Do the general public know how bad the conditions in the NHS are?

[Gakatsbsk]

Hello

Expecting to be roasted.

However, I’m an NHS staff nurse. Qualified almost 2 years. I’ve worked through the pandemic. I initially worked in England and now work in a different UK nation - which is better but only because England was so poor.

My union is about to start a consultative ballot for industrial action in light of the nhs pay offer. I have had two family ‘acquaintances’ (who do not work or have immediate family that work for the nhs) complain in one breath about delayed appointments, delayed A+E waiting times, cancelled surgeries etc but then in another tell me that nurses going on strike is disgusting, lucky to have a job, NHS more secure employment etc. These are of course English Tory voters who said this

For reference, I have never and will never cross a picket line and will be voting in favour of industrial action (whatever form that takes due to emergency cover staffing etc).

When I was a few weeks qualified as a nurse I was looking after double the safe ratio of patients in my speciality. Completely unsupported, me and my (equally junior) colleagues having to consult google for solutions to our patients problem, if a medical emergency occurred (in ICU there should always be medical cover - this isn’t the case) we had to pull a buzzer, put out a page and get on with it until a medic appeared. This has not improved post pandemic.

In my current workplace (same speciality area), different country we are the only part of the hospital that is safe staffed, because of this every single day nurses and HCAs are sent to general wards, A+E and different hospitals often to be the only RN on a ward for 30 patients. There is such a crisis of care home beds, and ward beds that patients are staying in critical Care for weeks waiting on a ward bed. On the wards patients aren’t able to be washed each day as there might only be 1-3 staff members for 30-40 patients, meds rounds take 4 hours and ultimately patients who are sick go unnoticed until they are peri arrest. Nurses from day shift often have to stay on to night shift as there is no night shift nurse available.

I have only had negatives from the general public - it’s our fault for having degrees and being too posh to wash, bring the matrons back, etc etc. our colleagues who trained in the 80s and 90s pre degree say it is the worst it has ever been for safety and staffing. Racism and xenophobia towards our brilliant overseas colleagues is rife when they keep the NHS clinging on by a shoestring.

Four and a half years ago I was a first year student nurse and times were hard for the NHS, it has only got worse and worse for my patients since then. For the sake of my patients I will take industrial action.

However, it is so concerning how anti union, anti public sector and pro Tory the English public seem to have become? The decisions and government of Westminster negatively affect every nhs patient and worker in the UK. Just look at the widespread abuse, disdain and disgust directed at the RMT workers recently. I fear the same or worse for NHS workers.

So, is this NHS worker wrong for not enjoying being told to be grateful to work for the NHS? Is there any future for the public sector of the UK?

I apologise if I seem to have generalised England but I am English and from a northern Tory heartland. An area completely brainwashed.

@TiredNHS a lot of people cannot care for family because they have to work. There have been threads on here in the past where family carers have been really looked down on by some (not all) NHS workers. I remember 3am discharges being talked about on here which were done to try and force family to care even though they had to work.

It's not meant to be rude. Commenting on intellectual ability isn't an insult, or isn't meant that way.

The nurses you mention are the ones earning the really high salaries I talked about before. As I said, some of my friends are on 50k even 70k+. They would have been doctors in less sexist times but were funnelled towards nursing in the 80s. I honestly still find those to be good salaries. I realise in mn world that earning 50k is peanuts.

I also still think an above average salary (nursing average salary) to be perfectly acceptable for a job an average person could get on a 3 year degree course to do if it was something they were interested in doing.

@oldageprancer

So why do you think we're in a nursing recruitment crisis?

I wasn't asking why doctors should be paid more (although fy1 and 2 are still training posts)

I was asking why nurses shouldn't be.

But given that you're clearly ignorant about the role, it's kind of obvious

So you feel that nurses rely on doctors to make all the decisions. Now I know you actually have no idea what you're taking about.
I was a community nurse for years, specialist in my field, prescriber. I had to tell the gps what to prescribe. Our managers wanted us to teach the gps. Often had calls from GPs and consultants how to manage the patient.
Nurses are autonomous and are wholly responsible for their own practice. If a doctor prescribes something and its wrong dose , wrong drug or whatever and the nurse gives it...she is to blame.
Nurses time and time and time again stop doctors at all levels from making grievous mistakes.

