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'Recognise and reward the moral code of nurses'

The day of industrial action certainly left nurses with a moral quandary.

Many of those we spoke to (see pages 4–5) decided to take action, but those who decided not to felt they just couldn’t because of their code of conduct. During my webchat on Wednesday I spoke to a few nurses who had declined to pick up a placard because it just didn’t feel right to “turn their backs on patients” as they put it.

One story that reached the Nursing Times office this week was of a nurse who had said she would picket “but only if the strike fell on her day off”. A genuine show of support - a protest maybe, but in terms of having an impact, such a universal approach would hardly make George Osborne run to get his calculator.

Of course nurses’ desire to stick to what they consider to be their “moral code” is admirable, entirely defensible and understandable. After all, the teachers and many other civil servants don’t run quite the same risks by standing outside their work waving banners and encouraging drivers to hoot their horns, do they? Little Sammy may not get his weekly dose of algebra on Wednesday afternoon, but it’s not quite the same as Moira not receiving thrombolysis to increase her chances of surviving her myocardial infarction.

There are fears (see page 9) that in “doing the right thing”, nurses are not making their feelings on the subject felt and their stoicism is being mistaken for acquiescence or apathy, and could be seen to back up David Cameron’s view that the strike was a “damp squib”.

So will the utter determination of nurses to do their jobs come what may put them in a vulnerable position in resolving this issue? If anything, their attitude shows how much more nursing should be valued – and rewarded appropriately.

Follow me on Twitter @nursingtimesed


Chat live with the editor and other nurses at every Wednesday at 1pm about this column.


Readers' comments (61)

  • This is such a difficult one.

    Don't get me wrong, I understand the feelings of those who felt they couldn't strike because they felt they couldn't leave their patients. As you say Jenni this moral code is admirable. However, I feel that it is this same moral code that has been subverted and become almost a 'martyr' attitude in Nurses and has been used against us. The government have relied on the fact that they can get away with whatever they like because we wouldn't do anything, would we?

    For many, myself included, it didn't though. I have a moral code, of course I do. I got into Nursing to help people, to care for them, to save lives, I don't WANT to strike, I would rather help my patients. HOWEVER, and this is an important point, I refuse to allow my moral code to be used as emotional blackmail. Does the fact that we have an essential role and our actions do affect patients care and lives automatically mean we can never stand up for ourselves? Does it mean we should automatically bend over and accept what is done to us by the government? Scrap our pensions, cut our pay when it is already barely enough to live on, make our working conditions even worse? It doesn't matter because we can't possibly do anything can we?

    We are not the only ones who have a responsibility to our patients, the government and the powers that be have a responsibility to ensure the staff and the conditions are there to care for patients too. When Nurses go on strike again, people should know it is an absolute last resort and a last straw for us, and they should start blaming the government for forcing us into this action and start calling on them to fix the situation to get us back on the wards!

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  • We are constantly being told on this forum that working conditions are bad and need improving. I always find this puzzling and would welcome it if someone explained the "poor conditions" we nurses have to put up with.
    Going to work in a clean warm building, wearing a free uniform that is laundered for free, having an occupational health department on-site and willing to see you, provided with personal protective clothing, being paid an above average wage (average nurse wage is £26,400 for a 37.5 hour week whereas average chefs wage for example is £13,600 for about 50+ hours) with a well above average annual leave entitlement and free chocolates on most shifts, does sound awful, doesn't it.

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  • Anonymous | 6-Dec-2011 12:31 pm Are you for real?

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  • Yes Mike, I am for real, are you?
    I presume from your lack of an answer that you cannot tell me what these 'poor conditions' are.
    I am also presuming from previous posts by yourself and others that you mean, not getting designated breaks and getting crap off duties and shortage of staff. As you have said yourself it is down to individual nurses to make sure they get their breaks and finish on time, it is also their responsibility to negotiate the off duties and therefore blaming others for these shortfalls is pointless. As for shortage of staff, this is debateable depending on where you work and therefore to raise staffing levels everywhere as you keep demanding is not feasable or sensible.

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  • I would like to know where nurses earn an average of £26,400 as most nurses I know do not earn that! Does Anonymous realise that nurses often do in excess of their contracted hours for free??

