Monthly Archives: March 2016

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.

TwitterNurse – first instalment

So one day, I decided to become a nurse.  Not a new, sparkly nurse, but a ‘mature’ nurse, because I have seen a lot of life and feel like now I can tackle some of the sadness that comes from caring.  That and the fact that I have an inherent desire to make a difference.

And now.  Two words: Jeremy Hunt.  An NHS in crisis. My mother remembered what it was like without a welfare state: her grandmother cutting her own tooth out beneath the dining table, drunk on gin, because of a raging toothache; and because she couldn’t afford a dentist.  Paying a shilling for 2 visits from the midwife after the difficult and traumatic birth of my brother.  The NHS was always a beacon in our house, something we could always rely upon.  Something that would always be there.  And Bevan was a God.  So, I have to do something.  I go on marches.  I write to my MP.  I engage with social media.  All in the hope that I can convey some of the fear I have that our wonderful health service is taking its last breaths.  And in the hope that I can help to save it.

So, now I’m tweeting, face booking, emailing, arranging and generally wearing my fingers out.  I am multi-tasking – phone in one hand, laptop open, land-line on the go.  There are multiple bleeps and pings around me, alerting me to some form of message from a new ally, someone I have never met but who understands, who wants to preserve what we have left of our NHS.  These are amazing times.  We could save the most important institution this country has every seen, or has ever had the privilege to be part of.  I want to be part of that fight, I want my voice – shouting for the NHS itself – to be heard.  I WILL be heard.