You still seem to be of the mindset that the nurses are all running around after the doctor cleaning his or her sweaty brow. Some doctors start off with that attitude too...it doesn't usually take too long before they're put straight on that.

Of course there is a level we don't go beyond but to suggest we are the chattels of the doctors couldn't be more wrong. Funnily enough if you speak to enough decent doctors they'll tell you that too.

Based on your previous statements you are also implying most people could be nurses...on that you appear to be contradicting yourself....if it is so easy why aren't more people doing it, why are they leaving, why are they stressed out, why are they being so rude to patients. I've worked with perfectly decent and intelligent people , lovely kind people but they are not nurses, I had to carry them through the working day...maybe they flourished in other areas , but not where I was. District nurses who I admire so much, couldn't do my job, but likewise I couldn't do theirs, maybe with time and patience but plenty of them told me it wasn't for them....just like paediatrics isn't for every doctor.

If your point is that pay should reflect the job, then why as a prescriber, a specialist in my field, and NO doctor support day to day for years was I still being paid a low wage . No money, no band 7 positions. I had my own caseload, covered hospital and community clinics supported gps district nurses patients and families.

Community is the forgotten Domain, high dependency patients shoved out the door of hospitals terrible discharges, with gps who don't want to know or see their patients, it is the NURSE who oversees their care.

Stop spouting about things that it is evident you know nothing about. Leave it to the people who know what they're talking about, ....you ....not so much.

@RosesAndHellebores

Yeah I couldn't find direct comparison either. And I've not looked for funding for social and elderly care.

Saying you'd happily pay more for a system like france but wouldnt pay more for the current nhs is kind of missing the point.

If the govt was spending more we wouldn't have the problems we have now.

I also don't for 1 minute believe France is problem free and no one ever suffers poor care

I'd gladly pay and extra 60 quid a month to improve pt care and staff conditions and morale

Fuck me id pay double, triple even.

Yet when we say we need more money, you're saying no!! Can't do it.

Why not?

I stand with you op.

20 years nhs as a nurse and midwife.

Until conditions and pay improve I cannot see that staffing levels will increase. We have the money for staff but no applicants. My colleagues in the scan department are the same.

It is bleak and frankly terrifying.

You actually just said 'based on?' so I explained both parts of my personal opinion about pay

So back to nurses, again the same, it's an average level job that requires average level skills and intellectual ability, and pays average (well, above average) levels of pay. Where it requires above average skills and intellect, it pays above average. Higher rate tax payer is definitely above average.

Topgub do you think the support was there for NI increase? I feel like it was from this thread but maybe not in reality?

not sure though

With reference to the nurses being somehow 'lowlier' than the doctors. . .

The last time I was in hospital, the registrar, poor sod, was at the end of a very long shift. He did his best to offload me - despite the fact I couldn't sit up without throwing up, couldn't walk, couldn't see.

I got plonked into an area where a nurse thought that I wanted to go home, thought DH wanted me to go home, and tore us both a new one, because there was no way, in her opinion, I could go home. We both agreed! She kept me there on her mandate. She was a lioness, that woman.

The consultant the next day, totally agreed with her. That poor registrar got torn a new one. The thing that interested me, was the registrar was really rather rude and arrogant with the nurse(s), and the consultant, very respectful. As much as anything, he consulted with the nurse, respecting her knowledge and experience.

It was very educational all round, I'm sure.

@oldageprancer

What are you basing your assessment of average level job on?

@MarshaBradyo

I've not really heard much said about it other than folk don't trust the tories to spend it properly.

I think many called for it to be dropped but I don’t see how support is there unless extra funding is through NI

Because more money goes hand in hand with the provision of better standards of care and a better approach to the patient in the context of affording them the same level of courtesy in relation to their care as any other stakeholder. It means a system where one can get a GP appointment within 48 hours and without being on hold for 40 minutes. It means a system that is joined up and where the separate parts talk to each other. It means a system where an A&E dept is downgraded if there is no consultant oversight overnight and no facility for orthopaedic reg review or emergency surgery. It means a system where the triage nurse takes the gum out of her gob when she is speaking to a patient. It means a system where men and women are treated equally. It means a system where women are afforded acceptable access to pain relief and clean and kind post natal care. Need I go on.

