Friday, 22 Sep 2023

Inside the looming nurses strike

Written by Isabelle Aron

Earlier this month, RCN members voted for a national nurses’ strike, the first in the organisation’s 106-year history. Stylist speaks to the nurses taking a stand. 

Ameera, 30, a nurse based in London, is at breaking point. “If nurses leave, the NHS is going to crumble,” she says. “There is no NHS without nurses.” Ameera’s been a qualified nurse for seven years and has worked as a healthcare assistant in the NHS since she was 17. The conditions in nursing have been getting “progressively worse” over the last few years, she says.

“Right now, it’s exhausting. You’re not able to give the care that you want to give to each patient as a nurse because you don’t have the time.” To give an example – on a ward, there should be one nurse to four patients, but some nurses are having to look after up to 12 patients at once, she says. “That’s how understaffed the majority of the hospitals are. We’re exhausted emotionally and physically.” 

The NHS staffing crisis is a serious issue right now. According to the Nuffield Trust, 40,000 nurses have left the profession in the last year alone. As well as the pressures of staffing, nurses are struggling with rising costs of living and salaries that aren’t keeping up with inflation. Research by London Economics, commissioned by the Royal College of Nursing (RCN), found that since 2010, the salary of an experienced nurse has fallen by 20% in real terms in England, Wales and Northern Ireland. 

Now, nurses all over the country are saying enough is enough. This month, RCN members voted for a national nurses’ strike, the first in the organisation’s 106-year history. Across the UK, staff at 176 NHS employers voted in favour of industrial action over pay levels and patient safety concerns. The RCN is calling for a pay rise of 17.6%, which is 5% above inflation. The strikes are expected to start before the end of the year.

But how did we get here? And why are so many nurses leaving the NHS? Ameera says it’s a mix of things. “Nurses have chosen to leave because of burnout, being underpaid and not being able to afford their mortgages, their rent or food.” The pandemic has obviously had an impact, too. “A lot of nurses are traumatised by it and have left the profession entirely. Some are completely overworked and have chosen to do agency work, where they get better rates and better hours,” she explains.

Rachel, 40, is a mental health nurse based in the south-east of England who has been in the industry for 20 years. “I’ve never seen staff turnover be as bad as this,” she says. “It feels like the whole system has been dismantled. I see how the lack of services impacts my patients. The government has allowed the services to get the way they have – and it’s absolutely shocking.” Rachel works with children suffering from issues such as disordered eating and bipolar disorder. “Kids get sent home and don’t get to see anyone because they’re not self-harming yet or they haven’t lost ‘enough’ weight. Those kinds of decisions shouldn’t have to be made because the waiting lists are so huge. Why should young people have to attempt to take their own lives before they’re seen by somebody?”  

As well as concerns over safety for their patients, nurses are grappling with their own issues over money, as the cost of living soars and wages aren’t keeping up. “Everybody is talking about gas bills, electric bills and food shopping on their breaks. I don’t think I’ve got any colleagues that aren’t worried about money,” says Rachel. “It’s not like we’re asking to have lavish lifestyles. We’ve gone into nursing; we don’t expect to be rich. But you’ve got some nurses relying on food banks.” These conversations are happening among Ameera’s colleagues too. “People are working night shifts and weekends and they’re not able to buy food and have to go to food banks. Some nurses can’t afford their mortgages. Some are just about able to meet rent but cannot afford food. It’s really scary,” she says.

Nurses at all stages of their careers are struggling with the current working conditions, but the last few years have been a particularly challenging time to join the profession. Becky, 34, is a nurse based in Bedfordshire who trained through the pandemic and qualified in 2021. “In my first six months, I contemplated leaving and never returning after most shifts. I felt my workload was too much,” she explains. “Imagine coming into work knowing there are too many patients to look after, no beds for them and little managerial support as they’re stretched as far as they can be already. It’s like fighting a losing battle.”

Becky voted to strike and encouraged her colleagues to do so too, but because each NHS trust has to receive a certain percentage of votes to strike and her organisation didn’t quite meet the threshold, she isn’t able to take part in the industrial action. “I never thought we would be fighting for the government to listen to us. We advocate for our patients on a daily basis, but when we are trying to advocate for them on a larger scale, it falls on deaf ears,” she says.

The combination of the staffing crisis, the pandemic and the cost of living crisis has created a perfect storm, leaving many nurses to see striking as the only option. Rachel says there’s “a lot of resentment” towards the government. “We were clapped through the pandemic, told that they’d look at our pay scales and look at our wages, and it’s just never happened.” For Ameera, industrial action is “very much the last resort”, but she’s tired of hearing excuses from the government around pay for nurses: “I am so uninterested in hearing that MPs – who’ve received nine pay raises since 2010, including during the pandemic – are telling nurses that there is no money to pay them fairly.”

RCN’s general secretary and chief executive Pat Cullen says government funds aren’t being distributed properly. “Billions of pounds are being spent on agency staff to plug these huge workforce shortages. Temporary staff have vital roles in providing safe care but they should not be continually used to offset a shortfall in permanent staff,” she explains. “We are doing this for patients because there simply aren’t enough nursing staff to care for them – and there will never be enough until they are paid fairly. This lack of logic from the government needs to be reversed in this week’s budget. Nursing and patients deserve better. When politicians neglect nursing, they neglect patients.”

Ameera is keen to stress that the strike will not put patients at risk, as agency staff will cover the roles of those striking. She says that while the public may think the strike will increase waiting lists, it is the current situation – staff shortages and a lack of bed space – that is causing long wait times. “Nurses have not taken this lightly at all. We’re not doing this for fun. We’re doing this because we’re struggling. If we continue to be paid the same amount, nurses are still going to leave,” she says. “Blame the government; don’t blame the public sector workers. We’re trying to do our best for the public and getting this pay rise will help. People will then come back into the NHS and work.”

Becky is hopeful that the strike will be the start of changing things for the better. “For a long time, there’s been a culture in nursing that nurses are passive and that care continues regardless of how bad things get, but members are now being active and feeling supported to speak out,” she says. “I feel positive about the future of nursing. Our members won’t stand for the substandard care the government is forcing us to give. We’re standing tall and being counted.”

Images: Getty

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