Treatment of nurses in the NHS is mad

[OverseasNurse]

I'm an overseas nurse and been in the UK for a year and a half now (came just before covid so seen the worst of it) I first want to say that I have respect for what the NHS does and that everyone can access care here. I have the highest respect for my fellow nurses who work tirelessly.

BUT I am shocked by how nurses are treated here! The expectations that we work unpaid overtime regularly (nearly every shift each week), absolute crap staffing ratios, understaffing and shit pay with no advancement for further training or development or skills, plus regular abuse from patients who are angry about service delays that are completely out of our control. I don't know a single nurse on my unit who isn't actively considering leaving the profession. (Compared to my home country where people are stressed by Covid but not considering leaving the work.)

I don't understand how the system can or will continue. We have been at approximately 40% staff level in the last month or so due to pingdemic, covid infections, isolation, etc and our patients have only increased but we literally can't run our service. AIBU to think it will fall apart any day now? Is this part of Tory privatisation plans to just run the NHS into the ground? Has it always been this bad for nurses in the NHS or is this all due to covid?

[quote Toddlerteaplease]@EachandEveryone, yes I think Paediatrics does get off lightly compared to adult land. We spent most of Covid colouring and cleaning. It was boring!! We've had a few students not want to make beds etc. Err if I'm doing it, then your are too.
I wonder if people now are seeing nursing for the degree, rather than as the vocation it needs to be. [/quote]
Think it’s going to be our turn now the respiratory surge is predicted. 😩

@bogoffmda fully prepared to be told I’m wrong here but in my experience AHP students don’t tend to do nights on placements. I’ve seen the odd student radiographer on a nightshift but never anyone else. Student doctors in my trust don’t do nights until the end of their training and often only do part shifts.

And student nurses, especially senior ones, definitely impact the staffing in my trust. It’s very common to hear things like Ward A has two rns, one HCA and two students. Ward B has no students so they can have the RN from Ward C. They shouldn’t be counted but they absolutely are.

@GreatAuntEmily I can only speak for myself here but I personally could never walk out of a short staffed ward because in my view that is just adding to the problem and putting more pressure on my colleagues.

I’ve been in situations where I’ve stayed late, had to arrange alternative childcare etc because I genuinely felt it would be unsafe and detrimental to patients and colleagues to leave on time. It is this “goodwill” from nurses that is being abused and it will eventually run out for some. And that thought is terrifying

Very occasionally I have seen patients be genuinely verbally abusive - intimidating, aggressive, making threats, namecalling, personal attacks, etc. Quite rightly that has been dealt with under the zero tolerance policy.

Often, I see patients who have been treated very, very poorly (instances of neglect, being touched without consent by staff, being spoken to rudely or aggressively or disrespectfully by staff, left in pain, left for days without any update on what is happening to them like they're an item in a warehouse not a human being, having their privacy breached, I could go on...) and are quite justly angry, frustrated, frightened and distressed.

Those patients have every right to express that anger, frustration, fear and distress without staff falsely labelling them "abusive" to further silence them, because it makes staff feel uncomfortable to face the harm they were (hopefully unintentionally) responsible for. Expressing anger or frustration or fear or distress is not abuse. You do a huge disservice to every victim of genuine abuse to make such claims.

Attempting to silence and discredit harmed patients with malicious allegations that they are abusers is an abusive practice and an abusive of power. But that is tolerated. The zero tolerance policy should protect patients from staff too, yet I have never seen patients protected from abuse by staff.

Professionals with a duty of care to human beings who are being mistreated and failed have a duty of care and a responsibility to escalate that - not to be complicit in allowing it to happen by maliciously and falsely labelling those people "abusive" for having been abandoned to try and rectify matters alone. It is a toxic dysfunctional mindset to be seeing all patients as "out to get you".

If you made your points without the vexatious claims of abuse against patients who are simply having normal acceptable reactions to being harmed by our health service, people would be more receptive. Otherwise it makes you seem untrustworthy and not a credible source.

