TwitterNurse and the General Election

These are confusing times.  A General Election has been called and, as always, my thoughts turn to my job, the NHS, and the millions of patients who use and need the service. As a nurse, I want to do what’s right by them, I want to make the right choice. I want to vote for the right people who will save the NHS before it becomes just a memory.

Firstly, I am convinced the NHS as I know it – free at the point of need – is taking its last breaths and I remain committed to doing all I can to make sure it receives the treatment it needs.  Like any good nurse, I want to see improvement. With this in mind, this General Election seems to me to be one of the most important I have ever voted in and, because of this, I feel the need to balance all the odds.

I believe the current Conservative government are committed to dismantling the NHS as we know it – they are not really interested in addressing how it is used and by whom, these much discussed issues are smoke-screens to blindside the public and divert real analysis – they are instead interested in selling off the NHS to the highest bidders and this process has already begun.  Their commitment to this plan is staggering – they have developed a media campaign that has potentially convinced enough of the public that the NHS is failing because, amongst other spurious reasons, the staff are not good enough or not working hard enough, and that therefore ‘something has to be done’ – it is bewildering how many people seem to think the NHS is failing because it has suddenly become dysfunctional. The solution is simple: the government need to fund the NHS instead of systematically starving it of money, staff, talent and resources.  Perhaps because I work in the NHS, I am under no illusions: if a Conservative government are elected again in June, I believe there will be no NHS at the conclusion of its term.  If I am right, it is no longer a case of whether the public will somehow wake up and see this, it is now make-or-break for the NHS – vote into office another Conservative government and the price will be very high: no NHS as we currently know it.  The reality of this would certainly result in the ultimate of wake-up calls for the public.

So, while I have decided how I will not vote, I have not yet decided how I will because I am really not sure I believe in the political process any more. For me no one political party seems to be shouting about the NHS enough; I know the constant barrage of ‘vote for this’, ‘vote for that’ doesn’t appear to be working and, while I occasionally use the information as a source of research, the bombardments will not ultimately sway me one way or the other.  It has also been disheartening to see the occasional dispiriting remarks when two or more political views don’t align – accepting the views of others in a non-judgmental way is a crucial element of nursing and castigating others for not agreeing with you brings nursing into a competitive arena I am personally not happy with.  Like many others, I have marched, lobbied and petitioned on behalf of the NHS – anyone who has read this blog or who has met me knows this and I continue to do these things because I believe the NHS is worth saving  – I just remain unclear who should lead the charge and I sympathise with colleagues who feel as I do; from my own experience, there are plenty of nursing colleagues who remain uncertain and undecided about their own political voice or stance.  Perhaps nursing is suffering from a hangover of perpetually not being listened to – if your opinion is constantly ignored you begin to stop giving it, and you eventually stop hearing it being asked for.

This being said, I also appreciate that this fight is not just about nursing, in my view it is also about asset stripping a fundamental and crucial part of our welfare state.  Dismantling the NHS, no matter how surreptitiously, would be one of the biggest changes to our society and would leave us bereft of the caring safety-net we are all used to relying upon.  It would be a retrograde step of unimaginable significance and, as a nurse, a mother, a sister, a wife, I cannot stand by and watch that happen.  So I will do all I can to shout, to tweet, to Facebook, to lobby, to petition, to march, to inform, and to work collaboratively with others who also care about the survival of this wonderful institution.

And I hope that eventually I will know what to do with my vote and how to make it matter most to my NHS.  This is my responsibility.

Your responsibility is to vote.

Please vote wisely.

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TwitterNurse – my patient journey

This week I was a patient.  I found a lump residing somewhere it shouldn’t.  As a nurse, I knew it might be nothing, I knew the likelihood was that it was a harmless bump, signifying nothing more than a new, if frightening, imperfection.  But, as a nurse, I knew I needed to get it checked, and this is where my patient journey began.

I think nurses will agree, as a group nurses do not make good patients! This is perhaps because we have knowledge of how the body can let us down, we see sadness relating to illness daily and, as a consequence, we desperately do not want to be a patient.

