“People are tired and they’re just saying we’re worth more than what you’re giving us. I don’t blame people for striking. If you know your value, fight for it. We know our value as nurses. We’re fighting for it.”
The Royal College of Nursing (RCN) voted for strike action two weeks ago, for the first time in its 106-year history in a dispute over pay and patient safety, demanding a 17.5% pay rise.
“It’s very cyclical. Why are staff leaving? Because they’re burnt out. Why are they burnt out? Because there’s low staffing. Why is there low staffing? It’s all connected together.”
Jess, whose name has been changed as she wishes to remain anonymous, is a mental health nurse who voted in favour of strike action. “There needs to be a whole change of culture,” she says. “Funding, education, support, wellbeing for staff. We deal with really challenging situations. And then suddenly, we’re meant to go home and everything’s meant to be alright. And it’s like, no. We’re looking after really vulnerable people. We get assaulted on the daily. I can’t just switch off that I’ve been a punching bag all day. That’s not easy. I’ve used up all my niceness at work and I come home and I’m just a shell.”
NHS nurses don’t get paid for their breaks and Jess shares the unsurprising but deeply demoralising reality that nurses often work straight through for 13 hours.
“I didn’t have a break yesterday, the day before I didn’t either. Because things crop up. And you know when you leave the ward to have your break you’re leaving it understaffed. When people need your help. And you need to support your staff. And I feel bad for going on my break because these people come first. Especially when you’re busy and you’ve got paperwork and patients are becoming agitated and you need to spend time with them. That eats into your break.
“It’s not only the mental stress that gets to you as a nurse, but it’s also physical health as well. The back goes. You’re tired all the time. Can’t be bothered to get up in the morning, but you have to because these people rely on you.
“I’ve gone into work when I feel sick, and then I’ve had to go home because I literally can’t cope because you do feel bad. You feel you’ve let the team down. These people need me. Especially if I’m the only nurse on. That happened to me a few months ago when I was really ill and the next day I ended up in hospital.”
Jess shares a recent experience of when she worked a 16-hour shift because there were no other staff to cover an absent colleague.
“There was no one. Every single ward had only one nurse for the night shift and there should be two. So on my ward there was no nurse for the night shift. So I stayed until about half 11. I’ve had to do their medications at 10 o’clock at night when I’ve been working for 15 hours.”
Jess talks me through the pressure involved in making sure medications are accurate and the trauma involved when forced to perform injections against a patient’s will under the Mental Health Act.
“When you go into that medication room you’re thinking, okay, how am I going to manage this situation? I’m the nurse in charge, I’m managing the situation. But then you’ve got a patient who’s really agitated and distressed outside, your staff are becoming anxious because they’re like, okay, how do we manage the situation until the nurse is here.
“Have we got the medication in stock? And then if the patient doesn’t accept that tablet, preparing the injection, which can take some time because you’re having to do maths calculations very quickly. And then you’re having to get all the equipment, drawing it up in the right way and checking that it’s the right dose, the right medication, whether it’s in date. If we don’t have it, does another ward have it? So you’re spinning plates all the time. Whilst you’re doing this, you might become distracted because you can hear the patient becoming more and more agitated. And they’re screaming and you think ‘oh God, I need to hurry up’. But you need to take your time because you need to be accurate. And then you go to them with the injection and offer the tablet again and if they don’t accept it, then you have to give the injection and that’s a really traumatic thing to do. It’s even more traumatic for the patient, but I don’t want to do that to someone against their will. It’s horrible. It’s traumatic for everyone involved.”
For most people, it’s impossible to empathise with how mentally taxing it must be to deal with experiences like this every single day. So it’s understandable why NHS workers have been labelled ‘heroes’ for the work they’ve done through the pandemic. But Jess rolls her eyes at the mention of the word.
“Just because I’m a nurse doesn’t make me a hero. I’m not Superman flying across the city saving all these people’s lives. I’m saving lives, but I’ve done the training for it. During COVID when people would clap it made me cringe. I can’t cash in claps! The government doesn’t care about us.
“I think the people making the rules are so out of touch with what’s going on. You’ve seen nurses going to food banks. They’ve studied for three years and have got an amazing career but they’re going to food banks because they can’t afford food for their family. And they’re working overtime and it’s still not enough.”
When asked what the perfect day at work would look like, Jess laughs: “I’ve not even thought about it because I’m just so used to a rubbish day.” But amongst the hard times, there are glimpses of light that shine through.
“The other day I had a one-to-one time with a lady who has been distressed a lot throughout her admission. She was crying all the time and we couldn’t console her. And just recently, she started to improve and although she can’t articulate herself well, we were having a conversation. I don’t know what about because part of dementia is you enter their reality because their reality is different from yours. And it was just so lovely because she was happy. She was smiling. She was laughing with me and it’s just those little moments that, albeit are few and far between, makes the job worth it. I got teary-eyed because you get so much out of seeing someone happy and comfortable, not in pain, not in distress. And you just cling on to those moments especially in dementia because things can change really rapidly. And I said to my patient, the day before: ‘Are you a proud mum?’, and she said, ‘Yeah, I’m proud’. So I told her daughter and she started welling up. And it’s those moments that make it all worth it.”
There is currently a record high of 46,000 NHS nurse vacancies and 2022 has seen a 25% increase in people leaving the profession compared to the previous year. With all of the challenges nurses face, it’s easy to see why. But talking to Jess, it is even clearer to see that the nurses who do leave do so with a heavy heart.
“One of my friends has just started working at a social media agency and they take her out to cocktail-making classes and they have meetings in these really extravagant bars in London. And I’m just there at work and sometimes think what the hell is my job? Like, it’s so weird. And then if I’m working all different hours of the week on all different days, I wake up and I’m like, ‘What day is it?’ Like the other day on Monday I was like, ‘is it Sunday? I don’t know.’ My brain is all over the place.
“I sometimes think I’d love to be in a normal job. But then I think, actually, I wouldn’t. I care so deeply about my patients that I wouldn’t want to work a normal job because I couldn’t imagine myself doing anything else.”
Of the eight trusts in the Manchester Central and Greater Manchester RCN branches, The Christie NHS Foundation Trust and Tameside & Glossop Integrated Care NHS Foundation Trust voted in favour of strike action.
The North West Ambulance Service and Health Education England North West, which provide services for the entire region, have also voted for strike action.
Industrial action is expected to begin before the end of the year, with more detailed plans and timelines to be announced.
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