I am writing this letter in response to the recent news reports regarding the current state of the NHS and the increasing numbers of young nurses leaving the profession due to the sheer level of stress put upon them.
I made the unfortunate decision to read some of the online comments from the general public in response to these articles and I was horrified.
Such comments as ‘all jobs are stressful, get on with it’, ‘a Nursing Degree doesn’t teach you how to become a nurse it’s just writing essays’, ‘They have a degree, they think washing someone is beneath them’ ‘Millennials have been pampered all their lives so don’t know what hard work is’.
I am a qualified nurse in my twenties and I have left clinical practice and I would like to tell you why.
When I applied for my Nursing Degree I was under no illusion, this was a career choice that would be hard both physically and mentally.
I watched nurses on oncology units provide care, compassion and empathy towards family members and provide support at one of the most difficult times in someone’s life.
Seeing this inspired me to apply for my nursing degree.
I would just like to add that previous to this decision I had already completed a degree in another subject and I had been working within the catering and hospitality industry so I was no stranger to ‘hard work’.
My Nursing Degree was split with half of your time in lectures and half of your time in clinical practice.
My first-year placements included a community hospital and a busy ward environment where as a total novice I worked closely with Health Care Assistants and Nursing staff to learn the basics of all personal care, basic observations, and learning about the ward environment and routine.
Although I was on a degree course the thought never crossed my mind that I wouldn’t be involved in the most intimate of personal tasks, in fact all good nurses know the giving a patient a wash and seeing all skin integrity and pressure areas is a vital clinical diagnostic tool.
We can see any wounds, infection, any signs of malnutrition, excessive bruising can show either abuse or blood clotting issues (which is particularly important when patients are on anti-clotting medications), any rashes that may indicate an adverse reaction to a drug,
I could go on. Likewise, with regard to bodily fluids my nursing degree did not teach me that this was not my job to deal with, in fact it taught me that this was a vital clinical observation, one of the first signs that someone is acutely unwell is that urine output will decline or stop altogether.
The colour and concentrating can indicate dehydration or trauma, a urine test can inform us of pregnancy, infection and high blood sugars.
My degree taught me to think critically, why am I doing this? What is the evidence base behind this? If I do this what will the side effects be?
As nurses we no longer just follow orders, our medical colleges respect our opinion on treatment and diagnosis. My degree has enhanced, not hindered my career.
My clinical experience combined with my academic teachings in university prepared me for the job I was about to undertake.
I knew once I qualified it would be a steep learning curve but I felt supported and prepared for this after three years of training.
I worked in acute care settings dealing with the most unwell patients. Working with other healthcare professionals to provide the best care to treat illness and trauma and save lives, sadly we were not able to save everyone through no fault of our own and in such cases we supported families and made sure the individual was comfortable and upheld the upmost patient dignity.
I loved my job, I was tired by the end of the day and it was stressful but I was proud of the work my colleges and I provided and proud of the NHS and the Trust that I worked for.
However, something has changed within the NHS, community beds have been lost, smaller hospitals have been closed, mental health services have been starved of funding and jobs cut, funding has been cut year on year, these are just a few examples I can give.
The numbers of acutely unwell patients coming into the emergency departments is increasing but the services and facilities available to us is declining.
There are a lack of community and rehab beds meaning patients remain in hospital despite being medically fit.
This has a knock-on effect with new admissions meaning there is just no space. Escalation beds are then made within acute care units meaning the nursing and medical staff have to care for more patients but having no extra staff to help with the extra work load.
All of these patients need close observation, intravenous drugs, all care, in some cases a ventilator or device keeping their blood pressure stable, they have pain and nausea, in some case patients have dementia or are confused so require extra observations and support to keep them safe.
The demand is so much on so few that you are in a position that you are just trying to keep people alive and prevent harm.
You inform management about the unsafe nature of the unit and they give you a sympathetic look, there is nothing they can do, every ward is exactly the same, there is no one to help.
You have no time to support patients or families because every moment you spend with them you are acutely aware that your other patients who are equally unwell now have no one monitoring them, which is an awful predicament to be in when the sole reason you joined this profession was to provide medical care but also emotional support and comfort.
You live with a chronic guilt as you cannot provide the care that you want to give every individual, basic tasks like helping someone wash or eat just cannot be done and it pains me to admit that there have been times I have not been able to help someone.
I still carry the guilt that I have not had the time to listen to someone who tells me how lonely they are since their wife has passed away and they are struggling to cope at home alone because a monitor is alarming or Accident and Emergency are bringing yet another patient through the door or someone is due medications or a drip has run out and needs replacing.
I am sorry, and I will remember that I haven’t been there for them and I will take that home and it will stay with me.
You have no time to eat or even go to the toilet as your colleagues are just as busy as you are and they cannot cover your work load or cope with any emergency situations whilst you leave the unit, this has an effect on your own physical and mental health.
Only at the end of your twelve-hour shift when your other nursing colleges take over for the next shift are you able to sit down and do your paper work, meaning having to stay an extra hour or two late (unpaid), you go home exhausted, despairing and listing all the things you haven’t done. You go to bed, wake up and do it all over again.
The NHS should be the envy of the world but it has been treated so poorly that even with all the will and dedication of all staff involved it is struggling to provide even basic care.
As I nurse I ask you not to judge us so harshly, it is not an easy decision to leave this career behind.
Our colleagues who we are leaving behind are our friends and we would not leave them unless it became intolerable.
You cannot safely practice under such conditions, mistakes will be made and people will be harmed, some fatally.
I ask you if you were a builder would you work for a company that made you cut corners due to demand resulting in unsafe building practices, could you live with that?
If you worked in catering could you work for a restaurant that was under so much pressure that you were not sure if the food you served was safe for consumption. Could you, with a conscience carry on?
It is no different with nursing, please do not presume that we are weak, we are strong, we have stood up for the job we were trained to do and we refuse to compromise care.
Not in our name. Until the environment is safe again I will not return.
The letter was originally published in the Plymouth Herald.