So, my patient journey began with a visit to my GP. After asking me how I was and how she could help, my GP held my gaze quietly, listening to all I said.  As she examined me, she focused on me in a very discerning way – looking at my body whilst watching my face too meant that she also saw my growing fear that all was not well, as well as carrying out an examination of the lump. We together decided that a two-week referral would be appropriate after talking me through her hesitant diagnosis (possibly a cyst, possibly a more sinister lump), and an urgent referral because of what the lump could signify.

Two days later I received a call from one of my local hospitals giving me an appointment to see a consultant.  Let’s think about that – two days; in any analysis, that is a pretty quick response time to get access to a consultant, someone who specialises in the field of my lump and where it is – such is the NHS.

My consultant saw me in a hospital I am not particularly familiar with so, walking in, I nervously searched the signage in the foyer in the hope that I could figure out the ‘coloured zones’ and find my way to my appointment, like any other patient. Whilst I was searching the board, a member of staff approached me and asked if I needed any help and I cannot convey what this meant to me, I could have hugged her! I was apprehensive and she made me feel less alone while helping me to get to my appointment on time! The meeting with the consultant was preceded by a full introduction from a Healthcare Assistant, who told me what would be happening and showed me where to wait.  As the consultant examined me, he explained that I would need two scans, one of which could be done straightaway whilst apologising for a delay in the second scan because this one could not be done until the following day. Two scans and twenty-four hours later it was confirmed that my lump was harmless and could stay where it is if this is my choice. A celebration and good news all around, a wonderful feeling and one which I am now acutely aware some patients don’t get to feel.

My overall impression of the NHS as a patient is of having seen a well-oiled machine in operation, and it looks and feels very different when you are not a functioning part of that machine; the experience of being a patient was very enlightening and one from which I gleaned a number of things:

  • Being a patient is not easy because it requires a certain amount of passivity and relinquishing of control
  • Someone making a simple offer of help can mean a lot
  • Even with some knowledge, I still felt utterly powerless because the dynamic between me and my body had potentially altered – illness is very scary
  • Waiting for results when the news could be life-altering feels like a wait of years
  • When you consider an illness to be serious, you do not think of yourself but of those you love, and this was, for me, the most terrifying and excruciatingly painful of considerations

Throughout my relatively short – if intense – patient journey, I felt cared for and respected – cared for because people recognised what it meant to have answers as quickly as possible, and respected because information was conveyed in a way that was geared towards me, the patient, by watching and waiting for my responses, by ‘reading’ me.

Essentially, I was valued.

By placing patients are the centre of care in this way, the NHS provides a level of compassion that is unrivalled and we do this outstandingly well; this makes a huge difference if you are a patient.  But, perhaps more importantly, the NHS itself could be fundamental to how we care – as patients, we walk into a hospital and we have an expectation of how we will be treated; as practitioners, perhaps our own professional expectations are closely tied in with our workplace, namely the NHS.  What if our environment, our NHS, in part determines our response in how we provide compassionate care to patients?  The NHS teaches practitioners of all levels to place patients at the centre of all care, and long may this continue; it is horrifying to think that all this could be lost along with the NHS if that too disappears.

I want my patients to continue to receive the same level of care and expertise I received, and I want patients to receive this care in an environment that fosters such learning and compassion. The NHS has a proven track-record of doing this and, last week, I not only saw this but I felt it too. I cannot convey how safe I felt. I cannot convey how cared for I was. I now feel a stronger sense of ownership of our NHS and more pride in my colleagues than I thought possible.

Believe me, as a patient and a colleague, our NHS is worth saving. It is a unique and wonderful achievement.

Let’s fight for its survival because its demise could signify a loss too great to comprehend.

 

TwitterNurse – an update

It’s been some time since I wrote so I thought it’s time for an update!

The struggle for the NHS is ongoing, and long may it continue.  The Junior Doctor struggle has, of course this week passed through the High Court with a ruling that some see as a win, some see as a loss.  I have to say at the outset, I am filled with admiration for my Justice for Health colleagues – how many of us would put our names and our careers out there for all to see and engage in such a public battle? For me it has been a breathtakingly brave journey and these Doctors will remain in my mind for many years.  Currently, despite their best efforts, it looks like the Junior Doctor contract will be imposed, despite Mr Hunt’s assertions that he didn’t intend this.  What does it all mean?

