EDITOR’S COMMENT

'Cutting posts causes danger as well as distress'

11 October, 2011 | By Jenni Middleton

Recently, a newly qualified nurse told me, with tears in her eyes, that she was astonished to see a list of jobs on nursingtimesjobs.com.

“Oh, there are jobs. I got so frightened because at college I kept being told there would be no jobs once we qualified, or that there would be just one every now and again, with 70 people applying for it.”

How ridiculous that, having worked so hard to learn clinical skills and laboured so long over the books, one should feel grateful to have even a shot at a job - any nursing job.

With the Royal College of Nursing predicting 15,000 nursing posts disappearing over the next 12 months, it looks as though many nurses could find themselves as depressed and weepy as the newly qualified nurse at the prospect of a career involving years of training and hard work just waving goodbye to them.

It doesn’t make sense to dispose of those skills en masse when one day they may be needed. Just look at how hard the government is having to work to attract health visitors back to the profession. That is definitely a lesson to those making the cuts - you need nurses, midwives and health visitors. You can try and cut them, but soon, you’ll realise that’s a false economy and you will have to attract them back at great cost and often with enormous difficulty, or the health of the nation will suffer.

Nursing is frequently about making choices, such as choosing the ethical thing to do, even when it’s painful. But when will someone do the right thing to protect our nurses? It’s not just about protecting jobs - it’s about protecting the public.

After all, we don’t have to look too far back to see how cutting nurse numbers can distort patient care into something we don’t recognise as adequate or safe. And that is enough to make anyone - patient or nurse - a bit tearful.

Follow Jenni on Twitter @nursingtimesed

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Readers' comments (29)

mike | 11-Oct-2011 1:43 pm
I absolutely agree on so many levels with this. Very well said, Jenni. Perhaps you can send this article to Lansley and the rest of the idiots in charge? We'll all add our signatures if you like?

The job situation is absolutely disgusting at the moment, even for those lucky enough to have a job there is little hope for progression, I myself am not in the field I want to be in, purely because there aren't any jobs in that field in my area, at all. And we're the lucky ones! How many Nurses are out there without jobs, how many have given up and got jobs in other areas after qualifying? It is absolutely sickening! Not only that, it is unbelievable when every single ward, clinic, home, wherever you happen to work, is chronically understaffed!

It is disgusting, disheartening and demoralising. I can imagine it will be even worse for those without a job! I cannot blame for one second those who go and work somewhere else (and yes I actually know a few qualified Nurses working in offices, one is in a call centre for crying out loud!) because how long are they expected to sit around and wait for a post to open up? But it is absolutely sickening that they should have to.

And as good an idea the NT jobs section is Jenni, it still does not hold anywhere near enough jobs for the amount of Nurses who need them, especially newly qualifieds!

I feel so sorry for the students I see now, because almost every one I see is worried about the job situation, some are even questioning if it is worth continuing on the course, and there is nothing I can really tell them to give them hope is there? Not without lying anyway!

And this isn't even a new problem, it has been happening for the last 5 years at least!

Yet like you say Jenni, it is short sighted in the extreme!

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Anonymous | 11-Oct-2011 2:39 pm
What a sad short sighted situation this is, the basic fact is that good nurses will always be needed, there will always be people in need of the care and the expertise of a good nurse, this fact appears to be being overlooked or blantantly ignored by governing bodies.
As a nurse of many years my advice to anyone considering a career in nursing is think very hard, at degree level you will be expected to take on more and more tasks of a junior Dr, the pay will never reflect that of other careers requiring a degree neither will you have job security anymore! ask yourself...is it worth it?
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DH Agent - as if ! | 11-Oct-2011 2:50 pm
'Cutting posts causes danger as well as distress'

That was the title to this piece. Cutting the numbers of people providing health care almost inevitably leads to worse health care, something almost no politician will ever admit to - whether society can afford enough nurses etc, is a different question, but this 'we can cut posts but be 20% more efficient' line is absolute tosh, usually !
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tinkerbell | 11-Oct-2011 6:49 pm
I think there will always be jobs for nurses, but not necessarily in the NHS. I choose to work in the NHS because i believe in it so passionately but one day there may not be an NHS and that day appears to be fast approaching. It will then be health for only those who can afford it.
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mike | 11-Oct-2011 7:39 pm
Michael, I agree it is absolute Tosh. I remember reading somewhere (I can't remember the source and I am paraphrasing horribly) that the NHS, no matter how much the cost, is worth it. If you want a good healthcare system, you find the money for it. It really is as simple as that.

