All nurses know that nursing involves sacrifice. We know that a lot will be sacrificed, from our lunch breaks to our bank balance to our lifestyle, we prepare ourselves for what we will have to give up. However, it's not the sacrifice that makes the job so frustrating, it's the compromise. Nurses are compromising so much that something's got to give. I think this disheartening truth is what has caused mental health problems amongst nurses to recently double, and now with the added pressure of our ex-pat colleagues potentially being forced to leave, more nurses may be leaving the profession.
My fundamental reason for becoming a nurse was to have a strong skill and trade. Nurses are encouraged to develop knowledge and skills throughout our careers. However, the opportunity for career development in reality is scant. Fewer nurses are being supported with grants for post-registration training. Places on those courses are diminishing and nurse managers are reluctant to lose team members on the ground. Private agency nurses are more likely to achieve promotion through work flexibility and are better able to afford course fees due to pay increases. Meanwhile permanent NHS nurses have had affective demotions through de-banding. I have worked with people who have been nurses longer than I have been alive, who have dedicated a lifetime to the NHS, but have been de-banded so they are on the same banding as me. Nurses have been expected to compromise their careers to work in the job they love.
Like many other nurses, I had recognised my own symptoms of depression and severe anxiety. I encountered a lack of understanding of mental health, which is surprisingly common in physical healthcare. The NHS is a system we all take for granted and I cannot begin to express its worth, or the worth of its employees. However, when faced with the all challenges it has had, the NHS struggles to provide the help nurses deserve, much less adequately address and support staff with chronic health problems. Nurses struggle, and their health suffers.
For myself and others, nursing in the UK meant working for the NHS. It was the NHS that trained me, and it was the NHS that paid my bursary as a student. Ten years ago, if you had told me I would be working in private healthcare I wouldn't have believed you. This is something I hear nurses and doctors say often in the private sector. For me, the shift to private was a career choice. I had wanted to work in Ophthalmology and my hospital had just built a brand new eye department in order to accommodate for the volume of patients. However, after 2008 and the 'reappraisal' of funding in the NHS, there had been a change in the criteria for approval of cataract surgery. Patients were now being told their vision was 'too good' for surgery, and our once busy eye department fell quiet. This reduction in NHS treatment was clearly good news for private healthcare companies, and with no jobs at my NHS hospital, I moved to a private eye hospital. With Moorfields now also moving to become an NHS 'mutual', it is likely that NHS Ophthalmology could be privatised on the same scale as NHS Dentistry, meaning fewer NHS jobs for nurses. Many nurses go private because they believe it will be a less stressful environment, or for a pay increase. For myself, and for others, the move is a compromise of values.
No nurse wants to discuss incidents of compromised patient care, but we all see them. The patient who was overlooked, the patient who got ripped off, the ward that was understaffed, the doctor who was sleep-deprived, the department that was under-stocked. Additionally, in the private health 'free market', de-regulation of practice is risking patient safety. Every day, nurses see patient care compromised because of circumstances beyond their control. Patient care, the very root of why they chose the profession, is taken away.
Many nurses are leaving the profession for other areas, but with government cuts to the charity sector as well, it can be disheartening for those of us looking for a vocation. I believe that nursing can be one of the most proud, satisfying and enjoyable careers, but with all the challenges facing the profession as it stands, it can also be demoralizing and dispiriting. So, if someone were to ask me if I thought nursing was a satisfying job, I would have to tell them no, not anymore.