Despite all our progress, there are more slaves today than at any previous point in history. In the Nursing industry, this applies to any situation a nurse is forced to work against their will, in order to cover the work of 2 nurses due to staff shortage.
“Slavery refers to a situation in which individuals are owned by others, who control where they live and at what they work.” (Wikipedia)
In such cases, nurses have to not only to watch over their own patients, but they also have to float. By having to cover double the number of patients, the risks can increase exponentially. That means that the nurse will have to prioritise.
But how do you prioritize between a critically ill patient and a dying patient? How can you make a decision between whether to comfort and relieve the pain of an elderly dying man, or save the patient that is in Cardiac Arrest? NO nurse should ever have to make these choices!
This situation first affected me while I was employed as a permanent nurse. I had been working for 12 hours, and it had been a particularly busy day. I had just finished my shift, and was only waiting for handover so I could go home, but no nurse appeared for the handover.
I was hungry, thirsty and very tired, and no one was showing up to take over my shift. I phoned the deputy manager, the person who was on call, and asked to call an agency. The management were trying to cut back on agency staff costs, so I had to get their approval before even being able to call an agency.
When I finally I got the approval, it was already midnight. By that time, there was no nurse available to come. I couldn’t leave the floor, or my patients, and the deputy manager did not show any hint of compassion by coming to take over.
I was forced to work 24 hours.
Luckily all my patients were stable and I managed to nap for about 30 minutes before another patient required my help.
There were many times when I couldn’t detach emotionally and cognitively from work as a strategy to cope with work demands. I would be always wondering if I had recorded everything, signed all mar charts; I would be continuously backtracking throughout the shift. After a certain night shift, I found that I couldn’t remember whether I had actually administered the insulin to one of my patients! I could visualise myself in front of the patient with the pen in my hands, but everything stopped there. I remained stressed over this, even while not working, until I came back on shift, and my first question was “How is Mr. BB?” I calmed down when I heard that everything was ok, but the stress had deprived me of much needed rest.
Error rates go up when nurses work for more than 12 hours. I do not have super powers, I am a human just like everyone else. I swore that I would never again stay late on top of a 12 hour shift.
The combination of consistently understaffed hospitals, to the point of raising safety concerns, and poor working conditions can create extremely dangerous situations on the floors, not only for nurses but also for their patients. Many medical errors happens due to short staffing. An exhausted, overworked nurse might make a mistake that could have dire consequences. The thought that it could have happened to me made me make a very important decision. I needed to protect my license.
I left my job and I joined a nursing agency. As an agency nurse you have the flexibility to work where you want. If you don’t like a place you can refuse to go there next time.
When hospitals do not employ enough staff, there is a greater number of interruptions and distractions during drug administration, higher perceived workload, lower staff health status (fatigue, stress), worse nurse-to-patient ratio and poorer patient outcomes. All of these can lead to medication errors. Medication error consequences can be catastrophic: death of the patient, nurses being suspended, or fired from the profession they love. Then, they are left with the knowledge that they have harmed a patient they were trying to protect; a feeling that will remain with them for the rest of their lives.
This is what the new tax law is going to do with all the NHS staff. With the tax changes from April, nurses in the public sector will lose up to 30% of their salary. This is the second year in a row that the tax legislation imposes reduction in the nurses payment, in 2016 with the cap pay and now with the IR35. As a result, many nurses will choose to leave the NHS in favour of the private sector. Instead of focusing on recruiting more nurses, the NHS will lose even the ones it has.