Working as a nurse in the Austerity NHS is particularly stressful. A target driven management culture and the immense pressure on the NHS due to austerity can be felt everyday. Our management finishes the morning handover telling us to remember to fill in all our paperwork as we’re getting audited on it. It is sad when caring professionals become changed by management culture into target obsessed auditors. If we concentrate on patient care, we’re pulled up for not ticking boxes to show we’ve done the care.
Hospitals terrified of litigation weigh staff down with paperwork to cover themselves. The paperwork also serves as a way to control the workforce. Even if your patient care is good, you can be disciplined for not recording it. It is massively bureaucratic and places more power in the hands of management and removes nurses autonomy, and some of the joy from the job. It also creates a system which unscrupulous individuals can game. I had to report a colleague for signing for work they hadn’t done. Nothing was done though. Incidents like this demoralise staff and demonstrate the unwillingness to tell the truth, that the target regime and bureaucratic working processes don’t work and are actually harmful to good patient care.
When I started, it would be common to have a couple of empty beds on a ward for a day or two, sometimes more. Now the turnover is constant. Ward and Accident and Emergency closures elsewhere and the inability to see a GP forces people to come to our hospital. As soon as a patient is discharged, a new one is admitted from A&E. The pressure to meet targets drives all sorts of risky behaviour. The ‘four-hour’ target in A&E is one example. On several occasions patients have been sent up to the ward from A&E without informing us, or without adequate hand-overs. Nothing is as disruptive or potentially dangerous as having a patient arrive who you weren’t prepared for.
My colleagues are from all over the world, Africans, Asians, Europeans and South Americans. It makes for a diverse workplace which reflects the best bits of modern Britain. Peoples’ experiences are really widespread. Many people became nurses after other careers, for job security and the love of it; others because they lost their jobs in the recession and the NHS was one of the few places still hiring. People from education, media, finance, construction have all found work in the NHS and brought their own ideas an expertise to it. Unfortunately this great resource is completely underused. Management pays little heed to staff complaints and proposals for improving the service are not acted upon.
Our work is made even harder by the chaos created by cuts to social care. Arranging care for vulnerable patients in the community can be a struggle as councils try to force the costs of provision off their budgets and onto the NHS. Carers on poverty wages, with inadequate training and only 15-30 minutes per visit can’t meet the needs of heavily dependent patients. These patients end up deteriorating and being readmitted to hospital, putting further strain on the system.
Our pay has been held down for another year now. I don’t know how staff on lower bands can afford to live in London. Most of them do lots of extra shifts to make ends meet. Union organisation largely doesn’t exist in the hospital. Staff complain about the problems, but there is no one trying to organise people to respond collectively. There would be a big response if someone did, but that person would stand out and be targetted by management.
The NHS is fantastic and does great work but is being torn apart by the government. I dread to think what Britain will be like without it but we’re heading that way far quicker than most people realise.