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.

@DamnUserName21 may I respectfully ask if you have ever worked in a solicitor's office or barrister's practice to make such a confident prediction?

In his 30s/40s/50s my DH worked 70 hour plus weeks in the run up to a big case and when in court. The work may have focused on one team of clients but it was intense and an error would have cost the reputation he had spent years building. Had he ever been rude to or dismissive of a client - he wouldn't have been paid. Law at the top is ruthless and it cannot be done part-time.

I accept GP's are busy but your comment illustrates perfectly that they appear to think nobody else can be as busy of them or of very much consequence.

Generally, the public don't understand how utterly awful things are for nursing staff. Decades of underinvestment in the profession has brought us to where we are, as a government makes the choice to fund health care based on what it says it can afford, rather than in line with what's actually needed (older population living longer, complex health needs, pandemic etc).
If nursing staff strike, patients will be kept safe (recent IA in NI reflects this) however, if action isn't taken by the gov to improve recruitment/retention/pay/staffing levels, then inevitably patients will suffer - not through the fault of staff. People should be emailing their MP along with Johnson, Javid, Sunak asking questions and demanding answers.
Ministers will only act when the public get involved - it's up to us all to put pressure on them when things aren't right.

DamnUserName21 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.

You don't have a clue about legal work, do you? Or maybe you think that the rural firm, with the two partners who socialise with their wealthy clients on the golf course, is the norm. It barely exists any more.

What you are describing is work. The work that any professional is expected to do in the course of their job. Solicitor's working lives are split into 6 minute units, which are time recorded and assessed every few months for profitability. If you don't make a profit for a firm, unless you are a partner (and even then...), you are out.

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???

With all due respect, this is GP work. GPs go into GP and not hospital work/consultancy because they want the lifestyle of a GP. That lifestyle, like that of the rural firm of solicitors, hasn't existed for years. Patient demands are higher and treatments more complex. Everyone knows that very few ambitious medical students go into GP work because it tends to be boring, repetitive and frustrating. They go into it because they want to work with a varied case load, because they enjoy interacting with patients and yes, because some of them want to work part time and combine family life with professional work. If its not as cushy a job as they thought it would be, then it would seem that their expectations are not in line with professional reality.

Any solicitor, even in a regional firm, whose expectations weren't in line with professional reality would simply be fired.

What an odd contest. Lawyers v GPs.

@RosesAndHellebores
I'm not a GP and don't speak for them. I speak about what I see and experience as someone who works in a GP surgery. My apologies if I came across as no other job can be busy-not my intention at all. I really can't imagine GPs think this either.
My point was directed at those who feel GPs and, I daresay, other NHS staff should be full-time when, in fact, the workload for the GPs/NHS staff I work with is full-time although on paper it might be deemed less.
In answer to your question, no, I've never worked in a solicitor's office. You reference your DH and his 70 hour week case in which any errors would have cost him his reputation. In medicine, as you know firsthand, errors cost lives and that's one of the reasons why drs should not be doing 70 hour weeks. Added to which the sheer volume of patients GPs deal with day-to-day is not sustainable. Yet there is an expectation (from some) that GPs should be doing full-time as if it were a 9-5 role.

Its not odd, because both are professionals and subject to fiduciary duties and a professional governing body which can strike them off for misconduct. Both go into their respective professions expecting long hours, especially in the first years, and lots of unpaid overtime, and to behave in a certain way in keeping with being a professional. As a lawyer, I cannot sometimes believe how unprofessional some doctors and it seems to be casually accepted within the profession in this country.

Nope, don't think that at all and as I said there is no comparison.

@DamnUserName21 I don't think anyone thinks GPs should work 9-5. It isn't possible in any event for routine checks, which GPs insist on and get quota payments for, for the simple fact that the majority of the UK population from 21-64 is in full-time work, often and hour or more away from their GP practice. What would help for such routine things is a system of dual registration or the ability to consult an alternative GP on the NHS for routine matters.