We pay significantly more tax every year just for the NHS portion of the spend than the per capita contribution. I question how much of the GDP spend actually reaches the patient in the UK and that is where the problem is. Example in 2014/15 after a review our local CAMHS service was given an additional £2.3m. It pissed it up the wall on an additional tier of third party bureaucracy. It got so much worse there was another review in 2018. There had been a previous review in 2009. In 2022 - the CAMHS service is worse than ever according to Surrey Healthwatch. Does anyone ever add up the cost of the reviews and the failure to act on them and the money wasted?

Another example. In 1992 I developed Graves disease. Had surgery, obviously hypothyroid subsequently and need Levothyroxine. No problem - it's as cheap as chips. From 1992 until about 2000 I got an annual blood test and an annual orescription for 365 tablets. Then we had 28 day prescribing, followed a few years later by 56 day prescribing. I am thrilled that the NHS had first the admin capacity to do something 11 more times pa than necessary and then improved a bit and now only does it 5 more times than is necessary. I also think people who need levothyroxine should have free prescriptions for levothyroxine but not for everything else if they are working and paying higher rates of tax. I'd rather that money helped diabetics or asthmatics. Also adding that if I didn't have thyroid issues, all my lrescriptions would have been free in any event for the last couple of years. It's absurd I still work full-time and earn six figures.

The waste, idiocy, bureaucracy and too often actual rudeness and an inability to make an accurate note are breathtaking.

My SIL is a doctor and has been working on “boarding” which is when they put you in wherever they’ve got space even if it’s not the right ward for you. One doctor and a few juniors if you’re lucky. 40+ people scattered wherever they have beds all over hospital. It’s making her ill- can’t be everywhere at once. This is in Scotland which is meant to be better than England. I’m shocked her union isn’t doing more, if that were me I’d never shut the up complaining to whoeverd hear. It’s not safe!

@RosesAndHellebores

The first part of your post appears to make sense but the second part is just I hate the nhs so despite acknowledging that increasing funding lead to better care, you insist on refusing to make 2 and 2 make 2

I wonder if all French people adore theor system as much as you do?

There's always an unpleasant remark or two like' gum in gob'.

32 years I've worked as a front line HCP, now top of band 6, but was band 7 for years. The NHS is struggling and I don't think it can even be fixed 😥.
Awful pay means that lots of brilliant applicants no longer want to train to work with us and lots of European staff quit during Brexit. The staffing crisis is huge.
There were 120 applicants on my DCs nursing course (which graduates in March), over half have quit. No wonder! My other DCs all work in niche fields of IT, on double my salary at 24 and 22.
It's crazy.
One thing that Sajid Javid is right about is that the IT systems in most trusts are completely useless and management is ineffectual. So many incompetent Band 8s who dint want to rock the boat and are more concerned with completing their own personal CPD projects than what is best for patients.
Finally, everyone needs to take responsibility for not wasting NHS resources, this week I have had 12 people fail to show up for appointments, (and its only Weds!) with no warning, so couldn't book anyone else in. IMO these people should be fined as with dentist/ vet and hairdresser missed appointments. There is currently a 6 week wait for appointments in my clinic and its wrong that people just fail to turn up.

lastly, in general people from middle to upper classes can provide less support for their parents. But they are very good at raising complains and they don’t think it is acceptable to discharge their mum home with only 4 care calls a day. They wont even do the shop for their mums as they work long hours (they live in the same town!) and demand social work to organise this.

Actually, it has been the law in this country since the creation of the welfare state in 1945, that no adult has to care for another adult. It is the responsibility of social services to organise this - they are supposed, as part of the assessment of need for social care and support to consult with the family, as to what care they are willing to provide. The family are entitled, as per the law, to say that they are not able to provide anything. The assessment of what care the person needs should be produced; and then a financial assessment done. If the patient has more than £23, 250 in assets (not including their house), then they are charged for all the care they need.

