, don't prove that hospital overcrowding contributed to the nurses' depression. But they raise the possibility that chronic stress due to a heavy workload might impair some hospital workers' mental health, lead researcher Dr. Marianna Virtanen, of the Finnish Institute of Occupational Health in Helsinki, told Reuters Health in an e-mail.

For the study, Virtanen and her colleagues used data from 16 hospitals to look at monthly bed-occupancy rates for the years 2003 and 2004. They then linked that information to data on sick leave for 5,166 staff members in 2004 and 2005.

Wards that, for the year, had no more than 85 percent of beds filled on average were considered to be operating at optimal capacity. Wards that topped 85 percent were deemed to be overcrowded.

Overall, Virtanen's team found, staff in the most crowded wards -- where more than 95 percent of beds were filled, on average - had double the risk of taking sick leave for depression as their counterparts in wards with an optimal number of patients. The researchers took into account factors such as workers' age and area of medical specialty.

The overwhelming majority of nurses and other staff did not take leave for depression, regardless of ward crowding. Of 486 workers in the most crowded wards, 23 took leave due to depression over two years. That compared with 41 of 1,766 staff members in wards with optimal bed occupancy.

Still, the findings point to an additional concern about hospital overcrowding. Past studies, Virtanen said, have suggested that overcrowding may compromise patients' care -- increasing their odds of infection, for example.

"Good practice could be to keep the bed occupancy levels at a reasonable level," she said.

Virtanen acknowledged that other factors not measured in the study -- like hospitals' financial difficulties or poor management -- might explain the connection between overcrowding and staff's depression risk.

SOURCE: here Journal of Clinical Psychiatry, online May 4, 2010.