Thankfully our GP surgery has cover from 8am to 7pm; or even 8pm a couple of nights a week. Again it is a large practice and it is notable that no GP partner works full-time for the practice but every one of them does out if hours clinics at our local private hospitals for which they are separately remunerated and I believe the practice also has contracts with a core of local boarding schools. I don't think they have a bad whack to be honest.

I write to my MP regularly. He thinks the local health economy is tip top and seems to believe everything the various CEOs of various Trusts tell him.

@RosesAndHellebores
You stared. ‘If there are issues in the NHS they are because patients for decades have been expected to express gratitude for suboptimal standards. This combined with CV building and a disingenuous approach to massage targets.’

You have not answered my questions. People expecting to express gratitude to suboptimal standards is not the same as someone actually receiving suboptimal standards.

Targets have been set by the government and yes some are actually inappropriate and now near on impossible to keep in many cases.

You have obviously received poor care and shouldn’t have happened. However this has not happened to everyone and there are people who have received very good care.

On the subject of whilst we are addressing personal circumstances. I too have been on the receiving end of poor care. On the flip side, if it hadn’t been for the NHS my father in law would have died.

My best friend is currently awaiting a gynae operation which she has been waiting for the last 18 months. The reason she needs an operation is due to procedure undertaken at a private hospital.

A patient recently was discharged from a private hospital following an hip operation. No referral made to district nurses for wound care and for the stitches to be removed. The lady was 89 years of age and lived alone and not very mobile. Instead a letter was posted to the GP out over a week later to advise of the procedure which had been undertaken. There was already signs of redness around the wound. Luckily, it was covered with antibiotics and the district nurses were involved but could have been much worse.

Im sorry you are angry at the NHS nursing and midwifery staff but we are really trying our best. You need to direct your anger at the Government!

So on one hand you want to call a doctor by his first name, on another you want distance, on another you want to be called Mrs h , on another you object to 'terms of endearment' when being addressed. And that's before you get to your health issue.

From a personal viewpoint I intensely dislike 'love', but a good friend of mine refers to me that way so I take it as it is, a friendly endearment. One would assume any nurse using it is not ill intentioned. In order to identify you they would have to use your full name at any initial interaction at the very least. If someone responds to me I am Mrs so and so I take their lead and call them that or ask later is it ok i call you Marjorie....i personally dont use any of the terms you abhor but really at the end of the day unless you are not identified correctly it shouldn't matter. If you are so set on it just say I'm Mrs so and so and leave it at that. But you seem to be fixated on some sort of heirarchy being established. Some colleagues I find are pompous and full of their own self importance i ignore that bit and focus on whether it matches up with their competence in what they do. And this above ALL else is what should matter.

If your main complaints are just about what your are referred to, then maybe you need to be less focused on this and more on the greater issues at hand. Thinking about it most of the nurses I work with address people by Mr/Mrs initially but after establishing a relationship with them may refer to them by their first name. Most nurses are referred to as nurse or their first name, I dont think they really care. If i started stomping around insisting on being referred to as nurse windypants I'd be laughed out of the building and rightly so.

As an ex trainee medic I was completely unprepared how poorly I was treated during my training and in extension how poorly patients were treated. I think the problem extends beyond inadequate staff. The whole approach to medical training IMO is outdated and in many cases doesn't care and actually does harm.

I think the NHS should be abolished. People need to pay for health insurance and taxes reduced.

Public services don't work well because people aren't willing to pay enough to fund them and then expect the earth.

And they also take it for granted.

They take risks with their health and well being which they wouldn't if they thought that they would get a bill at the end of it.

As I think that the OP said up thread one of the reasons we are in this mess is because we are keeping seriously ill old people alive when in the past they would have just died.

Unless attitudes change so that old people are only kept alive if they will living rather than just existing then young people are going to keep dying because of the lack of resources.

@Sitdownifyoulike

Yes but they are threatening to strike because they don't want to work Saturdays

The NHS could be kept and those who are devoted to it could remain with it, but it could be one of several competing universal healthcare providers with access to formerly public healthcare facilities. Allow people to opt out and make health insurance compulsory for employed people like pensions and otherwise provided by state contribution for those who do not work.

