Nurses - do you enjoy your job?

[DratThatCat]

Im 41 and I really, really, really want to start my nursing training in a couple of years when both of my kids are at high school, but after reading the midwife thread on AIBU I'm worried about what I'm letting myself in for. I know nursing has never been an easy job, its thankless and underfunded, but is bullying common? Are patient lives being put at risk because of staff shortages? Do you ever regret being a nurse? Any insights are much appreciated!

I hear that @ChuddleyCannons but every time I visit an elderly person in hospital there appear to be between 4 and 6 nurses chatting at the nursing station (usually about their weekend), who also appear grossly inconvenienced if you happen to mention that your loved one's catheter bag is full, or cannula should have been changed six hours ago. I can't remember the last time I saw a nurse running their socks off.

Having said that, I am tapped up twice a year to run an HR service at an NHS Trust and I always say no due to the hierarchy which is years our of date and the bullying culture.

@Bumblebee1223

Is anyone on this thread a children’s nurse?

I have the same thoughts as you OP, but just don’t think I could as I am currently in a very secure family friendly job that is low stress! I’m 30 and the time to do it was 10 years ago but I do wonder what could have been.

I was in hospital with my baby girl for a week, and the nurses were just amazing. Being on the children’s ward felt so different from when I was on the maternity unit where they have no time to properly take care of you.

I'm a children's nurse in a specialist tertiary unit. I would never work on a general paers ward because I don't want to juggle 7+ patients who may deteriorate at any moment. I'd much rather have 2-3 sick patients and be able to give them my time and attention. In my experience ICU/HDU (and paediatrics generally) are better staffed. I did placements in adult wards as a student and could not work in that environment. Children's you also generally have parents on hand who are doing cares/meds/feeds depending on the area. We have school on site and play specialists/play room/courtyard.

OP if you are interested in palliative I would look into hospice roles, community and inpatient. Onc/haem daycare is also a lovely environment if a little manic sometimes x

It's 0745. You've just taken handover for your nine patients. You should have a carer with you to support with washes, obs and nutrition, but one of the carers phoned in sick, so instead it's two carers for 27 patients.

You know from handover that one of your patients is receiving end of life care; family have been with him all night and you want to check on them. But you also know that one of your patients is very sickyou've checked the obs chart and the last set of obs was slightly worse. You're concerned that the patient only had two sets of obs during the whole night so you can't see a trendbefore you start your drug round you want to repeat the obs so you can bleep the very junior on-call doctor if the patient is in fact deteriorating.

It's now 0750. You start towards the sick patient but then you hear a crash and a shout from the side roomyou run in to find that your patient has upset her water jug all over herself. This patient has been medically fit for discharge for a week and a half, but due to her unsettled behaviour it has been difficult to source appropriate community care. She has had several falls alreadyit's got worse since her routine MRSA swab came back positive and you had to move her into a side room. You know she should have 1:1 but there is nobody to sit with her.

She's very distressed and it takes fifteen minutes to sort a change of clothes and bedding and make sure the floor is completely dry--normally a carer could do this, but obviously both carers are already with other patients.

0805 and you finally repeat the obs on the sick patient. Definitely worse and the patient looks very unwell, you head back to the nursing station to bleep the on-call. When you get there the ward clerk is already on the phone--she looks flustered. "Please could you just give an update to Mr Smith's daughter."

You introduce yourself and explain that you've just started, but from handover he's had a good night, and the doctors will round later in the morning to decide if the plan needs changing. "How come every time I phone this place nobody has a clue what's going on? Are you all stupid? He caught sepsis from you people and all you can ever say is that the doctors will see him later." It takes five minutes to wind up the call. You can see Mr Smith from where you're standing--he's chatting on his mobile phone and enjoying a cup of tea.

You put the bleep out and wait for a response. It's now 0815 and you haven't started your drug round or seen your end-of-life patient. The response comes five minutes laternight doctors just going into handover, put out a 2222 call if you're worried. You are worried but not sure if you're that worried? You go check the patient again but decide against the emergency call. You know they're unwell so quickly start a fluid chart and take bloods in the meantimesick patients are more difficult to get access, so that takes you to 0830. Another five minutes to request labels on the system and ring the porters to take them to the lab as urgent.

You are fully out of time to check on your end of life patient, you need to get your drugs out. You start your drug round when the agency nurse approaches you to let you know that the trust hasn't given them any e-learning for IV meds, so you'll have to do their IVs as well as your own. That's fine, you say, how many do you have? Six, and one of the patients just pulled out their cannula.