My understanding is that this contract was designed to address a truly seven-day NHS but essentially in a cost-neutral way, meaning no extra funding.  This means that imposing the Junior Doctor contract stretches an already under-resourced workforce across a seven-day period.  Let’s be clear, our current NHS workforce struggles to cope with the demands placed on it now and, as many have argued, without further resourcing this contract cannot safely be achieved.  As has been debated by many, with no further resourcing this means that Doctors will be doing unsafe shift patterns and this will have an inevitable impact on the role of the nurse, on our patients and on overall NHS service provision because there are only so many Doctors to go around.  Long shift patterns leading to severely disrupted sleep patterns and resulting tiredness, and leaving little time to socialise or have a life could lead to more mistakes, in an environment where mistakes are costly.  As Doctors have claimed, the imposition of the new contract will result in Doctors leaving the NHS at a time when more, not fewer, are needed.

To me, this contract seems a bit like punishing NHS Doctors for working hard, going the extra mile, and sometimes working on goodwill alone.  My colleagues work tirelessly to make patients better; in the NHS we try to make life easier and safer for patients; we work collaboratively to ensure the very best outcome is achieved for patients – we have no desire to see the NHS fail, to see its demise, or to take part in its wholesale destruction.  Nurses, Doctors and allied healthcare professionals want our patients to get well, we want our patients to have a good experience of our care and we strive to deliver a service that the public will be happy with.  So, when the same public ask why the NHS isn’t working any more, I would advise that they look to this government, not NHS staff.  Quite frankly, we can’t work any harder.

This would be a good place to say that I absolutely love my job! Seriously, it is the most rewarding career in the world. My patients and my colleagues make being a nurse worthwhile. And working in an organisation like the NHS is priceless.  The teamwork in the NHS is breathtaking – on an average day a nurse like me can talk to at least six other practitioners about one patient; such conversations take place to ensure the right pathway for the patient, often to keep them safe.  This week I like to think that, with the assistance of many others, I have helped several patients to cope with damaging physical and emotional symptoms; sometimes with medication, sometimes with a listening ear, sometimes with a hug, sometimes by arranging another step on their journey, and always with empathy – the possibilities to help someone are endless and my job affords me this privilege.  It can be the most rewarding of things to lighten someone’s burden.

I will continue to fight for the NHS and my patients – because to me these two are inextricably intertwined.  My patients deserve the best of care and I believe that the NHS delivers it.  So, I will march for the NHS, I will shout for it and I encourage all parties to do the same. I will fight further NHS cuts to budgets.  I will continue to support my colleagues – their input is vital for patient welfare and, importantly, they are good human beings.  I will do this because I believe the NHS does work; it sees record numbers of patients every day; to listen to the media however, we fail at every juncture.  So who is right? Only the public can solve this conundrum by declaring what they want, what works, and by being open about what we do well; until they do, the sand in the hour-glass is slowly flowing towards a breakdown of the NHS that no collaboration, no medication and no hug will fix.

 

 

TwitterNurse – eighth instalment

I am struggling to write my blog this week, hence the delay.  This is because my feelings about the NHS and what is happening within it are all over the place.

As a practicing nurse, for me some of the issues within the NHS that I face every shift are about funding, resourcing, and patient safety.  These issues are all interconnected and deciphering them into an understandable collection of sentences and arguments is a difficult job.  In the words of many a person in a difficult relationship: it is complicated!  And this week I’ve struggled to find my place in all of the arguments, the issues, the demands, and the politics.

Firstly, I need to just say that I believe recent struggles to save the NHS ARE political.  This will not make me popular amongst some people, lots of who try to keep politics out of the NHS.  I don’t think this is possible and a couple of my reasons are these: some political parties appear to be more protective and supportive of the NHS – all political parties have neglected the NHS in some measure – but some are downright obstructive, preferring instead to invite the heads of multi-national private health providers to debate which bits of the NHS they would like to buy; and the NHS is rife with ‘politics’ – I’ve lost count of the number of nursing colleagues who have told me ‘I left because I couldn’t stand the ‘politics”.  The NHS is embroiled in politics in both minor and major ways.

