I’ve been a paediatric nurse for nearly 10 years now, working everywhere from ICU to in theatres. I’d say I’ve developed a lot of patience and learnt to roll with the punches pretty well over that time, but I can categorically say the current NHS crisis is the hardest we’ve been hit so far, which is why I’ll be taking part in Thursday’s nursing strikes.
Last month’s strike ballot was the biggest in the Royal College of Nursing’s 106-year history and this week’s walkouts will now go ahead after health secretary Steve Barclay refused to discuss pay in talks to avert them. I can assure you that those of us voting in favour of the walkouts have not signed up lightly. I love what I do, I really do. My team are amazing, I literally help to fix broken hearts for a living, and I have the privileged position of being part of some of the best and worst days of people’s lives - that’s why I went into nursing. My sister was quite ill growing up and there was one particular nurse who’d always keep her company on a night shift. It stayed with me.
I never wanted to get to the point of striking, but we’re at breaking point and it feels like this is our last resort. The most experienced frontline nurses are now around £10,000 a year worse off in real terms than in 2008 so we’re essentially working the equivalent of one day a week for free. We’re also dangerously understaffed, to the point where I worry it’s risking patient safety. That’s why we’re striking: not to risk patient safety, but to save it.
I currently work in theatres, doing investigations under x-ray, and the situation is complete chaos. We don’t have enough physical boots on the ground, we can’t get patients into bed or out of hospital because there’s no one to triage them, and there aren’t enough staff out in the community for people to be sent home.
Morale is the lowest I’ve seen because of that backlog - and the backlog isn’t just because of a lack of staff, it’s a lack of beds to send patients to after an operation, it’s whether ICU has capacity in case everything goes Pete Tong. That’s the split-second judgement we’re constantly having to make as nurses. Do I cancel this operation? Is the hospital ‘on red’ yet?
I currently (formally) work a 40-hour week — 8am to 6pm, four days a week — which sounds less intense than the 12-hour night and weekend shifts I used to do in ICU, but it’s never just those 40 hours. I tend to work at least one agency or ‘overtime’ shift at least every other week, even if I’m technically on a week of annual leave. I don’t know a single nurse who isn’t doing some form of overtime work. We all do it, both to supplement our income and to boost staffing levels, because they’re so low. The difference between now and when I started nursing nine years ago is that we used to do these extra shifts for pocket money — for a holiday, to save up to buy a house. Now, it’s getting us from pay cheque to pay cheque. It’s an essential.
My pay has never kept up with inflation, but every year it gets a bit more difficult. By now, amid the cost-of-living crisis, there’s literally nothing left in the tank. I’ve been reaching the bottom of two overdrafts for a while now and I’ve had to opt out of my pension for the next three years, which my parents are absolutely horrified by. But I don’t feel I have any choice. I’ve struggled to replace my trainers recently with anything that’s not just £5 and going to break in two minutes. I haven’t been on holiday outside the UK in several years now, because I can’t afford it. And . I try not to because it’s such a physical job, but occasionally it just means one less thing to worry about.
I’ve definitely skipped the odd meal so I don’t have to worry about money – thank God I don’t have kids
My mum has taken to taking me shoe and clothes shopping whenever I go home to the Midlands, because she knows I can’t afford it. It’s very sweet of her but she shouldn’t have to do that. I’m in my thirties. Thank God I don’t have children or I wouldn’t be managing. My colleagues who are parents never see their partners. They’re working extra shifts at weekends just to feed and clothe their children and in almost every case the grandparents are having to pick up the childcare duties.
I live in a flat in west London with another nurse who works in the private sector. We’ve been living together for five years and she pays more rent than me because she has the bigger room, so she’s essentially subsidising me being able to afford to live there. It’s hard to compare our jobs because she does triage over the phone, whereas I work in theatres, so the pressures are different. But the stage it’s getting to now is that her job — while pressurising — isn’t actively putting patients in danger. I genuinely believe that’s happening in my line of work.
The guarantee of an ambulance coming, even if you are life and limb in danger, is currently not a given. I cycle through central London on a regular basis and I would really like to know that an ambulance could get to me if something were to happen, but my 92-year-old relative was told there was a 10-hour wait for an ambulance the other day. That’s terrifying.