Brilliant, don't suppose you can pop another one in? No--no e-learning on that either apparently.

You're just winding up a patient's insulin dose when Mr Smith waves at youhe's finished his phone call now. "Nursenurse, I need a new cup of tea. This one is cold, I can't drink it, it's disgusting."

As he's saying it you see a family member put their head out of the end-of-life patient's side room and look around uncertainly. Your heart sinks because you recognise the expression--they wave you over and quietly tell you they think their dad has just died.

You go into the room and check--the patient is sallow, staring, and perfectly still.

The death won't be called until a doctor comes into the ward, but you tell the family member that they're right, and he has died. You've never met the family or the patient before. 0855.

I’ve been qualified over 25 years and have worked 20 of them in primary care. I’m now a nurse practitioner prescriber.

I love my job. Most of the time. It helps that I work in a great practice and with a lovely team. I have a good work/life balance. No nights, no bank holidays, no weekends usually (apart from Saturday flu clinics in the autumn) but the last 12 months have had lots of Saturday clinics for Covid and now flu so it does feel busier.

It is hellishly busy, tiring and as a NP there’s a lot of responsibility and pressure but nothing like hospital work. I wouldn’t go back into a hospital for all the tea in China.

@ClockworkNightingale exactly this

Word of warning. I have broken my shoulder and although it's improved I'm typing with non dominant hand which is time consuming, tiring and full of typos. Id write more if it wasn't for this.

I'm an RMN in community services. I started as an HCA mid 80s, started training 1990, qualified 1993.

While I like seeing patients I'm sick of the continuous cuts in services, meaning patients have a total lack of resources. The only beds are if you're detained. Home treatment teams stretched to the limits. Day hospitals/centres and drop in centres now non existent. People with conditions like schizophrenia often discharged to the GP for "not engaging"....this is the nature of the beast. Services used to have assertive outreach exactly for this kind of client. Guess what, not now. I'm sick of seeing patients carrying out an assessment to tell them we can't help them.

I'm counting the days till my retirement at the moment.

@RosesAndHellebores are you a HCP because as usual you are derailing the thread. OP is asking for advice not wanting anecdotal stories from someone who is clearly unhappy with nurses.

ChuddleyCannons and ClockworkNightingale thank you for explaining what working on the wards is like. Its sounds unbelievably stressful. Sajid Javid should read this thread but I imagine there's nothing here he doesnt already know.

Thanks again for sharing everybody, it's really helpful, even if it's only to prepare myself for what I'll be jumping into.

@ClockworkNightingale

It's 0745. You've just taken handover for your nine patients. You should have a carer with you to support with washes, obs and nutrition, but one of the carers phoned in sick, so instead it's two carers for 27 patients.

You know from handover that one of your patients is receiving end of life care; family have been with him all night and you want to check on them. But you also know that one of your patients is very sickyou've checked the obs chart and the last set of obs was slightly worse. You're concerned that the patient only had two sets of obs during the whole night so you can't see a trendbefore you start your drug round you want to repeat the obs so you can bleep the very junior on-call doctor if the patient is in fact deteriorating.

It's now 0750. You start towards the sick patient but then you hear a crash and a shout from the side roomyou run in to find that your patient has upset her water jug all over herself. This patient has been medically fit for discharge for a week and a half, but due to her unsettled behaviour it has been difficult to source appropriate community care. She has had several falls alreadyit's got worse since her routine MRSA swab came back positive and you had to move her into a side room. You know she should have 1:1 but there is nobody to sit with her.

She's very distressed and it takes fifteen minutes to sort a change of clothes and bedding and make sure the floor is completely dry--normally a carer could do this, but obviously both carers are already with other patients.

0805 and you finally repeat the obs on the sick patient. Definitely worse and the patient looks very unwell, you head back to the nursing station to bleep the on-call. When you get there the ward clerk is already on the phone--she looks flustered. "Please could you just give an update to Mr Smith's daughter."

You introduce yourself and explain that you've just started, but from handover he's had a good night, and the doctors will round later in the morning to decide if the plan needs changing. "How come every time I phone this place nobody has a clue what's going on? Are you all stupid? He caught sepsis from you people and all you can ever say is that the doctors will see him later." It takes five minutes to wind up the call. You can see Mr Smith from where you're standing--he's chatting on his mobile phone and enjoying a cup of tea.