However, I always struggle to write my blog.  I have a professional code of conduct that means I have a responsibility towards my profession, amongst other things, and I cannot just write in an irresponsible way, no matter how tired or disillusioned I might sometimes feel.  However, like my colleagues, I work in the reality that has become the NHS and it can be a very challenging environment. It sometimes seems monolithic, it is an immovable object that will sometimes not countenance change, and its disciples sometimes seem locked in ways of working that have become obsolete.  It has its faults.  As a nurse, I see that change is an inevitable part of progress and I want to embrace it and see it impact in a good way on my practice – I am not a nurse who will always just do something that way because ‘that’s the way it’s done’.  But the current issues and challenges being faced by the NHS are not about change for good – they are not about unpalatable truths, necessary improvements or cutting wastage.  These issues are about castigating and dismantling our NHS.  Be under no illusions.

As a nurse, my professional ‘place’ within any of these issues is always to keep my patients safe and advocate for them. Within the context of increasing pressure, this is not as easy as it sounds.  In the NHS, I feel under almost constant pressure to see more patients, to do more, to work harder.  And, put simply, I cannot do more than I am.  Not only is the NHS taking its dying breaths but, I believe, the goodwill of the staff is running out too.  Last week I was offered a new job and I turned it down.  I turned it down because I couldn’t bear the thought that, by seeing patients, I would be earning money for someone.  But I considered it.

This week I witnessed the junior doctors withdraw emergency cover.  I worked one of the strike days so I saw first hand what resulted from their action: senior doctors saw patients, assessed, cannulated, monitored and made decisions; they developed plans of care, did take-home prescriptions, and liaised with other practitioners.  They cared for our patients. They ensured patient safety was of the highest standard.  They went that extra mile. This is not unusual.  As a team, our NHS does this daily – reduce the numbers and we will just fight harder for our patients.

Because this is where we are today  – we are in a fight for the NHS.  We are shouting to be heard amongst the detritus that is now journalism in this country.  We are struggling to be heard because there seems to be an apathy towards the NHS, a certain belief that it will always be around and a part of our lives.  A lot of the public do not seem to believe that a prescription for an antibiotic could cost them much more than a prescription charge currently does and they do not seem to believe that they could be paying that in the coming years.  Without the NHS, the public will be paying for the care they are currently freely given.  That’s why I believe this is everyone’s fight, the NHS belongs to us all, and I cannot understand why all the public are not shouting from the rooftops that the NHS is theirs and they are taking it back.

In my blog I have tried to convey a number of things: my love of nursing, some of the current issues surrounding the NHS, and the danger the NHS is in.  This danger is current and real – the NHS is dying.  It is gasping for air.  The shouting of some of the public, the marches, the lobbying, these things are what the NHS needs to continue breathing.  Without us, it will die.  As a nurse, I love the NHS. Yes, I love it; I hope I have conveyed this.  Put simply, I love it because it helps people and, as a nurse, this is always my aim too.  The NHS and I are therefore good friends.

I am doing my bit.  I am shouting, if not from the rooftops!

I am marching.

I am organising.

I am delivering last breaths.

Are you?

Gig Up Our NHS  @nhssaveher  @NursesRoar

 

 

 

TwitterNurse – seventh instalment

Yesterday I attended a march in London.  The reasons for the march were all under the banner of ‘austerity’, cuts to various budgets affecting the welfare state in some way or another or changes to working conditions, impositions placed on whole sections of articulate, educated and caring professions – teachers are threatening to strike due to the imposition of academy status on schools, student nurses are staging walk-outs because of the cuts to their student bursaries, junior doctors are about to stage a full walk-out in a few days’ time because of proposed changes to their contracts.  Many more groups representing a range of social and funding issues attended the march too, all of them worthwhile.

The NHS was well represented demonstrated by the garb of scrubs, uniforms and paraphernalia denoting NHS workers.  For me it was a day of highs and lows.