Tink, I'm not so sure on that either, since even private sector jobs seem to be drying up. That may change when the NHS dies a death.

Anonymous | 11-Oct-2011 2:39 pm I have to agree with you absolutely. I have said very similar things to people asking me should they go into Nursing, and I felt horrible doing so, but it is simply a fact now. I have felt from time to time also that I would go even further than you and suggest to those WITH a job that it is time to get out!
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tinkerbell | 11-Oct-2011 8:32 pm
mike | 11-Oct-2011 7:39 pm

"the NHS, no matter how much the cost, is worth it"

Absolutely! In a nutshell and don't care how horribly it's paraphrased. It is the truth.
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Jenni Middleton | 11-Oct-2011 10:16 pm
Thanks for all your comments. Don't forget to join me on the home page of this site tomorrow at 1pm so we can all chat more about these issues.
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DH Agent - as if ! | 12-Oct-2011 10:34 am
tinkerbell, I am basically with you - except there is only a certain amount of money to go around. So if my choice was 'more money in the NHS' or 'giving poor pensioners £150 per week to live on instead of £100' I would need to think quite deeply !

And mike, when I said 'usually absolute tosh' it is often (not always) possible to make SOME organisational efficiency savings, and to potentially get more performance for less. But not normally huge amounts.

And 'efficiency' must mean precisely that. A more efficient NHS, does NOT involve staff (nurses, porters, cleaners, surgeons) WORKING HARDER FOR THE SAME PAY. A more 'efficient' NHS, INVOLVES THE STAFF WORKING 'CLEVERER' - the staff putting in the same amount of effort, and the outcomes in terms of patient care being better.
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DH Agent - as if ! | 12-Oct-2011 10:37 am
Jenni Middleton | 11-Oct-2011 10:16 pm

So I am allowed to make comments then, in the Editor's opinion !
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tinkerbell | 12-Oct-2011 3:45 pm
michael stone | 12-Oct-2011 10:34 am

sorry Michael but don't think you are going to end up with either the way elderly care is being shut down in our service, or 'mothballed' as they are now calling it. We have had 2 wards shut down and one due to be mothballed since the beginning of this year. The closure of elderly services is being 'fast tracked'.

Everyone knows savings can be made, i don't think anyone denies that, but they are being made on frontline services where i work.

The extra £50 a pensioner might get will not cover their care if and when they need it in the private sector. Elderly care seems to be the target at the moment on where to make cutbacks as it is such a 'drain' on the overall NHS budget. The word 'drain' is not my word but that used when taking about budgets.

No one can work more cleverly with less staff when we are already short staffed. This is simple maths, how many staff does a ward need to provide quality care as opposed to just coping. It doesn't matter how clever you are if you don't have enough staff to start with. You might be very clever but that's not much help to you as far as providing hands on care matters and a bit of TLC. Sometimes people can be too clever to understand what is very simple and miss the point entirely. It would be possible to do the job where i work with just 2 staff per shift but there would be no quality care involved, there would be no other staff left on the ward for the other patients whilst we provided this care, there would be a lot of patients left in bed all day until the arrival of the next shift of 2 staff. Most of our elderly require at least 2 staff to hoist. They are total care. It would be very clever and cost effective if we just used 2 staff but not very caring.

Do not mix up being clever with providing quality care. Be careful what you wish for you may just end up with it.

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mike | 13-Oct-2011 8:17 am
Exactly Tink.
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DH Agent - as if ! | 13-Oct-2011 10:22 am
tinkerbell | 12-Oct-2011 3:45 pm

Tinkerbell (and mike) I am not using 'cleverly' in any 'academic' sense - I mean, better organisation and better 'behaviours'.

The CQC came out this morning, and they have pointed out that some better-resourced elderly units provide WORSE care than less-well resourced units. The CQC puts this down to 'bad leadership' and 'bad staff attitude' where the problem is not just down to resourses - but, OF COURSE, in general terms less resources is always unhelpful !

The CQC, and Lansley on R4 this morning, want patients and relatives to voice their concerns/complaints more strongly: so do I, as it happens.

I think, many people, including me, want professionals to think rather more along the lines of 'If it were MY mum in that bed, would I be happy about how she is being treated both medically, AND ALSO AS A PERSON ?'.

I am not disputing your points about resources, at all. I am saying, there are other factors in play as well.
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DH Agent - as if ! | 13-Oct-2011 10:28 am
PS to previous.

Re this 'relatives helping out' issue, which caused such fury. I think the point is, that some people might be 'fairly capable but not fully independent' or the equivalent: for example, someone might be able to do some things much more easily if a bit of simple help were provided. For example, just an arm to steady someone as they walked from A to B, etc. I think this 'relatives could help' point, was about that type of thing - nobody is saying that relatives should be operating hoists.

