Something needs to be done to reward nursing staff still willing to work in areas where night shifts are a necessity

The pandemic put nurses in the spotlight. The recent strikes have turned that spotlight on again, but the industrial action is about so much more than just pay.

Take, for example, recent news about the raising of the state pension age. There are fields of nursing where nurses can potentially (and do currently) work into their late sixties; roles that allow for siting down, regular and guaranteed breaks, no night shits — rotas that enable sufficient rest between shits. For older nurses working in acute busy areas, where none of those things are realistic, it would be very physically and mentally challenging. Many of us would be forced to reduce our contracted working hours to protect our health. Most would need to make further significant changes to their standard of living to manage the resulting drop in income.

I have just over 40 years’ experience as a nurse in the NHS. My experience has always been in acute emergency services. I did the traditional “hands on” training in the 1980s — not a degree, not even a diploma. With my registered general nurse qualification, I progressed eventually to matron and lead nurse of a service in a large NHS hospital in central London. I‘ve seen what is possible in the NHS with sufficient resources used in the right way and managed by a small group of “can do” leaders.

I have spent my career in large, relatively wellfunded hospitals. I have seen basic working conditions steadily deteriorate over the past couple of decades, the implications of which apply to staff in many clinical roles — nurses, doctors, physios.

From inadequate changing facilities — there is very litle chance of any privacy, dignity or respect with 27 nurses starting a shit in the equivalent of a large cupboard — and not having somewhere to lock away valuables; to poorly maintained, overused, flooded staff bathroom facilities. We have small break rooms with too few chairs, and limited access to hot or nutritious food.

Compulsory nursing degrees were introduced in 2009 but I believe that the NHS needs a mixture of degree-trained and (paid) apprentice-educated nurses, so as not to miss out on the swathes of people who are less academic.

I haven’t seen solid visible evidence of our profession’s ability to influence decisions at grassroots level — one of the suggested benefits of the change to training. Yes, I have seen more qualified nurses continue in academia and research (important areas), but I have also seen an increase in newly qualified nurses who seem to find that clinical (shop floor) nursing is not for them ater all, having been forced to a make a decision when they were 17 years old and didn’t fully understand what nursing was. We are informed that there are more NHS staff than ever. Many of these will be business managers. Others will be nurses keeping patients out of hospital, enabling patients to be discharged quicker. But there is an ever-increasing shorfall in 24-hour services such as A&E and intensive care.

Most people re-evaluated their work-life balance during the recent pandemic. Something needs to be done to reward staff still willing to work in departments where night and weekend shits (including bank holidays) are a necessity. We deserve more than an uplit in pay for unsocial hours. Basic things – provide free tea and coffee, quiet rest space and access to hot meals. Give us somewhere to lock our bikes or park cars so that when we finish shits late at night we feel safe.

The overall objective of every manager should be to ensure that the patients receive the best and safest care possible. I suggest we return to a situation where HR does more of the HR work, recruitment does more of the recruitment work and nurses do more of the nursing work.

As a former matron, I know all too well that most nurse managers do their very best to look ater their team but have litle say in how their pot of money is utilised in practice. No wonder nurses feel tired and devalued, for reasons that go way beyond their pay levels.

We shouldn’t just accept experienced nurses leaving or retiring early – those who have experience of what works well and what doesn’t, what initiatives have worked or failed before, and why. This kind of information is invaluable now. There is far too much time and money wasted on reinventing the wheel.