NEWS… BUT NOT AS YOU KNOW IT
If Carmen and David had the chance, they’re not sure whether they’d ever become nurses.
‘I think it was in my second week of training when I thought, you know what, this might not be for me,’ Carmen, who works at an NHS trust in London, says.
‘There are some times I dream about an alternative universe where I had quit in the second week, and how much better my life would have been.’
David, who also works in London, says that ‘going back in time’ and deciding whether to still go into nursing is a common water cooler topic in staff rooms.
‘And if I was being really honest with you, I wouldn’t,’ he says. ‘The post-traumatic stress, the trauma, the self-harm and the suicides I’ve witnessed and resuscitated. Nursing is a really tough job.’
‘Last year, I resigned. I was working as a nurse in charge,’ David says, explaining that he almost daily worked two to three hours beyond his shift.
‘Every day was absolutely horrific. It made me physically ill. I was stressed and I realised I was about to have a breakdown.
‘I did horrific shifts – thankfully nobody died. We are spread too thin and more patients are coming and coming.
‘I realised I hated the job. This is the worst it’s ever been. We’ve been in a rut now for two, three years and it’s only getting worse.’
Carmen feels she’s about to go through this too. ‘I’ve been a registered nurse for three years and I’ve already sent my first job applications,’ she says.
‘That’s a disgrace.’
Both Carmen and David take immense pride in their jobs – they are, after all they say, literally saving people’s lives for a living.
But ‘living’ isn’t quite something they feel they themselves are able to do, not on the salaries they and other nurses like them are on.
Both are members of the Royal College of Nursing, Britain’s largest nursing union, and among the 300,000 nurses preparing to strike.
The earnings of an experienced nurse have plummeted in real terms by at least 20% since 2010 in England, Wales and Northern Ireland, the RCN found.
Hospitals and other health services still carry the scars from the Covid-19 pandemic, leaving them short-staffed and shouldering a spiralling backlog of treatments and appointments.
And these problems were already there even before the pandemic, the RCN says, after years of Tory government underfunding.
Prime minister Rishi Sunak has said the RCN’s demand for a pay increase of 5% above inflation is ‘unaffordable’, while former health secretary Nadhim Zahawai has said a pay rise would benefit Russian president Vladimir Putin.
But their current salaries aren’t ones where having dreams is an option. David just about makes his mortgage payments, with owning a house being a top life goal.
‘But what about everything else? You’ve got aspirations for a child, well how are you going to feed and clothe that child? Do you want two or three children?,’ he says.
‘What about aspirations you want in terms of food or holidays? The pay in nursing is not for having aspirations.’
Carmen adds: ‘I’m so proud of nursing – I really want to say that – but as it stands, I have plans, I have dreams, I want to afford things and I might want a child.
‘If I stay in nursing, the prospects are looking very bad.’
This isn’t quite how Carmen and David imagined being a nurse would be like.
Carmen moved from Germany to Britain in 2011 before becoming a nurse in 2020, working in a cardiology department at a London hospital.
‘What struck me was how insanely competent the nurses are. One colleague told me she went several shifts without a doctor, “a doctor couldn’t run my ward”,’ Carmen recalls.
‘What people don’t realise is the amount of dedication and learning that’s required to do this job. If they understood this, they’d also understand why nursing needs to be more recognised.’
David has been a nurse for more than a decade, working in prisons, drug detox centres and emergency wards. By this point, he says, he’s seen it all.
I know staff who are skipping meals, who have gone to dodgy payday loans and who are prioritising their children eating rather than themselves.
‘To me, nursing is so much more than a job. There is something different about treating cancer patients, speaking to relatives when things go really well,’ David adds.
‘The camaraderie of nursing, the jokes, the parties, the pride you feel when you’re putting on your uniform.’
‘I’ve had a few shifts over 13 years that are a little bit like a TV drama, running down a corridor with bleeding patient type thing,’ David adds.