As I marched alongside friends and family, I felt overwhelmed by the amount of support around me for our NHS.  A lady thanked me for all I did as a nurse – her two daughters had received transplants in the past and, without the NHS she said, they would have died.  She gave me her megaphone, encouraging me to shout out for our service – I did, with pride.  I shouted for my colleagues – for those who couldn’t attend, those who have cried to me from weariness and desolation caused by the current state of our NHS, for those who have left nursing because of the unbearable sadness they felt for a declining NHS;  I shouted for my patients – those whose hands I have held, whose tears I have wiped, whose sadnesses I have tried to hug away.

And I shouted at Jeremy Hunt.  I shouted at him because I wanted answers: why are you so intent upon making nurses feel like they are unworthy of their jobs? Why are you so intent upon ensuring that future nurses are unable to embark on their training? Why are you so intent upon robbing our NHS of vital resourcing and staffing?  Why are you throttling our NHS?  Why do you hate us?

Today, in the cold light of day, I reflect upon why I need to speak out, and how these questions make me feel: I feel bullied and abused for being a nurse because the boss at the top of the tree, Mr Hunt, does not value me or my work: I get no positive reinforcement from his plans to remove the student nurse bursaries;  I get no pat on the back from his new, proposed junior doctor contract;  I get no ‘well done’ from his derisory 1% pay cap. Like lots of nurses I think, I feel isolated.

That is why I marched.  I needed to remind myself why shouting out is important and yesterday reminded me that I am not alone.  I am a part of the NHS family; yesterday we marched together, we shouted together, we were angry together, and we chanted together.  As I listened to the impassioned speeches, especially those of my NHS colleagues, I almost cried;  I felt such passionate resolve to give something back to the institution that I have seen help so many people in so many ways, to the institution that has supported me to become a better practitioner and person, and to the institution that has also saved the life of my son.  The NHS represents a core of compassion that runs throughout our country that we cannot afford to lose.

Marching yesterday reinforced my belief in my NHS; shouting for it made me feel like I was giving it breath.  The fight will continue and yesterday reminded me of that.

It will need every ounce of our energy if the NHS is to be saved.

Please march.  Please shout.  Please save our NHS.

TwitterNurse – sixth instalment

This week I almost resigned from my nursing post.  The reasons are complicated but relate solely to my feelings towards patient care in our current NHS.

When you become a nurse I think you have an intrinsic desire to do good, to help out, to make people feel better.  You are a rescuer.  Sometimes this desire translates into clinical care – injecting, bleeding, cannulating – sometimes into emotional support – listening, talking, watching.  As practitioners, we all want to deliver holistic care, that is to ‘read’ our patients and thereby interpret their needs; in this way, we give what the patient needs, not to be mistaken with what we sometimes want to give.  When we can’t give what the patient needs it creates a tension – we can’t do our jobs and we feel bad about not being able to give our best to our patients.  We don’t feel good and, no matter how hard we work, we feel we have delivered sub-standard care.  Or importantly, we work so hard to try and avoid a drop in our standards of care that we become tired, lost and sad.  This happened to me this week.

These feelings are not good and have an impact on professional confidence and mood.  They appeared in my mind because, this week more than usual, there were significant demands on my time, not all of them directly relating to patient care: sometimes in my job I am asked to do things other than direct patient care – audits, responding to emails, delivering talks to other healthcare practitioners, to name but a few; sometimes these demands impact on direct patient care.  I am not always asked if I can fit these these other tasks, I am instead told they are necessary.  At these times this means that my patients are left waiting for me while I carry out these other tasks that take me away from the department.  Let me be clear, I am instructed to carry out these tasks by people senior to me and I have no choice but to carry them out.  These tasks are varied and can be undeniably important, and multi-tasking is a very much a part of a nurses’ job – these issues are not in question. What leaves me feeling sad and professionally disillusioned is having to leave my patients because someone tells me to do ‘other things’, taking me away from patients who need my time, and patients for whom I am directly responsible for.