The main problem is there are only so many staff and there are only so many beds. People are regularly getting sick and suffering with burnout. If you’re knackered all the time from working overtime, regularly working 50+ hour weeks and working in your annual leave, it’s obviously going to have a detrimental effect on your health. You’re obviously going to end up getting sick; I’ve got good at looking after myself over the years but I’m just waiting for the next time it happens to me. Covid has caused a massive uptick in sickness in the last month.
It’s getting to the stage where I genuinely believe patients are being put in danger
Today we had three people off sick out of a team of 24. That might not sound like a lot but we’re operating on such fine margins already. It means I won’t have colleagues to cover me so that I can rotate out of theatre for lunch or or a toilet break. If a patient hadn’t peed for five or six hours I’d be worried, but that happens to my colleagues and me on a regular basis - you can’t exactly stop surgery to go to the loo, you just have to wait until the patient is done. It happens once or twice every week: I’ll have my breakfast before 8am, then I won’t normally have a chance to eat lunch until 3pm, and I won’t have had any water until then. If I’m scrubbed in for five or six hours, I won’t have a drink the whole time. There’s no leeway. And it’s not ok - and that’s if we’re just down one or two staff.
If crazy numbers of staff are off, we’re talking about cancelling operations because it’s literally not safe. In theatres, we are constantly having to weigh up two bad options: this needs doing yesterday, or we’ll have to leave it for a few months because it’s not going to kill them. If this continues, the less urgent, elective surgery like hip and knee operations will keep being pushed back, and eventually those elective cases will become urgent.
This is why we all do overtime. I’m meant to leave at 6pm but if a patient is still on the table, they’re still on the table. There’s no one to take over. I probably stay at least an hour late at least once a week. Sometimes until as late as 9pm, so that’s a 13-hour day. No wonder so many people are taking an early retirement or going private or turning to locum work full-time. On ICU, about a quarter of my colleagues would be locum staff. That just shows how many people taking that decision.
I’ve thought about going private a couple of times. I’ve thought about retraining somewhere else in healthcare for financial reasons, which makes me really, really sad and really angry. My days can be hard but there’s never been a day when I’ve not laughed at least once. The people are amazing. But I am consistently getting into debt from just living day-to-day and I can’t help but ask myself: can I actually afford to do this anymore?
I’ve thought about going private, it’s getting to the stage where I am getting into debt just from doing my job
I didn’t come into nursing for the money. I’d have gone into finance if I was minded that way. But it would be nice if we could pay the people who look after our most vulnerable and also do a lot of prevantative care. I was part of the Covid vaccination programme and it made me so proud. But something my mum said at the time stuck with me: she said ‘it’s very nice they’re clapping, but it doesn’t pay your gas bills’ – and she was right.
When there was a lorry driver shortage, they were paid more and they got more drivers. It’s logical. But when I met Sajid Javid when he was health secretary his answer was ‘if I pay you more, I can’t have as many nurses’. It feels like that’s the Tory stance on it to be honest. But we haven’t got enough nurses in the first place. How many more will leave if they continue to pay us below what we’re worth? If they pay us more, it’s not as though we’re going to be putting it offshore in the Cayman Islands, we’re going to spending it on the essentials like food and clothes — in the economy.
I didn’t want to have to get to this point, of striking. But if it’s that or letting the NHS crumble beneath my feet, I’m not prepared to let that happen. We have to care — caring is at the core of what it means to be a nurse. I need to feel the pain of the family when that patient doesn’t make it. I need to understand that parental instinct to care for their child. I need to have the compassion and thoughtfullness to fill my pockets with stickers and bubbles in case that child’s teddy needs an injection too. The day things don’t upset me anymore and I don’t feel that compassion is the day I need to leave and go and stack shelves in Tesco, because you can’t be a robot in this job.
Ultimately, this strike is about patient safety, so of course we wouldn’t put that at risk by walking out at the same time. There is no nurse who would agree to doing that. Strike days will use the same staffing structure as on Christmas Day so we will still cover all life saving and life sustaining care including A&E, cancer care and emergency surgery, to name a few. If we don’t strike and push to get more bodies in to do the work, this NHS chaos is only going to get worse and those of us still in the job will bear the brunt. I don’t know how the government just expects us to do this out of the goodness of our hearts.
As a nurse, my strategy when I go in each day is to prepare for the worst and hope for the best. I don’t even want to think about what that worst looks like right now.
