Nurses in England took an average of a week off sick last year because of stress, anxiety or depression, NHS figures reveal.

The disclosure has prompted concern that the intense strains nurses face in their jobs, including low pay and understaffing, are damaging their mental health and causing many to quit.

Nurses and health visitors took a total of 1,675,275 days off sick during 2023 as a result of stress and similar conditions, NHS England data showed.

That means that each of England’s 352,125 members of both professions missed an average of 4.95 days at work for that reason, according to a Royal College of Nursing analysis of the figures.

“Dangerous stress levels have become normalised inside an NHS which is unable to cope with demand,” said Prof Pat Cullen, the RCN’s general secretary and chief executive.

“Chronic workforce shortages are putting nurses under unbearable pressure. Nursing staff … are running on empty. Government and NHS leaders need to stop normalising poor mental health among staff.”

In all, nurses and health visitors took 6.9m days off sick last year, but the 1.68m days they missed due to stress, anxiety and depression were the single biggest source of illness. They comprised 24.3% of the total, up from 21% the year before. Colds and flu was the second largest group last year at 12%.

“These are sobering findings,” said Prof Alison Leary, the chair of healthcare and workforce modelling at London South Bank University. She highlighted that 2023 was the year that – for the first time – nurses who left the NHS cited work-life balance as the reason rather than retirement, according to other NHS data.

Many nurses are experiencing “moral distress”, Leary added. “It exists when a nurse can see what care the patient needs but doesn’t have the resources to provide it.

“Nurses generally are committed people and come to work to do a good job, [but] extreme workloads mean that they cannot do all of their work and this causes them distress,” she said.

Nurse shortages are widespread, with 34,709 vacancies in England. A hospital nurse in the West Midlands told the RCN that the “lack of staff combined with demand for services is a constant worry. It is causing stress and a lack of sleep. I feel low and let down by the system.”

Another nurse said: “[I am] so stressed and anxious about lack of income and financial pressures that my mental health has seriously deteriorated to the point of taking long-term sick leave for the second time in two years.”

The intense pressures of their jobs lead to many nurses and midwives quitting, especially early in their careers. One in eight nursing students drop out during their training, one in nine midwives do not join the profession after they graduate and one in five nurses leave within two years of joining the NHS, according to research published by the Nuffield Trust health thinktank in September.

An independent analysis commissioned by the RCN and published last month found that nurses’ pay fell by an average of nearly 25% between 2010-11 and 2023-24.

The RCN has said their pay levels mean many nurses have been struggling to cope with the soaring inflation that has hit households in recent years.

During 2022-23, more than 12,000 UK-registered nurses applied for a certificate of current professional status, which allows them to work in other countries such as the US and Australia, where nursing pay is higher. That was more than double the number who did so the year before and four times higher than in 2018-19.

A Department of Health and Social Care spokesperson said: “The most recent NHS staff survey shows improvement in morale and staff experience. And there are now record numbers of doctors and nurses working in the health service.

“NHS England has published a strategy to grow occupational health and wellbeing support, and the NHS long-term workforce plan will retain even more staff, meaning there are up to 190,000 more nurses by 2036-37.”