A nurse from the North of England says she is proud of her department despite how tough it can be.
Emma Francis, a senior nurse at North Tees and Hartlepool NHS Foundation Trust’s, has publicly shared her experiences and the harsh realities of working in an Emergency Department.
In her post, she calls on members of the public to give NHS staff “a break” because “more often than not we haven’t had one (or a wee) in 7 hours or more.”
She said; “As an A&E nurse I’ve seen the recent articles around inappropriate attendances or failings of the emergency services, and the subsequent comments mostly slating the A&E departments and staff, some say ‘I was sent to urgent care when the A&E waiting area was empty’, or ‘drunken aggressive people in the waiting room seen before me’, allow me to explain a few things…”
“You may walk into an A&E department with an empty waiting room and be furious you have to wait to be seen, these are moments i wish the walls were made of glass because little do you know each of our cubicles are full, full with people unable to sit and wait due to severe abdo pain caused by a ruptured appendix or a patient laid on the bed with a possible ectopic pregnancy that could mean they bleed internally, you also do not see that all the resus beds are full taking more than 1 doctor off the floor per patient, as one gets intubated and has 2 nurses making sure they maintain an airway, and another is arresting from a drug overdose, whilst the other is vomiting fresh blood from oesophagal varices and needs urgently to be stabilised and given multiple units of blood, meanwhile there may be a baby in our paediatric resus with suspected meningitis having febrile convulsions.
“That drunk aggressive person kicking off in the waiting room may be seen before you because that cut to their head from being assaulted means they now have a bleed on the brain which is why they are behaving so erratically, they may need an immediate scan which means we have to try and sedate them as we are unable to get them in the CT scanner because they continue to punch out at staff, but nonetheless we will put up with being swung at because we know their life hangs in the balance.”
“We are sorry you rang 111 and they said you had to be seen immediately or sent an ambulance but unfortunately they follow a flow chart of medical questions on a screen and have to suspect the worst case scenario, so yes we may triage you and decide your problem can wait to be seen in priority order, you are lucky you have the ability to wait, I bet the elderly gentleman in resus with a ruptured aorta surrounded by his crying relatives wishes he was well enough to wait in that waiting room.
“We also apologise you have to walk from A&E to urgent care to see a GP or a nurse practitioner and we absorb with professionalism the abuse you give to us at the desk when we stream you away about how you want to be seen immediately here, but unfortunately (or actually fortunately for you) your problem is minor enough that an appointment next door is all you need.
“The majority of us have many years of experience and more often than not we have seen your problem before and know what may be best for you more so than a quick google of your symptoms or a phone operator that thinks the sore neck you have had for months is a fractured c-spine and needs to be seen without delay.
“We are extremely proud of our service and our departments and you can have faith that we will want what is best for you 100% of the time and do whatever we can to help you, despite the verbal and usually physical assault we get from a number of our patients and sometimes even relatives, whether it be about the wait to be seen, or the fact we won’t pay for a private taxi to get you home. This isn’t factoring in what may be going on in our own lives, some of us may have recently lost a friend or a parent and just held the hand of a dying man whilst trying to comfort their family, all the while we are trying to hide our own emotions because it reminds us so vividly of our own personal experiences, but we will emerge from that cubicle, plaster on a happy face, and go into the next cubicle and try and make you smile because we can tell how scared you are.
Before finishing with; “You may be outraged that we stand for a moment and have a quick joke in passing with a colleague but in a job where you are surrounded by sickness and death every day that smile may just help us get through the rest of our shift. You may not feel your experience is perfect but in what service or job is every moment of every day perfect? We are still only human but together we make one hell of a team, we can only promise to try our damn hardest every single second of every single day, so go ahead and give us all a break because more often than not we haven’t had one (or a wee) in 7 hours or more.”
Last year, the Secretary of State for Health and Social Care announced a ‘crackdown’ on violence against NHS workers as reported instances continue to rise.
‘Student nurses graduate with £54k of debt, shouldn’t we pay them a wage instead?’
The Government claims students are “supernumerary” and “not contracted to provide nursing care”.
Student nurses are the unseen workforce and vital to patient care.
While I am pleased for the thousands of students who will soon be starting their journey to become a registered nurse, it comes with a stark reminder.
In November 2015, ministers announced the NHS Student Bursary and tuition fee payment would be cut in a plan to increase the number of available student places.
Suffice to say, this hasn’t worked.
Instead, we have seen a consistent decline in the number of student nurses qualifying. Official figures from the Universities and Colleges Admissions Service (UCAS) show an overall decline in applications of 8% since 2015.
There is no debate that nurses need to be degree-level educated – but are student loans the best way to fill an ever-widing gap in our workforce?
The unseen workforce.
Student nurses are the unseen workforce and are sometimes vital to the delivery of safe, compassionate, person-centered care.
Completing over two-thousand hours of hand-on, direct clinical practice over three years – is it fair to ask them to accumulate up to £54,582 (plus 6.3% annual interest) of debt?
With a starting salary of £24,214, this is a debt the majority of nurses will never pay off.
The Government claims that because student nurses are “supernumerary” and “not contracted to provide nursing care” they need to be treated like all other higher education students.
While is it true that the Nursing and Midwifery Council (NMC) mandates that student nurses are considered ‘supernumerary’ – how realistic is this expectation? We hear stories of student nurses, trainee nursing associates and healthcare support workers being used to fill nurse staffing gaps on an almost daily basis.
A self-perpetuating cycle.
With an estimated 40,000 unfilled nursing vacancies in the NHS alone, health and social care services in England are stuck in a self-perpetuating cycle.
Chronic under-investment in services has led to an increased demand on staff and subsequently affected recruitment and retention rates. Universities then fail to recruit enough nurses to meet the current demand and so the cycle continues.
The Royal College of Nursing has called on the Government to invest at least £1b per year into nursing education and come up with a long-term plan after its plan to increase numbers has failed to work.
Matching the proposed apprentice wage while student nurses are on placement would go some way towards alleviating the financial burden the government has placed on student nurses.
A fresh start?
I’m excited and I’m nervous. I qualified as a nurse just 15 months ago. I left a career in IT of “quite a few years” – I decided I needed a fresh start.
Now I’m sat on a train heading to my first ever RCN Congress. I’m a voting delegate and will be honoured to carry that responsibility for my branch.
I’m also excited to finally be meeting people that I’ve solely (or mostly) only ever connected with online.
Finally, I’m looking forward to the various debates and resolutions. Listening to the speakers will further inform my views and I might even share a thought or two myself – fortunately speaking in public does not generally worry me (I’ll be the one with the ukulele).
A brief glance back to this time last year when certain “irregularities” were noticed by some members around the pay deal and communications regarding it.
The train of events that followed uncovered a number of poor practices regarding transparency and accountability and our current council were elected to address these.
I also mentioned I am nervous.
Recently, it has become clear that further “irregularities” have occurred – and questions will be asked.
Tomorrow morning is the Royal College of Nursing’s Annual General Meeting – an opportunity for members to ask questions. An opportunity for the council to demonstrate its commitment to openness, transparency, and accountability. An opportunity for a fresh start.
I genuinely hope the answers to the questions I raise are clear and dispel the concerns many of us have.
And if they don’t? Well, that’s why I’m nervous.
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