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.

@Windypants21 never have I said I expect to use other people's first named whilst expecting them to address me with a title. What I have said, ad nauseum, is that I will not have my first name used by somebody who expects me to address them with a title. I think it is wrong that nurses and receptionists have to address doctors formally when the same doctors assume they may use everybody else's first name.

It is an equality issue and it is wrong.

Part of the issues for the NHS and for self employed GPs is that if you earn enough part time to kep yourself why bother working full time?

This comment reeks of ignorance. I work in a very busy and large GP practice. The majority of GPs work 3 days per week. What is seen as part-time. These are 12 hours days. They start seeing/phoning patients are 8am and, aside from break, mandatory meetings/training, will see/phone patients until past 6pm THEN they will check results/write notes/admin/do referrals. They are often doing this between 8pm and 10pm at night. They also check results/do refs/admin and follow up with patients on their days off

Forcing GPs to go full-time will lead to even greater burn-out and a mass exodus from a profession which is already haemorrhaging.

Yet lawyers in private practice do entirely what the GPs do but work five not 3 days a week and live to tell the tale, ofetn work all night and frequently without over time 2 weekends in 4 and sometimes all nighters.

This comment reeks of ignorance.

And? DS does that 5 days a week; occasionally 20 hours a day for a week. Sometimes he catches an overnight flight; goes to the client’s office for meetings all day on no sleep; or vice versa overnight flight back from client’s and goes straight into the office to work all day. Out of 300 staff, only 2 took sick leave for Covid, the rest worked through wfh.

No paid overtime - just gets paid for a 35 hour week. DS has worked more hours than doctor in the family, going through F1, F2 and three years GP training in the last 5 years, who got paid for his overtime and between £50 and £70 per hour for locum shifts.

Yet lawyers in private practice do entirely what the GPs do but work five not 3 days a week and live to tell the tale, ofetn work all night and frequently without over time 2 weekends in 4 and sometimes all nighters.

I don't know about you, but I don't want a doctor doing those hours and being dependent upon them if me or mine have serious health issues.

Have to agree here. Been around long enough to remember the doctors in the hospital coming on on a Saturday morning and finishing at 5 PM Monday. Day and night. Dangerous dangerous dangerous. One doctor told me she was clarking a patient in in a+e , the patient tapped her on the knee and said that's the 3rd time you've asked me that. Sleep deprivation, stress and ridiculous time constraints due to reduced staff and resources.

What people also forget is that you often have 6,7, 8 things coming at you at once, all with their own degree of urgency, that level of sustained pressure and with someones life dependent on any mistake you make is beyond reasonable in these overstretched and crisis times. There is no protected time to write your notes, take phonecalls and have a decent one on one with your patient, throw in a few arrests and it has ...asking for disaster ....written all over it.

Compassion fatigue. They warned us about this during training. The solution was lessons in 'resilience'... Not better conditions.
OP, I'm also a nurse, qualified a year before you. I take my hat off to you, I went directly into general practice because I knew I couldn't handle working in a hospital. If a strike is called, I will vote for it and strike in solidarity despite not suffering the same conditions as you.
I hear about how things are and I despair for the future of our NHS.

More fool them if they accept those working hours. Also being a lawyer in private practice is a completely different job to being a GP, so has no relevance.

I will add to this that we only have as many GPs as we do, because of the hours of general practice being more suited to raising a family than working in the hospital. All of our salaried GPs (not the partners) are women who have primary age/younger children and work the job around their family. The hours (though many will be doing paper work/checking results at home after their session) attract many of them to the job, thankfully, or we would have an even bigger shortage. There's not much else appealing about general practice these days!

Doctors are special, don't you know. Thats why they can do all sorts of things and not be struck off by their professional governing body for things that would disbar not only solicitors, but also teachers, pharmacists, etc..

So many of them seem aggrieved to actually have to deal with patients who have medical issues and complain about them. Bit attitude problem, much of it due to the monopoly that is the NHS. I suspect that lawyers would do the same if the vast majority of them received a large guaranteed salary via the state. Legal aid is tiny in comparison and only for a few.

Consultants are often on call for a week at a time.

This means that as well as running clinics, being present in the hospital for a certain number of hours a day for 7 days, they are 'on call' when they leave.

For those 7 days, they can be called at any hour of the day or night and need to stay close to the hospital if their presence is required.

Imagine having to drive, make clinical decisions, give instructions down the phone, do ward rounds, attend meeting and run clinics on broken sleep and with the bleep and mobile going off at any time.