But any help staff can get with 'less infirm' patients, should allow staff more time for 'more infirm' patients.

There are issues of responsibility which come into play here - as usual, the problem is that 'common sense' is not common, at all (in the sense that it is different from different perspectives).
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mike | 13-Oct-2011 2:31 pm
Michael, you really do not understand the pressures we have to work under. Many of us DO think 'if that was our mum or dad', (and ANY assertion that we do not, despite the reality that there will always be a bad apple minority as in any profession, is highly insulting!) but no amount of right attitude or leadership will change the fact that there are NOT ENOUGH OF US to give the care we WANT to!!! If you think care is bad now, imagine what it would be like if there were no Nurses left at all. Who would be left to blame then? Cutting Nurse posts is beyond stupid.

And THAT is the point of this thread here! Nurses are losing jobs left right and centre as wards/homes/clinics close down and are struggling to find new posts, Student Nurses are qualifying and cannot find work because the posts aren't available, yet every single ward/home/clinic etc without fail is dangerously understaffed! Even the most belligerent moron can understand that will negatively impact not only patient care, but the health and working conditions of the few Nurses that are left! Well, every belligerent moron other than those in charge it seems.

And what about future retention? Who in their right mind would study for a professional degree with all the work and sacrifice that entails, for their to be no jobs, few prospects and dismal pay and conditions at the end of it? What hope of progression is there for those of us already in the profession? What hope is there of developing the Nurse led services and the advanced clinical or specialist Nurse posts that we know could have a tremendous impact on the care we can offer?

I am one of the lucky ones with a job, but even I can empathise wholeheartedly with that 'depressed and weepy' newly qualified nurse. God knows how those worse off than me are feeling.
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DH Agent - as if ! | 14-Oct-2011 10:47 am
mike, nobody is saying that ALL or even MOST nurses or hospitals, do not think 'would I be happy, if it were my mum'. But there are quite a few clear examples of a bad attitude/practice to care from some nurses, and in some places.

Your 'any assertion is highly insulting' works for everyone ! The protocols various professionals write and follow, imply things like 'we know better than you what your mum would want' and even 'without something to back up your word, we can assume you are lying' when it comes to relatives ! Being an over-worked nurse, gives you no more right to take umbrage, than any other person who is trying to act correctly has !
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DH Agent - as if ! | 14-Oct-2011 10:48 am
By the way, mike, re:

Even the most belligerent moron

do you think I am a belligerent moron, or a belligerent non-moron ?
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mike | 14-Oct-2011 12:23 pm
Michael, I was talking about those responsible for the staffing levels. As for the bad apples, you can say that about ANY job, you still cannot apply that rule to all. And actually, since we are talking about professional issues here, I think being an 'overworked Nurse' does give me a little more right to take umbrage.

But that is by the point, since we are talking about the job situation and post cutting that is facing Nursing!
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DH Agent - as if ! | 15-Oct-2011 11:42 am
mike | 14-Oct-2011 12:23 pm

You have no more right to take umbrage about being blamed for something which you did not do, than anyone else has !

And the title of the piece was cutting poists causes danger - that danger is not TO nurses, is it, so it strikes me that patients and their relatives actually have the most to lose when posts are cut, and therefore the most right to comment ! NOT 'professional issues' - it is this 'we are the professionals' attitude which I dislike ! And get over this belief you have, that 'the public' tars ALL nurse with th esame brush - untrue, but IF you all behave in a way which APPEARS 'bad', then you will all get painted as 'bad'.

PS You didn't answer:

do you think I am a belligerent moron, or a belligerent non-moron ?

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mike | 15-Oct-2011 12:12 pm
Michael, read the rest of the article, not just the title.
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Anonymous | 16-Oct-2011 9:51 am
michael stone | 15-Oct-2011 11:42 am
"And the title of the piece was cutting poists causes danger - that danger is not TO nurses"
What a stunning display of ignorance?! Of course cutting posts is dangerous to nurses. For those whose posts are cut, it is a removal of their livelihood and the consequences that this brings. For those trying to keep services running with fewer staff, there are increased levels of stress and depression, exacerbations of existing physical conditions (which many nurses have, following years of a tough physical working environment) and care standards inenvitably cannot be maintained, which is bad for both patients and nurses (nurses are usually made the scapegoats and their registrations are put on the line).
Mike has every right to take umbrage about this situation, and every right to express that on this site.
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