This is my interview with a staff nurse in the Emergency Department (ED). It’s presented without commentary and just the my questions and and the answers.I’ll let the words speak for themselves. The practitioner I spoke to was passionate about trying to keep the service hitting its target despite concerns about the health service, working conditions and pay.
Ashley Black: Can you give me a bit of background on your experience and history in the NHS?
Staff Nurse: I have been qualified as a Staff Nurse since 2006. My background’s in emergency medicine. I have always worked in the ED, I qualified as an emergency nurse practitioner several years ago.
AB: What are the three main issues facing NHS staff?
SN: Salary, staff retention and recruitment. Poor staffing and safe skill mixes, which have always been an issue, even before the pandemic. This due to inaccurate banding of skills, and subsequent pay scales. Our pay has not risen with inflation for the last 20 years and as a result staff are not able to pay bills and are having to depend on food banks. Let’s face it, who wants to do a job that has so much stress for such a poor wage.
AB: I heard nurses don’t want to have to strike, so why are they doing so?
SN: For years we have been striving to get better pay and conditions and for years we have been ignored. Then people started dying during Covid-19, and we were fighting for our patients for oxygen and ventilators, and then it was our colleagues we were fighting for. The people who were with us day in and day out ran towards the danger as the public ran away.
I guess it was at that point when we realised that, in fact, the government had no respect for us. We worked for 18 months in terrible conditions, physically, mentally and emotionally, and would again for our patients, but not been able to heat our homes properly or feed our kids adequately without doing extra hours, it broke us.
Last year staff were angry. This year they are furious! Those colleagues that survived have crippling symptoms as a result from Long Covid and some are no longer able to work. People who could retire did the smart thing and retired, some of them coming out of retirement to help during the worst of the pandemic in the first place.
Even after all that the respect is still not there, now we are in a cost-of-living crisis, and we are terrified. There are not enough staff, as those that have left have never been replaced, staff are leaving in large numbers and patients are suffering as a result of this.
AB: Let say it’s 2025, nothing has changed, how will NHS Scotland look?
SN: What NHS? I hope you have great insurance!
AB: It’s 2025, again, staff have their demands met, how will NHS Scotland look?
SN: The NHS will still be providing valuable and crucial service, free at the point of care for all.
AB: What would you say to people who dismiss your concerns by pointing out that its worse for NHS staff elsewhere in the UK?
SN: To quote my wife, “just because our shit sandwich is smaller than their shit sandwich, doesn’t mean we are not still eating shit”. It doesn’t change the fact that the NHS is still broken.
AB: Is the anger at pay and conditions felt by NHS staff at all grades and roles?
SN: Yes, as we are all in this together irrespective of grade of job, and by sticking together we can be a force to be reckoned with.
AB: If you could sum up the mood of the NHS in one word, what would it be and why?
SN: Tired, let down, sad, unhealthy, scared, angry, betrayed.
AB: Could you describe a typical day faced by a nurse and how the current state of NHS Scotland impacts patient care?
SN: A ward of 30 patients, two nurses — we have been known to sometimes only have one — and two support workers if we are lucky. Ward rounds with doctors, medication rounds, observation rounds, physical patient care, answering patient requests, dealing with relatives both on phone and in person and requests from the doctors.
Then there is the paperwork. Care plans, daily patient notes, charting of nutrition, falls, exercise, observations, safety, infection control, the list goes on.
In the ED, patients in waiting areas unwell, patients arriving by Ambulances. Some patients have waited so long for an ambulance that they are unwell and need huge amount of intervention. Poor staffing in all areas, sometime only one or two experienced staff members. This is due to trying to fill experience staff gaps, so they bring in brand new inexperienced staff to make the number look good. Unwell people in an ED require immediate care and this is not happening efficiently. The rest. They should be at their GP or a pharmacist. They do not require ED care.
AB: Is there anything you want to say that I haven’t asked about?
SN: The reason people come to the ED for help is because the GP practices are not running at 100%. They advise people to attend ED. They are not meeting patients face-to-face, and don’t get me started on these telephone consultations! Cancer patients are not getting diagnosed as quickly as they should because the GPs have been leaving painkillers for patients and not performing examinations. Rant over!
Next, Ashley Black speaks to another member of NHS Scotland staff. Do you have any suggestions for who else she could speak to? Send your suggestions to [email protected]