From my perspective, if their ego is so fragile that they HAVE to be called doctor then that says more about them than me. No doctor has ever said call me dr so and so. I usually just call them 'doctor' because it identifies who and what they are to the patient/colleague or whomever, especially if both of you are in scrubs, as alot of us have been over the last 2 years. It also helps with the older age group who still occasionally struggle with seeing a female as anything other than a nurse. Finally I want to keep some professional distance and calling them doctor helps me with that, I'm not there to be their friend.

I get called nurse all the time by doctors patients and other AHPs, in the thick of it no-one really cares, just get the job done.

@Eddiesferret ...you know something...if you'd said that to me a few years ago I'd have dismissed it as BS but after the dismal way I was dealt with by the NHS for months (it's a long story for another tIme) I took advantage of the private health scheme my company had included me on, the contrast I experienced was mind boggling. Two total hip replacements later (both within three months...no waiting list) I was on the road to recovery.

So @Windypants21 do you also understand that the patient may wish also to keep a boundaries, professional distance and be addressed in the same way as the Dr, and to maintain dignity to actually have their name used rather than "love", "sweetheart" or "darling". Patients are sentient beings, usually at their most vulnerable when they are in hospital. They are wives, mothers, daughters, husband's, fathers, sons and often professionals in their own right.

Solidarity with OP and NHS colleagues.

Nurse and prospective union steward here.

100% support strike action across the public sector.

To anyone who reckons their profession has it worse I recommend 1) joining a union and ballot for industrial action for improved conditions or 2) come and join us in the NHS.

@Xenia My father is a solicitor in private practice and senior director. The most senior in his firm. He works from home 3 days and office 2 days, he works 9am-3pm most days, the latest I have ever seen him work is 5pm. He earns almost double a GP salary plus bonus and has 36 days annual leave plus bank holidays. You don’t speak for all solicitors in private practice and using them to bash NHS workers and GPs is just embarrassing. I don’t doubt some solicitors work long hours and have difficult work - but one profession having it poor doesn’t mean every other profession should be as bad. That’s a race to the bottom mentality. I know my father is educated enough to not buy into it.

Op, is this only for nurses? I’m asking because some consultants I know work 3.5 day weeks for full pay and seem to be very relaxed! No extra workload or long shifts. Perhaps because one is in fertility and the other is an ortho surgeon. Both have very predictable work loads.

Tirednurse1 My father is a solicitor in private practice and senior director. The most senior in his firm. He works from home 3 days and office 2 days, he works 9am-3pm most days, the latest I have ever seen him work is 5pm. He earns almost double a GP salary plus bonus and has 36 days annual leave plus bank holidays.

That will be precisely because he is senior and of a certain age and presumably a partner, who is now afforded this luxury. Younger solicitors almost never get these kind of privileges and generally have to spend years working up to such privileges, if they ever get them. And seriously, court solicitors or barristers - get paid the same whether they have to travel or not. Working long hours in the professions unpaid is standard and everyone knows the deal, so tbh to here part time GPs in their early thirties moaning about full working days and having the luxury of being part time does sound a bit unrealistic.

The NHS will never get sorted because, although the public claim to be happy to pay ore for it, they are not happy when tax or NI is increased.

We built this idea of paying low taxes and cutting services over the years when the baby boomers were all working and paying in while the elderly were fewer. It is not sustainable to pay low tax with fewer people working and have minimal services with large numbers of elderly and unwell.

Over the last generation or two families have become more scattered and unable to look after their elderly relatives due to distance and work commitments too

I’m a midwife. I’m off sick with mental health issues directly related to the current conditions. I’ve reached breaking point. I was going to work and feeling jittery all day, having palpitations, crying at the littlest thing, I just can’t keep doing it. I want to give the families I work with the best possible care but it’s physically impossible with the resources and staffing. I would walk into work as early as possible (I start at 8.30), immediately start going through emails and messages, work out who was going to cover the latest person to be off sick, and then do back to back 20 minute appointments from 8.40 to 4.30 (which is simply not enough time to go through everything that the trust expects us to do, and answer any questions, talk about mental health, reassure anxious mums, talk about birth plans etc.), and then once clinic had finished, I’d be desperately trying to chase up social workers, add notes to the terrible outdated computer systems, make referrals, update my caseload folder, reply to messages, check the emails again, find something we’d missed earlier on in the day (a visit, a phone call, a discharge summary, an important message), realise that no one had done the safety checks all day, and then try to get as much done as physically possible before I HAD to leave at 5.30 (I finish at 5) to collect the DCs. Never did I finish the day without a task looming over me. I know that I still have an in tray full of referrals, messages, notes etc. that no one will address whilst I’m away. I have women that I am worried about and I lie awake at night worrying about whether someone else will have time to liase with their social workers, build a relationship with the family, and make sure they get what they need. It’s just too much for one person when you aren’t allocated the time for admin and are expected to somehow make sure you are contactable and responsive to emails and voicemails from clients all day. And this is when the day runs smoothly!