‘These are rare moments. What we don’t talk about is the night shift when I’m four nurses short. No one’s having a break. I haven’t eaten. I’m dizzy and delirious and dehydrated. I’m doing four people’s jobs: a housekeeper, a receptionist, an estate man, a porter and a pharmacist.
‘These things have been whittled down to the bone and all get dumped on the nurses.’
Carmen adds: ‘I left A&E a year and a half in because it was a warzone. I was tripping over patients. There weren’t enough seats. That’s the state of the NHS.’
This was never felt more than during the pandemic, one of the biggest tests to the standard of healthcare that a beaten-down NHS can provide.
‘I knew there’s gonna be death. Pandemic equals death,’ David says, adding: ‘I saw more death in one year than in 13 years.
‘I remember thinking this is going to be absolutely horrific. Staff will die. I’ve lost colleagues who have died. I took great pride – not so much in the clapping for hero things – but in a time of crisis, our department rallied around.
‘We went to hell and back and I feel great pride in that.’
Despite being celebrated as an essential worker, David feels the government’s attitudes to the strike don’t reflect that.
‘Nursing is very challenging, and if you’re not being paid nearly enough, you’re not valued by the government, you’re picking up extra shifts just to put food on the table or put the heating on, are you telling me that I’m a valued workforce?’
The government said a pay offer made in July of an average increase of 4.75% was in line with the NHS’s Agenda for Change, an independent NHS pay review body.
But David questions the pay review body’s decision: ‘Who are these people? How can I speak to them?
‘Who sits on this mysterious dark panel? The government need to get back to the negotiating table and offer a substantial, reasonable pay rise.’
On top of Covid, the healthcare sector is also feeling the pinch of the highest inflation rate in 41 years at a blistering 11.1%.
Some nurses, especially younger ones Carmen and David say, are taking pennies out of their pensions to make it to the end of the month.
‘Our healthcare assistants are the backbones of hospitals and they are picking up extra shifts,’ David says. ‘Rather than go home, they’re picking up five extra shifts – whether day or night – on top of their standard 150 hours per month.
‘I know staff who are skipping meals, who have gone to dodgy payday loans and who are prioritising their children eating rather than themselves.’
Something that’s stuck with David is the time he saw a nurse grabbing leftover biscuits from a patient trolley.
‘That’s my lunch today,’ David says the nurse told him as he added: ‘It’s so embarrassing. There’s no dignity in it.’
Carmen has seen this all too, she says, knowing exactly what David meant when he said hospital custard tastes great.
And the longer this goes on, the longer nurses are pushed to the limits, David fears this might take a toll on patient care.
‘A&E staffing issues, overcrowding, pressure point safety, critical issues of patient harm, people falling over, drug errors,’ David says, adding that he and many nurses are going home worrying about their patients.
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After a decade of below-inflation pay increases, David adds he’s seen more nurses than he can count leave the NHS, one of the world’s largest employers and an institution Brits often say is one of the things they’re most proud of.
Their reasons are often the same. ‘The driving force is their working conditions. Chronic understaffing and morale is rock bottom. We’ve come out of Covid but nothing’s really changed,’ David says.
‘Nurses are emigrating,’ he adds, ‘and shock horror, they’re not coming back.’
There are nearly 47,000 nursing vacancies in England alone.
Carmen fears that if the public begins to believe the NHS being ‘broken’ is the fault of the NHS, rather than the government’s years of belt-tightening, this could be reason enough for health services to be privatised.
‘The NHS does work – if you fund it properly,’ she says.
Nurses will strike on 15 and 20 December in parts of England, Wales and Northern Ireland.
Both Carmen and David stressed that the two strike days will run on a Christmas service, with emergency services, urgent therapeutic services as well as diagnostics and assessments all unaffected.
Carmen admits she knows how nurses turning to industrial action might look to some. But the reasons they have are not selfish ones.
‘For many of us, the fact we have a functioning healthcare system free at the point of care is one of the best things about this country. To save it would be incredible,’ Carmen says.
‘Thinking about how many more lives we could change and save,’ she adds, ‘that’s what a pay rise would mean to me.’
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