Simply, treatment of patients in the NHS is mad.

Florence - you are now splitting hairs. You do not work nights on a shift pattern as a student nurse throughout your training - a block may have some nights in it but not all the time.

No one relies on student nurses in the numbers until they are actually there. So often I hear our ward nurses that the students have not turned up.

I just object to nurses getting bursaries when other AHPs on courses, that are longer in some cases, involve distant placements and unsocial hours do not. Starting salary for a Band4/ 5 physio and a Band 4/5 nurse are the same - just one should have less debt.

Bog off - I think there may be a case for some incentives if there is a particular shortage of a skill set - eg is there a bigger staff shortage for nursing vs physios or psychiatrists vs surgeons? Not saying that a bursary is the best/fairest incentive though.

The problem sound more like a retention problem - in which case, perhaps a loan that is paid off after x years of service may be better?

@AdaFuckingShelby

Gone are the bursaries for student nurses, and with them the supply of new staff to replace those retiring.

That’s not true. Technically the bursary has gone but now replaced with an nhs student learning grant which does not have to be paid back. Worth at least 5k a year, more for students with kids.

There are plenty of people signing up to train. Courses are full.

Sadly that due to the situation the OP describes people quit as quickly as new people can be trained. A total false economy and one the govt does nothing to rectify. If staffing levels were better (and it’s staffing more than pay which makes people quit) there wouldn’t be such a high turnover.

Physios and other students also get the learning grant.

www.nhsbsa.nhs.uk/nhs-learning-support-fund

Namenic- the joy of Brexit is beginning to bite - we are short in just about every aspect of health care not just nursing and were pre-pandemic - now exacerbated by burnout.

Physios were nurses during the pandemic, doctors were nurses, admin staff became porters - everyone helped out each other. The stress of being redeployed to a job that is not your normal role can not be underestimated. People have been damaged by the experience and some have left - they have seen what can be done to them in an emergency and management think this is the norm - it is a dangerous place to be at the moment.

The nursing staff know this, management know this but what can they do? They work with the resources available. The government knows the NHS is run on good will, people will work unpaid overtime. It is only when individuals experience the sharp end of a failure in safety that they complain. There is no outcry until it impacts them directly. This is where the system fails. If we didn't turn away collectively until it impacts us, we would all be safer.

Beautifully put. Why should people have to leave a profession they love because the government and society as a whole want to act as if it is all ok until they cant, then want to blame one or two people rather than looking at the systemic failings.

@OverseasNurse totally agree with you. Nurse of 40 years who came out of retirement to help with the COVID pandemic.

I am so sorry to hear this, OP!! I have a number of family members who are nurses in the U.S., and while they have some complaints about the way they are treated, it doesn't sound as bad as this, and the salaries are definitely much, much higher. (www.online.drexel.edu/online-degrees/nursing-degrees/nursing-salary-guide/index.aspx)

This is a depressing thread, I am a band 6 ward nurse and think I have had enough. We cannot provide safe and therefore effective care to patients as the service currently stands. In my area students and super numerary staff are indeed included when moving staff, this impacts the safety it's very much well you have 6 members of staff for 26 so you will cope so, the students are used as HCA whilst the super numerary staff don't learn safely. I brought this to my seniors attention the other day and was told we are all in the same boat, them do not care. Also we are moved to areas we are not trained in so stressful and dangerous.

I don't want to leave but might look at the careers website someone suggested, might be time to look outside of nursing. Shame as I have over 20 years experience. Also I could never strike could not leave patients and staff in an even worse situation.

Most people in most professions are treated appallingly you know...

I’m a junior doctor. I agree. It’s the same for doctors. Short staffed everywhere. I can only think the conservative government are doing this on purpose. There is no other explanation for their policies and how dire the situation currently is. You have my sympathies! I feel the same with medics. Treated like crap.

People say we’re well paid but I spend thousands on indemnity, exams, portfolio, etc etc. The nhs is falling apart.