You put the bleep out and wait for a response. It's now 0815 and you haven't started your drug round or seen your end-of-life patient. The response comes five minutes laternight doctors just going into handover, put out a 2222 call if you're worried. You are worried but not sure if you're that worried? You go check the patient again but decide against the emergency call. You know they're unwell so quickly start a fluid chart and take bloods in the meantimesick patients are more difficult to get access, so that takes you to 0830. Another five minutes to request labels on the system and ring the porters to take them to the lab as urgent.

You are fully out of time to check on your end of life patient, you need to get your drugs out. You start your drug round when the agency nurse approaches you to let you know that the trust hasn't given them any e-learning for IV meds, so you'll have to do their IVs as well as your own. That's fine, you say, how many do you have? Six, and one of the patients just pulled out their cannula.

Brilliant, don't suppose you can pop another one in? No--no e-learning on that either apparently.

You're just winding up a patient's insulin dose when Mr Smith waves at youhe's finished his phone call now. "Nursenurse, I need a new cup of tea. This one is cold, I can't drink it, it's disgusting."

As he's saying it you see a family member put their head out of the end-of-life patient's side room and look around uncertainly. Your heart sinks because you recognise the expression--they wave you over and quietly tell you they think their dad has just died.

You go into the room and check--the patient is sallow, staring, and perfectly still.

The death won't be called until a doctor comes into the ward, but you tell the family member that they're right, and he has died. You've never met the family or the patient before. 0855.

This is so accurate ! And worse. The nightshift in a hospice that finally broke me was like this, we had a patient with a brain tumour falling out of bed and relatives of a man who was dying had to keep alerting us as no-one was availble to sit with him one to one. I had another man rapidly deteriorating in a side room who couldn't breathe. One lady terminally agitated and needed re-catheterizing and took four staff to do this due to her size and level of agitation, numerous other patients waking up in pain and needing pain relief as soon as possible. This is all at 6am at the end of a 12 hour nightshift. When it came to the point of asking a dying man's relatives to call us if the man tried to get out of bed again I decided it was time to quit and haven't looked back. The horrors of 35 years of working in this kind of environment did catch up with me once I left and I had a sort of mini breakdown and am on anti-depressants still, but I have no regrets leaving the profession. I still have nightmares occasionally three years after leaving.

@ClockworkNightingale - you and your colleagues are amazing - thank you

@RosesAndHellebores There are currently wards in Glasgow with one nurse looking after 30 patients so I would love to know what areas have 4-6 nurses each shift say around the nurses station in the middle of the day.

@ClockworkNightingale

I was completely transported back reading this to when I worked short stay receiving as a junior staff nurse and had 14 patients to myself on a nightshift. Sometimes could come in to 6 empty beds so multiple admissions overnight, actrapid infusions, exacs of asthma on back to back meds, a step down from ITU because acute rec next door were full, multiple demented elderly patients and then a couple of DT's just to wind it all up. The night I put up a unit of blood and then completely forgot about it until 2 hours later when I sat down to begin admitting three new patients was the night I started looking for a new job.

Went to Australia a few years later and it was a whole different ball game, 1:4 patient ration in general wards, 1:3 in ED. I've been back in the UK for one year and generally fearful for what's to come, luckily I'm no longer on the floor nursing or I would probably be reconsidering my options as well.

Just as an added extra I have a friend who's a district nurse and she says they are currently just as short staffed and heavy with junior nurses as some hospitals and patients are getting missed and readmitted with post op infections because they just don't have the staff for the workload. It's a bloody sad affair all round.

Management need to start managing and stop CV building imo. The entire culture of the NHS needs to change.

@RosesAndHellebores honestly you come on every thread aimed at nurses over years to slag off the profession.

I don't believe what you are saying. I don't know of any ward that has that many nurses on shift together. My team has two nurses to fill what should be five nurse roles over two different sites. This is pretty typical of most settings, everyone is understaffed.

The idea that nurses are bad if they aren't adequately caring/self-sacraficing is generally a misogynistic trope anyway. People only have the perception of female dominated professions that they must give all of themselves or be vilified.

Been a nurse 30 years. Left ward work 14 years ago, it was relentless. In a specialist role now, which comes with its own stress but at least no nights and weekends.

I would not recommend nursing to anyone. Nor medicine. AHP roles maybe, at least they have better role definition and boundaries and aren’t bullied and belittled by nurse managers.