If you don't agree with social care law in this country, then write to your MP about it.

It is irrelevant what people do in other countries. I suspect the reality is that middle aged women are expected to do the care for free, at the expense of their own career and pension? In this country, our generation were told in the 80s to get on a bike to find a job. For many of us, that meant moving hundreds of miles away from our family. House prices are such now, that usually both partners in a couple have to work to pay the mortgage, while paying for child care and later support their children at university, save for their pension and increasingly we are being told, we should be providing for care in our old age as well now. Women have to work until they are 66, while their grown up children are also expecting free child care from them for the grandchildren; and caring for their elderly parents - the sandwich generation. Something has to give!

I provide care for my own two adult DC (who both have significant problems), my husband (with his own health problems), my two grandchildren and I have to work. I do not have any more time or energy to care for my MIL, who lives 160 miles away (seeing as DH got on his bike in the 80s); and neither does DH who struggles with his health, and working full time in his own practice. Would you be telling the consultants where you work, that they should give up their careers and pensions to care for their elderly parents; and live off the state pension only when they retire? I suspect not?

@TheSummerPalace

Much like childcare, elderly social care has to be paid for.

I dont want or expect women to do it for free. But we can't provide the level of care required for the funding we have

Social care which is very poorly paid is also facing a recruitment crisis which has huge impacts on hospitals

@Topgub so actual examples, lived experiences extrapolate to "I hate the NHS". How very interesting.

@PomRuns yes "gum in gob" is indeed an unpleasant expression. Almost as unpleasant as a resoundingly unpleasant practice that does nothing to convince the patient that the person before them is a post graduate professional. Whatever may be said about the wettest behind the ear F1, they tend not to be quite so vulgar.

@RosesAndHellebores

Yes.

Its in every comment.

You never acknowledge all of the amazing work the nhs is doing in really awful circumstances.

I'm sorry you've had poor care.

Unfortunately refusing to increase funding is only going to make things worse.

@TheSummerPalace

Life expectancy in 1945 was around 65. Now it is around 80. So the law needs to change.

I don't want to go in to a care home or have carers when I can't look after myself as I do not want to be a burden on the younger population.

I should be allowed to decide when I want to die but I am denied that basic right and instead I will end up costing the country thousands of pounds unnecessarily.

So back to nurses, again the same, it's an average level job that requires average level skills and intellectual ability, and pays average (well, above average) levels of pay. Where it requires above average skills and intellect, it pays above average. Higher rate tax payer is definitely above average.

I have been a nurse for over 20 years, lots of experience in various different areas. Work in community at top of band 5 so get just shy of 32k a year. I walk into patients homes alone, it is entirely up to me to assess what is happening with that person and what care they need, are they showing signs of sepsis ? Are they experiencing an exacerbation of a chronic illness ? an acute event ? Are they different to how they normally are, could they have an infection ? Has their chemotherapy completed, if it hasn't does it need to be removed or is it ok to keep it running until it completes ? Do they need the medication in their syringe driver increasing, do they need a syringe driver in the first place, what do they need in it if a chart hasn't already been prescribed (and if one has, is it still appropriate ), so what are their symptoms and which drugs will best alleviate those symptoms. Often patients aren't known to the OOH's doctors, so I need to be able to communicate a synopsis of what has happened and what is happening to that person now and what I believe is required. Those doctors rarely visit the patient and will prescribe on the information I give them.

Helping someone who is dying get the correct medication at the right dose for them, to alleviate their symptoms, rarely feels like an 'average' thing to do and if me and my average skills and intellect achieve that for them, well I am more than happy with that level of average.

@Topgub I didn't say I refused to increase funding. I said I refused to increase it under the prevailing system which is not fit for purpose. When I receive good care, I always write and note it. Regrettably for every episode of good care, there are two of sub-optimal or foul care. It needs to be dealt with. Would you be happy if you went out for dinner, paid £50 or £75 per head and the person serving you was chewing gum and acting in a "Little Britain - Comptah sez" manner? I suspect not.

I dont want or expect women to do it for free. But we can't provide the level of care required for the funding we have

But families can’t provide the care, just because the NHS or social care sector can’t either.