The Strain on Nurses.
IMAGE CREDIT- SQUARESPACE
The dedication of the best of us, tested by the rest of us and thanked by too few of us.
Nurses are the backbone of the NHS, they toil and graft with compassion and kindness and are at their best when we are at our worst.
A tireless and tiring vocation that many overlook in favour of the more suave and sexier image of the white coat-clad doctor.
But what of the trainee nurses?
Even lower down the pecking order and even lower in the public consciousness, save those who know them, are those not yet qualified but on placements within NHS trusts. These are an uncredited and unpaid workforce straddling both academia and the practicalities of life on shift work.
Shaniese Rani is a third-year nursing student at Coventry University and has been on placements from her first year.
She is also the chair of Coventry University Nursing Society at the student union.
“Four months into your degree you’re sent out on placement, so you go from having a student life to being unable to participate”.
The alienation of being a student with very little chance to engage in the hallmarks of student life leaves many exhausted and some even leave.
Support offered to students is caveated with the fear of being removed from placement and not having sufficient hours, thus leaving a student nurse unable to qualify.
“We're always scared to say something in case we get kicked off the course or temporarily withdrawn from placement. They might say, oh, we'll take you off this placement if you're having issues.
A lot of people, if they're facing problems, they do escalate it, but it doesn't get escalated higher up. It gets sorted out just so that they can manage within the placement and kind of grit their teeth and get along.
I haven't had an issue with my placement. I found them OK. We've had a couple of issues with other students because as third years we have to look after our younger students and make sure that they are finding it OK, but with myself, I haven't had an issue in terms of my placements. I've always been okay.”
Financially they are not well rewarded. A bursary of £5000 per year is awarded to nursing students, however, many say this is not enough and when divided by all their shifts falls well below the minimum wage.
“I don't agree with us not being paid; we get the bursary it's £5000 but we work 2300 hours in over three years. Well, 2400 we get 100 hours sick in between but the minimum required is 2300 hours for free with a £5000 bursary and we're doing unsocial hours. We're doing night shifts, we're doing weekends, we're doing bank holidays.”
So, to turn that into an equation £15,000 divided by 2400 comes out as a mere £6.25 per hour. The national minimum wage as of April 2024 for those over 21 sits at £11.44 and the rate at which an apprentice can be paid is £6.40.
“This month I'm doing both bank holidays.
We're required to do at least two every other weekend as well.
In the NHS, that's double pay those days.
It’s double pay on a Sunday.
It's unsociable hours.
They pay extra within the NHS to work, to do night shifts. Yeah. As a student, we're doing it for free.”
Student nurses work long hours and study hard with little reprieve, often forging strong bonds with their peers as they can relate to one another through shared experience and deadlines. Shaniese, like many of her third-year colleagues has taken to supporting younger students, as well as her place on the Nursing Society committee.
“You don't have to teach or take any first or second year under your wing. I think it's more expected, but I think a lot of us do it regardless because we've been in that place. We've been in that situation before. So, I always, if I see a second or first year struggling, I always try and help them out or try and call them over for a chat just to see if they're OK.
I know what it's like. I've lived through their shoes.
I've been through the 1st and 2nd year hurdles. I always say to them if I can get through it you can do it as well.”
This solidarity is much needed for a vocation that demands so much of its practitioners.
During the coronavirus pandemic nurses and student nurses were on the frontline, working through the most gruelling and frightening conditions with no roadmap of what the future would present.
The NHS relies heavily on migrant workers, however unlike the UK training schemes differ widely. For trainees studying under the mentorship of nurses who qualified abroad this too creates difficulties.
“a lot have come over to do a supernumerary period for 4 months. To get to know the hospital, and as soon as they've passed their exam, they can get a pin to be registered in the UK.
But I feel like because they've come from a completely different style of nursing, and then they're here, some of them are really struggling with the system that we have, it's very strict.
I was speaking to a nurse and she's saying in South India, that you don't bother about little things
She said you just get on with it and you just put the dressing on and sort out the main issues that are wrong with them rather than looking at the little ones, I think because this country is quite well developed, we're looking at every single little thing, which is a lot of strain and stress and pressure on our nerves.
We're struggling to learn from them because they're almost learning as well. And then some of their styles are not the styles we've been taught, but because they're a registered nurse, you can't really say anything. You just have to kind of go, OK and just appreciate that they have their own method”.
Approaching the end of her third year and like so many of her colleagues, both qualified and as yet unqualified Shaniese’s dedication to an often-demanding profession shines through.
However as with so many vocational careers entered into by empathic people, the rewards are few, and the demand is emotionally and physically high.
Another nurse, who chose to remain anonymous and qualified 7 years ago told a similar tale of relentless work and hiding challenges from superiors.
“Particularly when you’re very junior, or just working in a new hospital or ward it can be very difficult, if you don’t advance in your career you can easily be stuck earning just not enough money to survive, which means you can’t have a life outside of work, which means there’s no downtime and you can’t recuperate.”
Despite the drawbacks and a decrease in people training as nurses, many still remain, day by day working relentlessly in difficult conditions for the good of all of us who will inevitably need their invaluable care at some point in our lives.