Monthly Archives: April 2016

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.