As NHS nurses vote in favour of their first ever strike, The Glasgow Guardian speaks to a newly qualified nurse on the challenges facing students starting out in the career.
The Royal College of Nursing (RCN) has announced its members have voted in favour of staging their first strike. The nursing union is expected to hold UK wide industrial action before the end of the year, with a mandate until May 2023. The RCN is demanding a 17.6% pay rise, compared to the roughly 8% on offer from the Scottish government, as well as an addressing of staff shortages and the general state of the NHS.
The Glasgow Guardian spoke to a nurse who graduated this year from Glasgow Caledonian University, now studying an honours year, about how the morale amongst student nurses compares to that of the staff nurses walking out on strike. “There are already people I went to uni with saying they don’t think they’ll be able to stick this out for a year. I think most people who have jobs now are thinking – why am I doing this? It’s not even about the money – it’s unsafe, it’s not possible to do a good job with the amount of patients and the responsibility that you’ve got. If everyone is going home feeling like they’ve done a rubbish job, then you don’t want to go back.”
One of the driving forces of the industrial action is staff shortages on wards, which are having a perilous impact on the learning experience of student nurses, in this nurse’s opinion. On an acute ward where she works at the Queen Elizabeth University Hospital in Glasgow, they are already so short staffed that they are working below the work-to-rule staff levels that industrial action would see.
Student nurses are supposed to be supernumerary to staff on the ward, but most of the time this is not the case. This, along with the impact of having the Covid pandemic unfold in the middle of a three-year degree, has led this nurse to conclude that her year graduated at a lower standard than they should have, having been used to fill in basic jobs staff didn’t have time for on placements and then being expected to be fully up to scratch clinically as soon as they graduated. “There are things I definitely should know and should have done that I’m having to just learn on the job.” When The Glasgow Guardian asked the nurse if she felt her degree had adequately prepared her for starting on the ward, she replied that it had not.
“When student nurses go on placement right now, they are just being used as healthcare support assistants and not getting time to learn nursing skills, so they should focus more on that at uni. If I had a student on my ward just now, I don’t feel like I would be able to take time to bring them along and show them things, because I’m just trying to keep all my patients alive for 12 hours. It’s not a good learning environment for a student nurse.”
Staff at the Queen Elizabeth University Hospital put out a questionnaire to newly qualified nurses regarding which skills they don’t feel confident in, and are hoping to put on extra catch up classes – though it’s likely those wishing to attend would have to find time in their shift to go, near impossible in the current work environment, or come into hospital on their days off, unpaid. In addition, newly qualified staff are supposed to be held to a rule preventing them being moved wards during their first six months, but with staffing numbers as they are this commitment has been abandoned and new nurses are moved around the hospital to respond to demands as and when is needed.
Staff shortages often force students into situations they are not qualified to be in. The nurse recalls to The Glasgow Guardian a time during a third year placement when she was left alone with a patient in a diabetic ketoacidosis (DKA), a serious condition which affects diabetics when they run out of insulin. Although she did not know how to care for someone with the condition, and had to face questions from the doctor when he came to check up on the patient, staff numbers were such that a more experienced nurse did not have the time to sit as the patient needed constant care. “It would have been inappropriate even for a newly qualified nurse. It’s like neglect.” Student nurses looking after severely unwell patients they should not have responsibility for is commonplace, she says.
On the issue of pay, many of her recently qualified coursemates are looking to take the option increasingly popular to NHS staff, of leaving the Health Service to work for an agency. The NHS employs these agency nurses to work bank shifts at an hourly rate over double that of its own staff nurses, at £30 an hour compared to £13.50 an hour. While working for an agency does not have the benefits the NHS does like sick pay and maternity leave, in a cost of living crisis in which pay is below inflation, it can be an attractive option. For permanent staff at the hospital as well as patients, the downsides of having agency staff come in is that they are not familiar with the ward, constantly being shifted around depending on which ward has the lowest staff numbers on the given day. Nurses from agencies such as the Scottish Nursing Guild cannot take charge of a shift so they also have less responsibility. These nurses are also more firm about sticking to what is legally allowed, and will walk off a shift if they are assigned more patients than they should have. “You can see why staff morale would be low if you are working alongside someone earning double what you earn, and your employer is not giving bank shifts to your permanent members of staff.”
“My brother has one higher, no further education and has a job as a swimming teacher getting paid £12 an hour. I have just spent three years at uni, in a job that has so much responsibility and only earning about one pound more an hour. It’s demoralising.”
