A day in the life of a newly qualified student nurse in NHS Scotland.
I want to share my experiences as a student and recently qualified nurse.
As students, we are meant to be supernumerary; this is an absolute myth, and more people need to hear it. We are obligated to work a 37.5-40 hour week for free, which is exploited by those who are mentoring us and those looking after us at the university.
In three years, we have had no time off because we’re on placement, in class, and during the “holidays”, the university will set assignments that your degree depends on. There’s also little to no support from the unis.
In the first year of training, you will be an auxiliary who gets to do nothing training related except take observations, and that’s only because the Band five nurses are so stretched that if it weren’t for us, they probably wouldn’t get anything done. In one placement I was on, the management would redeploy as many auxiliary nurses as they could – if there were three students, all of the auxiliary nurses would be redeployed to other wards. So, we would have to take up their role, which would be fine, but all learning opportunities are taken from the students.
You aren’t doing medication rounds with your mentor because you will be handing out meals, feeding patients, etc. You aren’t going to be able to observe procedures or learn how to do them because instead, you’re going to be making beds, stripping bed spaces, doing personal care or doing the one-on-one nursing, which you’re not supposed to be doing in the first place.
In the second year, they’ll have you doing observations and blood sugar testing for the diabetic patients but other than that, you’re still going to be used purely as an auxiliary nurse. In some placements, you’ll also run between the wards to hunt down much-needed resources – in one placement, we NEVER had dressing packs, which are essential in any procedure that requires an aseptic touch technique approach such as dressing changes, lumbar punctures and placing catheters. If you’re lucky, you might get to see something you’re going to need nine times out of 10; the only thing you’ll see is whatever X-ray/scan the patient you’re escorting is going to get.
In the third year, it’s like something goes off in their heads, and suddenly, they expect you to do and know everything. On one third-year placement, I was told by management to do a one-on-one with a patient who had previously violently attacked numerous staff. When I challenged it because I knew fine well that I wasn’t meant to be doing it as a student, I was told, “you’re all but a nurse now; just do as you’re told.”
As a newly qualified nurse, what can I say? Having been on the job for three weeks, I was redeployed to another ward to make their staffing numbers “safe”. The definition of safe that day was me as an NQN, one other band five and two auxiliaries. I had 14 patients to care for that day, one was extremely ill and deteriorating, and I had four complex discharges to coordinate.
The hospital coordinator was to find a third nurse to help us, but they never materialised. We had no students to help boost the numbers. It’s a miracle no one died that day. Five weeks into the job, I went in to work a night shift to be told I was the only nurse that night and they would find a nurse or two to come and help. The first arrived a couple of hours after the shift arrived. The second arrived after midnight. Again, luckily everybody survived. This week’s nightmare is that I am working 5 12.5 shifts in a row – Friday, Saturday and Sunday and then Monday and Tuesday next week. I am dreading it. I am starting to understand why so many have sick lines in. One ward in my hospital has around five nurses total working it, and the rest are all off sick with stress/anxiety/depression. One of the nurses on my own ward is contemplating leaving because she can’t afford to be a nurse anymore because her salary simply isn’t enough to pay the bills, run her car and feed her family. Two others have left because they simply can’t face coming in anymore due to chronic understaffing. Another is leaving because she feels helpless.
Even as a nurse, I have seen all sorts – I have seen a terminal haemorrhage from when a patient’s lung tumour ruptured, I have seen patients literally drop down dead, I have seen patients attempt suicide in a variety of ways (I’m not even a mental health nurse), I have seen overworked, dog tired, stressed to the eyeballs nurses make mistakes that have nearly killed patients – and the guilt that haunts them daily thereafter. I have seen patients who have lost limbs and lives in tragic accidents. I worked through Covid, which included a shift where we lost eight patients in one shift to the virus. Now don’t get me wrong, I chose to become a nurse. I have worked through the pandemic as a band two and as a student.
I chose this profession because I want to help people, but there comes the point where we as nurses have to ask – what about us? Who is going to help us? Who will help us navigate this cost of living crisis when our salaries barely cover our living costs? Who will help us when there is literally no one coming to staff the wards? The stress of our daily lives and the stress of our work environments affect everything we do, and in turn, that affects our patients, and they most definitely deserve better. Every night I go home feeling like I should have done more, but I’m only one person; how can I do more when I’m already giving everything I have in me? Every night when I leave work, I feel like my patients deserve better than me.
I have worked on all sorts of wards in my time in the NHS as band two, three, four, and now five across more than one health board. I have seen our numbers dwindle. I have seen my colleagues make themselves sick with stress, and I have seen colleagues beleaguered by UTIs as they’re unable to keep properly hydrated or even go to the toilet during a shift because of their workloads. I have seen colleagues who have halved inside because they simply don’t have time to eat during their shift because of their workloads, and they’re too tired to eat when they get home. I have seen colleagues whose marriages have fallen apart because the stress of the job has affected them so badly that their marriages crumble under the strain of being a nurse. I personally worked through a bout of serious ill health because I couldn’t afford to take time off – I wound up as a patient in an HDU bed after collapsing at home.
These are the things I can think of off the top of my head. My first ever pay as a band five was £1330. A far cry from the numbers currently being punted about. A newly qualified nurse starts with all the same responsibilities as an average nurse for £27,000 per year. I’m not asking for danger money, just a salary that reflects the job and that pays the bills.
So now you have the background, here’s my average day.
I have three medication rounds for six to ten patients. Of those, at least three are diabetic – at least one of those will be insulin dependent. One or two will be incontinent to some degree. Or have a catheter/stoma. I’m a surgical nurse, so at least one patient every day will come back from the theatre – they require observations every 30-60 minutes. There’s always one on blood transfusion – they require observations every 15 minutes.
There’s usually a patient who requires close monitoring due to being a high fall risk or at risk of absconding from the ward – they’re usually vulnerable and under an incapacity order. In the nature of my job, any given patient can become seriously unwell at any given time. I’m also responsible for arranging their discharges which often require collaboration with social services, dieticians, physiotherapists, occupational therapists, family members and the suppliers of any equipment that they may need following their surgery. If a patient comes in from the prisons, then I’m responsible for keeping their healthcare staff updated too – thankfully, they come with a couple of prison officers too. I’m responsible for making sure that patients with NG tubes get their feeds on time and recognising complications that may arise. I have a ward round every day. I also make beds, change bins, do personal care, do wound care, write notes (if it’s not written, then it’s not been done), hand out meals, make cups of tea, hold hands, wipe away tears, reassure patients, reassure family members, reassure my colleagues. In my time with the NHS, I have been slapped, kicked, punched, bitten, had a patient threaten me with a dinner knife, urinated on, spat at, and threatened (one charming patient told me he would kill me and rape my children), hit with a variety of weapons including numerous frames and walking sticks and the list goes on and on.
I have had patients and family members abuse me in a variety of ways, including homophobia. I have also interjected on many occasions when my colleagues have been racially abused – nothing ever gets done about any of this, no matter how many Datix incident reports you file. During Covid, the abuse we got from Covid deniers and anti-vax folk was unreal – in what other job do you go to work and get told you’re a liar, a murderer and that one day you’ll be seen in the same light as the Nazis are now?
I became a nurse because I want to help people, and I do love my job, but more and more, I find myself asking the question of why I actually bother and if it will ever actually be worth it.