A nurse at a major hospital in the south east of England has revealed what a typical day in her job is like as nurses in the UK are set to strike next week. Nurses at almost all health boards across Wales will be taking part in the two days of strike action in the run-up to Christmas.
The strike will take place on December 15 and 20 at all health boards, except Aneurin Bevan, which did not meet the required threshold. Members of the Royal College of Nurses (RCN) union have rejected a Welsh Government pay award of between 4% and 5.5%, which is well below the rate of inflation.
One nurse at an English hospital, Rachael, has revealed to the Daily Mirror what it is like to work a gruelling 16-hour shift overseeing an A&E department. While Rachael is a nurse at an English hospital her experiences will be familiar to nurses working across Welsh hospitals as she works a 16-hour day in A&E, stitching up wounds and dealing with broken bones, while having to endure abuse as she carries out her job.
READ MORE: Everywhere nurses will walk out on December 15 and 20 as strikes confirmed
Rachael has given a candid account of what a typical day is like for her as she leaves the house while her children are still asleep and won't return until they are back in bed. Her surname has been withheld upon request.
6.20am: Rachael starts the first of three long shifts that start at 7.45am and finish at 8.15pm. Her children are still asleep when she leaves the house so she gives them a hug and a kiss goodbye before she goes knowing that she probably will not see them until breakfast time on Saturday unless she can fit in a quick video call with them on a break.
7.10am: She then arrives early so she has time to get changed for her shift. Rachael has been an A&E nurse for 11 years. She says shifts are getting busier and that she can assess around 20 people in just an hour on top of dealing with patients who are booked in as well as those coming from ambulances. On top of that Rachael oversees an entire department meaning she manages students, junior staff, and carries out any administrative work.
8.20am: Rachael says she gets the night team home as soon as possible before they have to return to the ward for their shifts that night. "I check with my colleague about how she is feeling now and we talk about the confrontation, the accusations that we are not 'doing enough', along with some of the worst language we hear," she says. When the nurse leaves Rachael is left with just one room and three seated cubicles to run the department and see the patients meaning she's in for a "tough" shift. Rachael says her team takes the opportunity to have a 15-minute break at this point "otherwise they will never go".
11am: She then checks in on the patients, chatting to them and checking for pain and comfort before having to explain that the wait will be a little longer due to numbers at the hospital. As well as dealing with emergencies, cardiac arrests, breathing problems, and patients with sepsis the staff are trying to help those who are injured and medically unwell. She communicates with doctors, makes up take-away medications, and chases up plans and decisions being made regarding treatments for patients.
12pm: At this point in the day Rachael says the department is "heaving" as staff attempt to assess new patients while still having to treat patients who are unwell. "When the queue is long it always leaves a knot in my stomach," she says. Rachael checks new patients' breathing, colour, and signs of distress as they come into A&E, picking out anyone who is particularly unwell for urgent treatment while preparing take-away medicines.
1.20pm: Rachael is dealing with a number of patients with broken bones. Two patients have broken elbows and another has a "visibly" badly broken leg and is in a lot of pain. The patient with the broken leg had had to travel to hospital by taxi so had been in pain for some time. "It's difficult knowing you have 15 people already here waiting to be seen but you know that this patient needs you now," Rachael says.
3.45pm: It's Rachael's first break away from her department and she says she knows she should call home as her sons will be back from school. But, with just 15 minutes to spare, she needs to eat and drink as quickly as possible before returning to the busy ward.
4.20pm: A young patient who has been stabbed comes into the ward in the middle of Rachael's triage queue. While they are calm Rachael says they are clearly just shocked. In addition to the stab wound Rachael's primary focus becomes checking for other injuries. The patient becomes a priority and the team are pulled away from what they are dealing with. They carry out a trauma call in which the patients is assessed from head to toe by the most senior person from each speciality in the hospital.
5pm: "I bring my drained team back together and tell them we're nearly there. It's tough but I try to rally them, discuss tasks, and off we go," Rachael says. Extra help is provided when a nurse from next door comes in – something Rachael says is a relief. As more patients come in Rachael takes all the injuries. "We all know nursing is rewarding in many ways and I've always said we're in a very special position to be able to assist patients and families at their best and worst. We know how vital the NHS is to everyone – it binds and holds us all," she says.
7pm: The shift is nearly over with one last round of observations to complete. The team stock up the rooms ready for the night team who arrive at 7.30pm.
8pm: Rachael carries out a handover and thanks the team for all their hard work before sending them home. She still has non-clinical work to complete. "In A&E you're making multiple decisions constantly and your decision matters at every point. That is the hardest thing because it is relentless for 12 hours or longer," Rachael says. She adds that she worked a 15-hour shift one day before carrying out a 12-and-a-half-hour shift the next – a situation she says is the reality of working in A&E. "We keep going until the situation is stable and it's safe to leave," she explained.
8.45pm: Rachael gets ready to leave, changing out of her work clothes. While the team work 37.5-hour weeks she says it ends up being much more than that, meaning staff have little time for family life. "It's emotionally draining work and it can be difficult to keep a harmonious personal life," she says. Rachael says she works two or three extra shifts a month in order to make ends meet. "If our full-time pay doesn't cover the cost of your outgoings then there's something wrong with the system," she says. "You can't keep telling nurses to 'get better jobs'. They are doing better jobs. Many nurses are struggling – particularly as the workforce includes more women and single parents. We also have nurses starting with up to £50,000-worth of student debt on £24,000 starting salaries."
10pm: Almost 16 hours since she left her house in the morning Rachael is back home. She puts on the laundry, kisses her children, and packs her bag for the next day before going to bed at around midnight. "I remember that once my oldest joyfully told me he wants to help people, like me, when he is older, which makes me feel better. I tell myself that there are only two more days of these shifts to go now," she says.
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