It can be difficult to say ‘no’ to a person.  My patients do not deserve a ‘no’; they are the ones who come to me for help, but with the best will in the world, there is only one of me. I cannot be with two patients at the same time and the demands on my time this week have meant that this was essentially needed.  To not be able to adequately care for your patients is a soul-destroying thing for a nurse, as much as it is life-affirming to help them.  Because my shifts this week have been full of conflict, my days have been full of tension, and this tension has lead me to believe I cannot do a good job.  As a nurse, this feeling is dismal and profoundly professionally damaging.

The NHS matters to me.  I want it to survive, not just because I love its heritage and original intentions but because I see its beauty: it gives real help and hope to millions of people in their darkest moments, it provides a form of sustenance seldom seen anywhere else.  But I cannot let the people who currently ‘own’ the NHS take my vim; this week I felt  truly hopeless and some of the people who are supposed to be part of a ‘team’ did this to me.  It strongly occurred to me that the NHS has people within it who are not being honest about what we can achieve and who show no compassion for their colleagues.  They are Machiavellian in their desires to succeed and step on colleagues to climb the ladder to professional success.  This week, I felt stood on and ignored with my professional opinion not even asked for. If these people are to stay in the NHS, I am afraid it is doomed to fail.  ‘Getting through it’ as a mantra for a difficult shift is no longer good enough because the cost to staff is too great; the NHS has to recognise this and to be heard you have to shout.  Stay or go, I will always support our wonderful NHS.

I am shouting.

I hope you will too.

 

TwitterNurse – fifth instalment

This week has been a busy one.  Staff sickness has meant that some of us have worked longer than we are scheduled to, meaning we have covered shifts we don’t usually cover.  At risk of repeating myself, I have been tired and not very energised.  I haven’t however been grumpy – my patients absolutely make my job worthwhile: the majority of them are consistently grateful, always vulnerable, and relatively understanding of waits for my time.

Today I had to explain the state of the NHS to a patient because she asked me for my views.  She specifically asked about the current junior doctor “issue” and how the NHS was doing generally.  I had to respond honestly.  For those who don’t know it, my daughter is a junior doctor; I did not, nor would ever, choose this career for her. Why not? Because I am fully aware of the crippling hours and the constant demands that would be placed on her.  Consequently, I tried my best to explain to the patient my understanding of the junior doctor “issue”, pointing out the constraints the new contract would place on junior doctors, whilst stressing this was my view and trying hard not to scare my patient.

My patient listened attentively: she made good eye contact, I received frequent nods throughout, and my views were sympathetically received. She was wholly sympathetic and explained she had been following the debate around the issue for some time, and with some interest.  I was thoroughly relieved – I was not attacked not was I ridiculed, my patient valued the care she received and respected me as a practitioner and as someone who understands my workplace.

This made me wonder how many of the public think this way? How many have followed the arguments, the strikes, the discussions about the future of the NHS?  If the public have followed the current discussions around NHS provision and problems, why haven’t more got involved by attending marches, by writing to MPs, by taking part in social media?

Despite my suspicions that the public are ‘sleep-walking’ into our current NHS crisis, I now believe there is a definite mood of discontent out there.  This is evidenced by the fact that my patient asked me about the “junior doctor” issue, and asked me for my views on my workplace.  I realise these are currently being debated throughout the various media outlets but I have never been asked this before; my patient genuinely wanted to know what some of the issues were, how long they had been going on for, and how they could be solved.  I ultimately batted the ball back into her court – the public, after all I believe,  have to take ownership of the NHS and decide to be its saviour.

My overwhelming wish is that the public, you, will fight for the NHS.  It cannot survive without you.  As professional practitioners we can fight, we can aim to deliver the best service we can (and we do, daily), we can advocate for our patients and genuinely care about their recovery, but ultimately, we cannot save our NHS without public support. The marches, the petitions, the social media outcries, will ultimately only matter if there is an overwhelming will to save our NHS from further privatisation.

Will you save it?

Will you fight for it?

I will. I can’t do it without you.