I worked for the NHS 20 years ago as a hca then a trainee nurse

The only way some nurses could get a break was to say they smoked to have a smoking break. I worked as a lone hca with 2 staff nurses some night shifts in a 36 bedded acute ward because we were so shorted staffed and hospital wouldn't pay for agency. I did a run of 7 nights like thst once.

We didn't have enough staff or resources. I did most of my shifts without a break.

And back in 2003 I earnt £200 a week as a hca for that.

It seems nothing has changed.

@Windypants21 you are still missing the point. If a Dr introduces himself/herself/(and for the NHS themself) as Dr Pants, I do not expect him/her/them to assume they may use my first name when not inviting me to use theirs. It isn't rocket science, it's basic good manners and has everything to do with the outdated patriarchal hierarchy of the NHS.

I am very pleased you start formally and then ask if a less formal approach is OK. That is how it should be. However in outpatients at my local hospital the staff unilaterally call women patients to their appointments as Jane Smith and men as Mr John Smith. The inequality in an organisation that is investing hand over fist in chest feeding initiatives is shocking. The Sex Discriminarion Act was passed in 1974. The NHS has had almost 50 years to embed it yet even now women receive poorer care than men particularly in relation to pain relief.

It's an important issue and it needs addressing. No other profession behaves less favourably to women than to men in my experience in 2022.

@RosesAndHellebores change the record!

I support you Op, I’m in community pharmacy and burnt out. We can’t recruit dispensers that we desperately need. They are the backbone of running a pharmacy but why would they want to work stupid hours for relatively little pay and be abused on a daily basis.

I'm tired of being yelled at because you had to wait 20 minutes for your medication because I was on the phone to the hospital sorting out a patient discharge because we need them to have the correct medication dispensed with no errors.

We are all doing three peoples jobs, 12 hours a day right now and our near miss logs make interesting reading because we’re all tired and stressed. Can’t remember the last time the team didn’t work through lunch and didn’t feel guilty for taking a brief walk outside to refocus the mind, I mean, why would anyone need a break from potentially killing a patient 🤷🏻‍♀️

It will be locums/ANPs manning those clinics, I imagine. Not enough permanent GPs to do it, handsome reward or not.

"they take risks with their health" Yep excersise is always encouraged. 🤔

www.expressandstar.com/news/health/coronavirus-covid19/2020/11/09/police-break-up-40-men-playing-football-and-cricket-in-park/

@Communitypharmacy I'll change the record when the NHS and those in it stop treating women less favourably than men thank you.

FWIW my local pharmacy opens at 8.30 and closes at 5.30. It used to open all day on Saturday but now opens until 1pm only since Covid. I make an effort to get there before 1pm on a Saturday because I'd rather give a local, family firm my business than Boots or Lloyd's at the supermarket.

If you mean your are connected to a GP practice or a hospital pharmacy I am sorry you are shouted at. That is unacceptable. However, is there clarity of communication around waiting times? Do people have the opportunity to come back in 3/4 hours if that's the waiting time? I am aware that the pharmacy department at my local hospital makes people wait and doesn't let them go away and do something useful which causes a lot of ire on local websites.

I told DD (dispenser) last night, about how one GP suggested larger pharmacies lighten their load by doing minor injuries, utis, ailments, bites, etc! She said that is alright for GPs to say, patients can only see them by appointment. People walk into pharmacies - if the pharmacist is tied up in the consultation room for 20 minutes with one customer; what happens when several customers in the queue ask to speak to the pharmacist or want P goods? She said, they already do vaccinations, emergency contraceptives for under 25s, order repeat prescriptions online for customers; and deal with customers sent by GPs for the most ridiculous reasons! Pharmacists are expected to do GPs’ work for them, for half the money!

@RosesAndHellebores loving your comments , really not important and if that's your only issue your doing well. Re the name issue the team I work with always ask what people wish to be called. And always intoduce our selves by 1st name and role. This INCLUDES the consultants . However we call people by as John or Janet Smith. Why? If you are gender neutral or Ms not Mrs this using the wrong title can be offensive and we don't know this or TBH have time to check when we call you in. Your status in that respect make no difference to our treatment of you.