What I struggle with is nurses being paid so much less than AHPs. Same level of qualification, arguably greater range of responsibility, coal face relentless slog. And yet where I work you’d be pushed to find an AHP on less than B7 pay while most nurses are stick on B5. Can’t be explained by supply and demand, we have many times more applicants for AHP positions than vacancies while our nurse vacancies are unfilled.

These stories are just shocking. Have I got it right, theres usually 1 nurse and a couple of HCAs to a ward?

The AHP roles, are they physiotherapists, occupational therapists etc?

When I was a student, over ten years ago it was 30 patients, three nurses and two HCAs on most wards I was placed on.
Closet I’ve come to ward working was in a nursing home, night shifting. Me, one HCA and 23 residents. Horrific.

Onandoff the vast majority of AHPs where I work are band 5 and 6.

I did a Return to Nursing course 4 years ago after being away from the NHS for a few years. I hated every single second, I couldn’t believe the ward culture and the fact that the junior sisters were never seen on the ward other than for an occasional drug round and the senior sister only appeared if a consultant came to see a patient.
All the work was left to HCAs and student nurses, who looked to me for advice and support. I couldn’t do the 14 hour shifts and was made to feel inferior because of that.
I had previously been ward or community based for 36 years and couldn’t stomach actually practicing again in such a hideous environment. The patients barely got the most basic nursing care, in the 3 months on the ward I never saw a patient have a proper bath and unless they could shower unaccompanied then they just had a bowl of water and were left to wash themselves. I actually got reprimanded for washing a seriously ill lady who was too poorly to wash herself.
I felt demoralised and ashamed at the lack of attention to detail given.
I would never recommend nursing to anyone nowadays, harsh and very sad.

@DratThatCat

The template number of trained nurses and HCA's varies dependent on the ward size and acuity. For example a 28 bed general medical ward should have 3 Band 5 nurses plus a charge nurse (either the SCN/ward manager or deputy) then 3-4 HCA's with maybe one of them being an early shift as generally the bulk of the hard work is in the morning. The same ward we would expect at least 2 Band 5 and 2 HCA's on nightshift. If there's a particularly unsettled patient sometimes we can put out for an extra HCA.

At the moment these wards are running with 2 + 2 or 3 on a dayshift and sometimes only 1 + 2 at night. Morale is very low.

[quote Ralph871]@DratThatCat

The template number of trained nurses and HCA's varies dependent on the ward size and acuity. For example a 28 bed general medical ward should have 3 Band 5 nurses plus a charge nurse (either the SCN/ward manager or deputy) then 3-4 HCA's with maybe one of them being an early shift as generally the bulk of the hard work is in the morning. The same ward we would expect at least 2 Band 5 and 2 HCA's on nightshift. If there's a particularly unsettled patient sometimes we can put out for an extra HCA.

At the moment these wards are running with 2 + 2 or 3 on a dayshift and sometimes only 1 + 2 at night. Morale is very low. [/quote]
The acute medicine ward I left should have been 3 RNs, 3 HCAs, 1 Ward Sister, 1 ward clerk, 1 housekeeper, then our food delivery people x2 at each meal. It was very often 2 RNs and 1 or 2 HCAs if we were lucky. It’s unmanageable and dangerous.

@ClockworkNightingale has it spot on.

The scope of nursing is very broad. I am a nurse and have worked in research and education for many years now. Nurses can work in industry, occupational health, schools, nursing homes, community, primary care, teach at universities. Within hospitals many nurses don't work on the wards as such and may work in patient safety, quality, tissue viability, infection control, clinical education, recruitment, operations...very varied roles
Definitely. Nursing is not all about working on the ward. I’ve done ward for 18 months now, learnt a lot ,am now looking into joining research nursing. Normal working hours 8-4 no long shifts/nights/weekends.

Get into nursing get your degree it’s a very good career with a lot of options. Don’t be put off by ward experiences yes it’s hard but you have loads of options.

ClockworkNightingale I felt very emotional reading that post, probably as it was giving me awful flashbacks to my own days as a ward nurse!

OP I would really take on board what the majority of posters are saying. My DH and I both worked as ward nurses a decade ago and DH ended up taking a nervous breakdown with the stress, he was off sick for two months with it. He left and became a HCA - after being a trained nurse he found this better for his stress levels.

I also left and am now retraining in a different health care field, one in which I have now spent years working as a support assistant. Would you consider something like dietetics, physio or OT?

Reading the replies and being in an allied health profession myself, I would research an AHP role. There's lots to choose from. Same pay, some great progression opportunities too.

AlanisMorningShed knowing what I know now, I kind of wish I’d done OT instead.