Another day in the life of an NHS nurse (what’s Lansley planning now?)

Andrew Lansley’s up to something. I don’t know exactly what it is yet – probably some new push in his semi-covert privatisation the NHS, or in his assault on the pensions, pay and conditions of health staff – but I know it’s coming.

As I’ve written about before, every time this government wants to take something away from a group that has the nation’s sympathy, it prepares the ground, doing its best to erode public support, even to demonise the target group. Over the last couple of weeks or so since the publication of the King’s Fund annual survey of public satisfaction with the NHS reported a record fall in satisfaction since the coalition government took over, I’ve seen a carefully orchestrated campaign being conducted. In a variation on the theme of ‘damned by faint praise’, Lansley is ‘defending’ the NHS in such a way as to vindicate the government’s handling of our biggest national treasure, while fostering a perception that the NHS is slipping. Let’s face it, the record 70% satisfaction rate in place under the last Labour government doesn’t exactly work in favour of the Tories’ contention that the NHS is in need of reform and improvement.

No, indeed. Since the coalition came to power, there has been a constant ‘drip drip’ of negative statements and media coverage of the NHS, designed to diminish the public’s affection for the Service. This has been successful to a degree – at least among people who haven’t had to use the NHS since the 2010 election. The King’s Fund survey covers the general public, not just people who’ve had experience of the NHS recently, so it’s all about public perception rather than experience. This deterioration is entirely the fault of Lansley and his government colleagues – both in how they’ve spoken about the Service being unaffordable and inefficient (it isn’t!) and by stretching the NHS’s resources as thinly as possible – setting it up to fail. All to ensure a smooth ride for his corporate masters’ and cronies’ takeover of the NHS while trying to avoid being held responsible for the situation. And people who don’t know any better are likely to fall for it.

The antidote to bad information is good information. My first article on a day in the life of an NHS nurse, about my wife’s experiences as a staff nurse on a busy ward treating seriously and chronically ill people, is one of the most-visited I’ve ever written. Since Lansley is seemingly being successful in his plan to lower the standing of our health-workers, and is planning his next push to denude the National Health Service and steal from its hard-working staff, I’m going to tell you about another, anything-but-untypical day:

My wife is coming off the back of a set of double and late shifts, and starting on a run of four night-shifts – she’s just gone out to work not long ago. She felt ill during the week, probably from being worn out and run down, but still went to work because others were already off sick and she didn’t want the ward to struggle or her patients to suffer, though fortunately she’s feeling better now. I’ve been away most of the week, but got back in time for her to tell me a little about her week at work, and get it off her chest before she had to set off for another shift.

On Friday, she was scheduled to do a modified ‘twilight’ shift, starting at 4pm and working until midnight, so she could be there to help manage the handover between late and night shifts. Because of a staff shortage, her ward manager phoned and asked if she could do a normal late instead, starting at 1.30 and finishing at 9.30pm. During the shift, one of the other nurses had to leave the ward for 2 hours to accompany a patient on oxygen (patients on oxygen are never sent unescorted) to a different part of the hospital.

As things were running behind because of this, because the staff were already thinly stretched and because she cares too much for her colleagues and patients to just go home at the allotted end of a long and tiring shift, my wife stayed on until midnight anyway. She almost certainly won’t claim for the additional 2.5 hours’ overtime – she hardly ever does, even though I tell her she always should. Her patients come first, and she’d hate to leave her colleagues in a bind.

A few ‘highlights’ of her day:

– Cleaning, on multiple occasions, a female patient with explosive diarrhoea. As the lady was absolutely mortified by what was happening, to minimise her distress the nurses keep a very cheerful, matter-of-fact demeanour while doing everything they can to reassure her that it’s fine, she can’t help it and shouldn’t worry about it. Most of us would run a mile, or vomit, or at the very least wrinkle up our noses in evident distaste – but for my wife and her colleagues, it’s not an option they’d ever consider. The patient’s wellbeing – emotional as well as physical – has to come first. So they smile, and get on with the job.

– Still on the ward is the poor lady with lung cancer that’s spread to her brain, making her behaviour erratic with occasional sudden violence. On this day, however, she wasn’t violent – at first. She just decided she didn’t want to be on the ward any more – and made a sudden dash for the exit in her nightgown, with tubes and nightdress trailing. Considering she’s so ill, she’s very fast and very strong. One of the nurses managed to just grab hold and hang on – but it only slowed her down, and the nurse was pulled along the polished floor like a water-skier behind a slow speedboat while calling for help ‘stat’ (I don’t know whether she actually said ‘stat;’ – it might well have been something more fruity!). As other nurses arrived, they were able to stop the patient’s progress to the exit – but then she started to lash out, trying to get away. The nurses hung on, risking the blows, kicks and teeth, until security could get there and help subdue the patient, at which point she was sedated and slept.

– Holding the hand of a ‘lovely, lovely lady’ while doctors broke the news to her that her recent difficulties in swallowing are because she has advanced, incurable cancer of the oesophagus and has only months to live. My wife cries her eyes out over each patient like this – and there are many, it’s that kind of ward – but she held back her own tears so she could be a support and comfort to a relative stranger in a time of terrible distress. She saved her tears for later, away from the hospital. Just occasionally, if she’s been particularly close to a patient, she has to ask a colleague to cover for her for a couple of minutes while she gets herself together. But it’s very rare – the ward’s so busy that the staff can’t afford the luxury of a ‘time-out’ to shed a tear.

– Finding – somehow – the time to sit with a ‘lovely old man’ with a permanent tracheotomy and so unable to speak, while he struggled to communicate to her what he needed; giving him time to get his message across so he didn’t feel either isolated by his lack of voice or that he was being a nuisance by taking a long time to make himself understood.

– Holding a busy ward down as the only qualified nurse for a ward of 20 or so patients, with only a 3rd-year student for support, during one of the 2 hours her colleague was missing, because there was no-one available for emergency cover until an hour later.

– And again, just like during the last day I wrote about, there was no opportunity to take a meal break or even get a hot drink. Just once she managed to make a cup of tea, but then there was a ‘code’, a patient whose breathing or heartbeat was in crisis. She knocked her ‘cuppa’ back cold – and then rolled up her metaphorical sleeves and dived back into the fray.

These are just a few of the things she tells me about as she unburdens herself to me over a (this time, hot) cuppa so that she can pick herself up and get ready to start all over again – this time through a whole night. There are a number of incidents I’d love to include, to really give you a proper feel for the day she went through, but I don’t feel I can as the details might compromise the confidentiality of a patient or colleague – but I hope that I’ve done enough to give you an accurate flavour of the life and dedication of our health-workers.

So I’ll end with a plea: when Lansley does whatever he’s preparing the ground for; when the latest carefully-timed, biased ‘exposé’ or statement is released to tarnish the image of the people who look after us when we stink of piss, shit, infection or despair; or when he just continues on his road of denuding our Health Service and setting it up to fail so he can sell it off cheap to his mates in the name of ‘reform’ and ‘efficiency’ – then please, please remember what you’ve just read, and see what’s going on for the calculated, cynical pack of lies that it is. And tell others, so they know to do the same. Our nurses, doctors, health-care assistants, porters etc – and our police, and teachers, and other public-sector workers – deserve better than what’s being done to them, and better than a cynical, greedy government of spoiled, self-interested ‘posh boys’.

And if you’re one of those public servants, don’t despair. Not yet. We do ‘get it’, most of us – and we take our hats off to you.