TwitterNurse – fourth instalment

Today I’ve been thinking about student nurse bursaries –  you might have heard that student nurses are about to lose their bursary payments.  These are relatively small payments, aimed at giving student nurses some renumeration for their hard work whilst on placement.  The understanding is that student nurses should not be counted in nursing numbers as they are termed ‘supernumerary’ in order to learn ‘on the job’.  Balancing learning with being part of a nursing team can be difficult, often causing tension because student nurses sometimes claim they are counted in numbers.  Whatever happens, during placement student nurses work exceptionally hard, often balancing rigorous academic assignments with twelve-hour placement shifts.  I have not always been a nurse – I came to nursing relatively late in life.  It was something I had wanted to do for a long time and, when I was financially able to – with the help of the student bursary – I returned to university to study adult nursing.  I saw being a ‘mature’ student nurse as an asset – I was able to bring a lot of life experience to my role and I have never regretted studying for nursing when I did.

The student nurse bursary was a crucial part of my decision to become a student nurse;  I had a growing family to support and a mortgage to pay.  I had to have help to achieve my goal, as do many student nurses.  There is no question that, without the student nurse bursary, my family and I could not have survived the training and the resulting financial implications.  My bursary helped me to buy some very expensive academic books, pay travel expenses or parking costs and to feed and clothe my children.  Crucially, I also left university with no debt handicap.

According to figures in March 2013 the NHS was still short of 1,199 full time equivalent registered nurses compared with April 2010 (BBC March 2014) and in February 2016, it was reported that tens of thousands of nurse and doctor posts remain vacant (BBC February 2016).  I find myself pondering how scrapping student nurse bursaries is going to help the recruitment of nurses in the future.

Scrapping student nurse bursaries could have a profound impact on the future of nursing and I question the timing of this decision.  The NHS is currently struggling with a financial black hole (FT 2015), and many forums and groups have appeared on social media in support of the NHS generally, a sure sign that the state of the NHS is a concern for many. With a backdrop of patient choice agenda, the lines are becoming blurred between private and NHS care (Net Doctor), and it is perhaps unsurprising that many are confused about what the NHS offers and whether private medicine is better.  To compound this, a King’s Fund study ranked the UK 13th out of 15 original EU members and casts doubt on ministers’ claims they are giving the NHS generous cash settlement (Guardian 2016).  Add to this a plethora of bad news stories and I am suspicious we are being talked out of the NHS entirely.

As practitioners we know what the NHS delivers: courage, compassion and exceptional value for money.  We have more patients who are happy with NHS care than not, demonstrated by how we are bought chocolates and sent cards thanking us for our care.  The timing of the scrapping of student nurse bursaries is designed to coincide with the NHS struggling to be understood.  NHS practitioners perhaps need to begin to believe in the NHS again and sing its praises. We need to challenge the misconceptions that are being peddled on a regular basis; the NHS may have its faults but would we rather it disappeared? I believe not.

The NHS is in need of our help – we, the NHS family know this, we understand it and, like family, we will be the ones to help it.  I believe we need to advocate for the NHS itself; it will prove to be our biggest and most important patient of all.

Let’s do it.

TwitterNurse – third instalment

This week I worked two 12.5 hour shifts, back-to-back.  For those who haven’t done this, it’s gruelling: I took a single, one-hour break per shift to eat and drink, rest, and re-group, as did my colleagues, some of who work longer hours than I do.  As the day progressed, my patients saw an increasingly tired nurse.  I was aware my words were becoming less pronounced, my talking was faster, and I was clumsier.  I don’t know whether my patients noticed, I think some of them must have; one patient had to return later in my shift from an earlier visit and said “Are you still here?!”  Such is the working life of a nurse.

At various points in the day I felt happy, sad, demoralised and pleased.  I felt happy because I love my job, I feel privileged to be there for the best and the worst parts of life and to be able to help my patients through that journey; feeling occasionally sad is an inevitable part of nursing – we see different aspects of sadness because we see so much of it and we are sometimes defeated by it; I felt demoralised because with just a few changes my patients could have had more of my time and therefore a better and easier experience; and pleased because I know I made my best efforts to put my patients first.  But never content because nursing is not a ‘content’ type of job!

