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I'm a nurse. Your applause won't pay our bills.

When ‘clap for carers’ was introduced, it made us feel appreciated. But little else was done, and we are at breaking point. Striking is our very last resort.

November 11 2022, 17.42pm

I am a community nurse, visiting peoples’ homes and carrying out the care they require. I travel in my own car, and although I can claim expenses, they do not cover the cost of fuel at today’s prices, let alone the wear and tear on my car. If something doesn’t change, myself and my colleagues will soon be forced to decide which patients to see at all, if we can’t afford to travel to every address. Who do we choose? The palliative patient in pain needing meds? The patient with a chronic wound needing a dressing change? The patient whose catheter is bypassing? The patient needing bloods taken as the GP is worried they have cancer? This is the reality facing myself and so many of my colleagues. 

I started this role following the pandemic, where I had been seconded to ICU. I was looking after critically ill patients and living in constant fear that I was taking killer bugs home to my young family. 

Now I have a whole other level of stress: being the link between my patients and other teams, including GPs, hospital, physiotherapists, occupational therapists and many more. I am on my own in a patient’s house. If I need assistance, my only tool is my mobile phone, as long as I have a signal. We see a variety of patients, from elderly and infirm to young people facing palliative diagnoses. All this accumulates a level of emotional stress that is difficult to just leave behind at the end of the working day. I relate to so many of my patients, and I am constantly reminded of my own family and my own grief. In community nursing, we also seem to be the ones to pick up the slack from other services, which puts us under even more pressure. 

We are a degree-educated profession, but our working conditions and pay do not begin to reflect the level of training we have to go through. Not to mention the fact we have to pay £120 each year just to remain on the NMC register, ensuring we are able to work. We also have to complete lengthy paperwork every 3 years to prove we are continuing our development and completing the required number of hours, in our own time.

We are told of pensions and lush severance payments for government ministers, and expenses claims for their second homes, even as the public are struggling to keep a single roof over their heads. I know of so many nurses who have had to take on second jobs - and even third jobs -  to try to make ends meet, all the while working full-time and caring for their families. Thousands of full-time nurses depend on food banks. It has come to that. 

Striking is a last resort. We don’t want to strike, but we feel that we have no other choice. We are at breaking point, and it is time to stand together to get something done. The nursing workforce is made up of gaps and burnt-out staff. Individual nurses sometimes face the kind of workload that would normally be shared with multiple members of staff, which has obvious implications for patient safety and the levels of care that can be provided. 

The short-term use of agency staff to fill these gaps is not the answer, and actually hinders care: agency staff do not know the workplace, may not be familiar with systems and may not even have access to the necessary computer databases. This only adds to burnout, as staff feel that they are doing more work for less money, while agency staff can sometimes be earning double what the existing staff earn on a shift. And this  is not solely about pay, as the media is portraying. It is about trying to improve conditions for nurses, for all members of NHS staff, and also for our patients. 

I am so saddened and disappointed that it is coming to this. When ‘clap for carers’ was introduced it made us feel appreciated. The very first night it happened, I was on nightshift, but was able to view it on social media, in tears -  along with the rest of my colleagues - at a show of solidarity from the public as we were just trying to get through the pandemic. Now we are being portrayed as the villains, trying to take money away from other valuable services. If other professions strike, everyone is affected by having to find childcare, or alternative transport to get to work. If we strike, we are being accused of killing people, even if we will always cover emergency and life dependent care when we strike.

We are not the problem, and we are actively trying to be part of the solution. But we are undervalued, exhausted, understaffed and underfunded. It cannot go on like this. 

"Louisa Jordan, Jr." is a pseudonym. The author is a community nurse in the NHS, and has asked to remain anonymous.