I'm so sorry to read this OP. I've worked for the NHS 30years.its at an all time low and getting worse. During the early 2000's we were getting there better staffing ok pay , regular training and support. There has been a decline. In the last 10 years worse than I have ever seen. I too live in a northen tory heart land where a sheep with a blue rosette would be voted in. Elderly population who wonder why the GP is so busy. The towns doubled in size GP numbers the same . I don't work on wards I ran away.from them many years ago to clinic work which is now getting worse too. I need another specialist staff member but can't get them funded. My waiting list is 12 months. I do support you. We cannot negotiate with the current government as they appear to be in denial about the situation . Its interesting they haven't let the pay review body report , it was due in April/ May. My guess is it was for alot more than they wanted. Stay strong and look for something else.

That's effectively what my dad had to do with mum. He needed help, he had been asking and asking and had cared for her FT for years. But he's 72 and was sleeping on the sofa so he didn't disturb her
He asked for help, they were still debating 15 min care visits when she fell and he had to call an ambulance. Luckily when she went into hospital they realised actually she needed FT care. That was maybe 14 weeks ago, she died the week before last so that's how bad it was before he managed to get help
Social services are so stretched

@RosesAndHellebores what a very strange reply. Why would I say please to you in my initial comment? You may want to read it again.

You have stated people expect to receive sub- optimal care in the NHS so kindly state what exactly are u referring to? To me that means they are are expected not to get the care they need so if you do not mean that then kindly clarify what you do mean.

I don’t expect to receive sub-optimal care as a patient. I expect I may need to wait but not sub-optimal care and I have never given sub-optimal care to any of my patients.

As for the consultant’s secretary, do you think the private sector secretaries respond quicker? I can assure you they don’t always. My husband waited over a week!
Your comments on here are exactly what the OP is referring to.

As my legal practice got busier and more relentless I felt more sympathy with my medic/hip friends and understood their complaints more.

Whereas previously when I had to build my own business it was harder.

There really is no comparison.
The GP caseload is much larger than the caseload of a lawyer. Again, I can only speak for where I work but GPs/ANPs will see/speak to patients every 10 minutes (most 10 min consults run over) until break/admin time so in any given day, you are looking at dealing with health issues for, say, 30 patients, and that does not include any follow up, checking scans/bloods/consultant letters/hosp discharge letters/safeguarding or social work issues,med reviews, etc, etc.

I work in a practice of around 25,000 patients. We have 11 salaried/partner GPs each with a registered patient list of around 2,000 people. We can't get locums and we are losing permanent staff to non-GP activities or going abroad.

If being a GP is such a cushy job, why are drs leaving???

@bakedbeans I have answered your questions already. However, please find noted below some examples of sub-optimal care I, or those closest to me have received:

1. DD: 2015 failure of the NHS to provide MH care to a teenager with anxiety, depression, self harming by cutting and overdoses. I had to find an adolescent consultant psychiatrist - the underlying issue was undiagnosed ADHD and the CAMHS nurse told me a 17 year old was too old to have it! Optimal or Suboptimal, and that's notwithstanding the A&E attitude after an od.

1. My father went to his GP four times feeling breathless and weak. He was prescribed four courses of ABs for a chest infection. He died 12 months later of Acute Myeloid Leukaemkia diagnosed after he collapsed and was admitted to hospital when on holiday. GP stonewalling him when he raised it.

1. Failure of midwife to obtain my consent before injecting me with pethidine, failed to realise baby was posterior, failed to realise I had reached 8cm on an open ward where visitors were present - just a curtain. Then failed to identify that the baby was in trouble and blamed the falling heart rate on a faulty belt. The baby had to be resuscitated.

1. Failure to diagnose a broken back in A&E where a junior Dr told me I had to be mindful of the risks of radiation and after viewing the XRay told me there was no new damage but failed to tell me the T12 had broken despite being categorically told beforehand only the L1 had previously been broken. On the basis of an incorrect report my GP then refused a referral to a spinal surgeon or physio when I had been in severe pain for two months. A severely fractured T12 wad diagnosed privately, physio was paid for, a five month delay arose in seeing my rheumatologist and accessing the best possible meds for my osteoporosis - which I have to pay for because although it's the optimal treatment the NHS won't fund it.

I trust all of the above help explain sub-optimal for you. If not, then God help us