And as the tiredness progressively hit me as the shift progressed, like all nurses, my colleagues were vital.  As colleagues, we laugh together, cry together, and generally sag together but we always understand why we’ve come to work that day, and this group direction gives us a connection that even the hardest shift can’t break.  In fact, the harder the shift, the closer we grow.

At the start of my shift, one of my colleagues told me how her good friend has become ill for the second time, and I hugged her.  Invested in my hug was sorrow for her sadness, for her friend’s battle that is only just beginning, and sorrow for my friend’s knowledge – she has a unique insight into the fight her friend has just begun.  This means she will worry about the things that she knows can go wrong, how the illness can win and what her friend can lose.  This insight creates a bond between us and it is strengthened by the things we have witnessed together during our patients’ journeys, creating from strong empathy and understanding between us.  This means that we can cut friendship corners: we can read each other, know our colleagues’ mood, quickly recognising when they are hurt, anxious or happy.  These are unique relationships and I treasure them.

The NHS abounds with these relationships.  We are one family – we can’t walk down the corridor without smiling or acknowledging a colleague, we all know someone because they usually work with us.  There is a wealth of talent and expertise within the walls of a hospital and patient welfare is at its core – it is this focus that binds us.  The NHS is home to all this effort, concern and care.  On reflection, it is astonishing that, as healthcare practitioners, we never need to talk about it – we all work alongside each other, caring for our patients and we never have to voice our focus or our concerns,  the patient is automatically placed at the centre of all we do.  We simply come together and each help the patient, each contributing our own effort within our own areas of expertise, without ever having to give this fact recognition.  All our skill and effort is consistently focused on the patient.  Such is the NHS.  It has evolved into a strong unit with one focus: to help the patient in whatever way we can.  This is our strength.  The NHS has a backbone of care, compassion and courage. I hope it cannot be broken.

 

TwitterNurse – second instalment

The NHS employs 1.7 million people in the UK and is the fifth largest employer in the world (The Telegraph 2016).  It needs a vast number of skills, so the people working together in the NHS are from a variety of backgrounds and have a wide range of skills – we are a diverse bunch!

The one thing we all have in common – we are all focused on the patients: what they need to get well and leave us to go back into real life, whatever that means for them.  It takes a lot of courage and commitment to completely care for someone, as any carer, whether employed or caring for a relative, will testify.  As nurses, we hold the hands of people after bad news, after good news, during procedures, and when they take their last breaths.  Because we do this, and with compassion, means that this is not just a job for us.

So, it’s a complicated job being a nurse, it makes many professional and personal demands of you – not just the hours and rigour (being on your feet for 12 hours, and running for most of them, takes its toll!) but the emotional memories and stories you carry with you from shift to shift.  The patients and their life-stories touch you forever.  It’s a rewarding but very exacting job and, recently I have been considering why I do it.   This is because Mr Hunt’s treatment of the NHS and his policies have made me doubt whether I am doing a good job, whether the organisation that I treasure is worth saving – somebody constantly telling you that your efforts are not good enough will do that to you, no matter how strong your professional confidence or your willingness to help.  However, a few days ago, when I helped a patient achieve something – quite a small something – the look of appreciation I received made me smile for the rest of the day.  My job made me smile for the rest of the day.

Nevertheless, as nurses, these emotional rewards for helping others also bind us.  While I think these moments of appreciation and achievement should be cherished, I now realise they are not enough to keep me going, even though they often make me feel better during very busy shifts.  They are not enough because they are transient and they do not make up for the demeaning pay rises and the  damaging comments by this government about the NHS.  Do I love my job? – a resounding yes.  Is loving my job enough? – a loud no.  This realisation has helped me because it has galvanised me – nurses deserve better and we should be expecting more. My patients value me, why shouldn’t my employer?  And the patients are the NHS.  This realisation has strengthened my resolve to fight for my NHS, so I will shout louder and harder until the NHS is no longer under threat or until it has gone entirely.  Either way, I will have advocated for my patients to the end and I will have a clear conscience.  I will do my best for the NHS, I will advocate for it – I will not let it die.