I agree. I had taken a sidestep to work in a specialised role but we have all been pulled back clinically as staffing is so awful.
Last week - I worked 2 x 13 hour shifts with no break, in an area I was unfamiliar with, incredibly high risk patients and was working on my own with a health care support worker (minimum safety 2 x qualified and 2x hca).

It's been awful. I don't feel safe in work.

[quote FlorenceNightshade]@bogoffmda fully prepared to be told I’m wrong here but in my experience AHP students don’t tend to do nights on placements. I’ve seen the odd student radiographer on a nightshift but never anyone else. Student doctors in my trust don’t do nights until the end of their training and often only do part shifts.

And student nurses, especially senior ones, definitely impact the staffing in my trust. It’s very common to hear things like Ward A has two rns, one HCA and two students. Ward B has no students so they can have the RN from Ward C. They shouldn’t be counted but they absolutely are.[/quote]
Paramedics. And they don’t get bursaries at all. They also can’t claim back travel I think.

The nurses that I know don’t do unpaid overtime, unlike other AHPs, they either get paid a flat rate or overtime pay. To the extent that a band 5 nurse was bringing home what I was as a top band 7 AHP.

Not to say that have it easy, it’s not a job that I would want to do for a number of reasons. But low pay isn’t one of them.

I suppose it has to get dangerously bad before any Gov is going to stand up and say taxes are going up to increase funding for the NHS. And while the present staff are frefighting it is not going to get seriously bad.

I think they should strike. But it doesn't look as if that is going to happen.

If everyone left a few hundred/thousand in their wills for the NHS that might raise something.
The problem is the public not wanting to pay but trying to educate the public (eg Theresa May's tax to provide care in their own homes for the elderly......
'Under the Tory manifesto, the elderly must pay for their own care if they have combined savings and property worth more than £100,000.

If they wish to keep their home, payment can be deferred until after they die when it will be deducted from their estate.' went down like a lead balloon.

Immediately called the Dementia Tax by Labour and lost the Tories many seats.)

@user16395699 completely agree with you that patients should be able to complain about poor care. I was recently in hospital for gynae surgery for cancer. My care and treatment was awful when I went back to the gynae ward after being in HDU. I (well my DH) had to make a formal complaint about a couple of incidents with some HCAs and nurses. I was genuinely scared of some of the night staff. They just didn't care and didn't escalate. Thank goodness for my surgeon checking on me twice a day and the fantastic Macmillan nurses who got me moved to another ward. I was so glad when I could finally leave hospital. Whilst I appreciate the difficulties on the wards, it's not good being a patient either experiencing poor care for whatever reason.

A big problem is that nurses are undervalued. Doctors are seen as important...nurses are seen as skivies.

I’m not sure that striking actually helps anyway. The junior doctor strike had very little public support (I was fully behind them and feel they were vilified in the press with no recognition of what a junior doctor is or how shit it can be to be one) and nurses’ strikes in other countries don’t seem to have been huge successes for various reasons as PP have said. I don’t know what the answer is other than for individual staff to walk away to protect themselves. While it is still easy to recruit student HCPs governments will not care about retaining them. Retention is much harder to solve than recruitment I think.

A big problem is that nurses are undervalued. Doctors are seen as important...nurses are seen as skivies.

HCA shouldn't be seen as skivvies but why is everyone in a similar uniform - the person could be a cleaner or a tray collector after lunch - or the senior nurse - why do that?

Does it matter that the public don't support your strike?? If you tell an 80 year old that they get 25,000 a year and are striking for more it's, unless they are well up to date on salaries, pretty likely they will disapprove.

Too much attention is given to the DM headlines. It would be better for the public if the wards weren't understaffed.

As long as the NHS can recruit from overseas, nothing will change.
The point for me was I felt there was at times a real risk of losing my registration as a result of dangerous understaffing and overwork. So many shifts understaffed, then management demanding endless paperwork which was prioritised over patient care for fear of legal consequences.
Nurses I know can’t wait to leave, they have no faith that they can change anything, and want out.