    I felt that all nurses should have walked on Wednesday to show the government exactly how much they need nurses in order to run the wards! Nursing is being ripped to shreds because they now want to have a voice, I am newly qualified and along with several hundred who I graduated with are unable to obtain posts because nursing is expected to pay for the bankers mess.

    Maybe that's the previous generation of nurses who are quite happy to take whatever is handed to them, but things need to change.

    My partner (who works in the private sector) pointed out that frequently missing out on meal/comfort breaks and working unpaid overtime on a regular basis would never happen with him and his colleagues and because of this management respect them more!!!!


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  • Anonymous | 6-Dec-2011 2:47 pm just read any of my previous answers because I have countered foolish claims like yours before.

    First point, that is NOT the average Nurses wage. Try £5000 less for an average band 5. Furthermore, considering what we do, the level of skill, education, qualification, accountability and responsibility we have, your stated wage should be the bare minimum starting salary! It isn't. Nurses ARE vastly underpaid. That is a fact. Constant attacks on our increments, pay levels (with pay freezes and cuts), pensions, the threatened cancelling of afc, and so on are adding further insult to injury.

    A free uniform? two tunics for five shifts as I received is not adequate, and if an employer expects a uniform they SHOULD supply it! furthermore, you show me the hospital that gives free laundry! I do not know a single one that does, and I doubt many others do either.

    I can't be bothered countering all of your foolish points, but you want to know what 'poor conditions' we put up with? Because it is obvious you are not a Nurse, I will explain them to you very slowly and clearly.

    How about unsafe and dangerous staffing levels just for starters, with far too many patients. How can 1 staff Nurse with 30, 40 or more patients to look after be considered safe? How about unchallenged job freezes and job cuts (with many newly qualified unable to find jobs) and downbanding? How about bed and ward cuts that put added pressures on wards? How about the majority of Nurses working vast amounts of unpaid overtime just to ensure paperwork is filled in to the legal standard or patients are cared for adequately, because managers refuse to get enough staff and Nurses do not want their patients to suffer? How about missed meal breaks for the same reason? How many Nurses have to put up with unhealthy and inconsiderate off duties, doing L, E, L, E, a day off then nights, etc? Yes it is down to Nurses to fight against this, that is why I argue that we need to continue striking, but Nurses of the past have been emotionally blackmailed into these conditions, and that needs to change. How about substandard or not enough equipment? You talk about PPI, I WOULD BLOODY EXPECT THAT AS A BARE MINIMUM! Clean buildings? Well, even I won't get into that one!!!!!

    I could go on for a long, long time with a dozen or more examples but I won't for the purpose of expediency. Just a fraction of the things I have already mentioned would be considered illegal in most professions or jobs, can you imagine any other job out there where the workers would put up with missing breaks or unpaid overtime simply because they had such a sense of duty that was exploited by their employers? No.

    But your foolish challenge (I mean £26,400 the average wage, please!) has bought us off topic slightly. These are just some of the reasons that Nurses need to continue to fight, strike and change their conditions, and it is about time Nurses stopped allowing their sense of duty, their moral code or whatever people want to call it, to be used against them. The emotional blackmail will no longer work.

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  • The problem is with nursing is that people don't take into account the skill, education, training, accountability and responsibility. Not to mention the continous updating of skills and jumping through hoops to keep on working.

    If you work on a checkout for example and make a mistake it might only annoy you or hold you up.If we we make a mistake at work it could kill someone.

    Probably not a good comparision I know but you get the drift.

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  • Mike, average annual salary for a nurse is £26,456 (Office for National Statistics, Nov 2010)
    Your above rant has not added anything to the discussion, you are merely repeating things that could be changed by the nurses themselves and have nothing to do with Government or higher management. Staffing levels as I said before are debateable and dependant on the area you work, many areas are under staffed but many are also well over staffed.
    Unchallenged job freezes and job cuts do happen in many, many other workplaces, redundancy is not something confined to the NHS.
    Nurses need to be better at prioritising, do the important things and leave the rest if they are short staffed, but make sure they document why so that when complaints come in the systems can be looked at properly and resources can be allocated appropriately.

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  • Bloody well said Mike, and so true of what it is like in nursing in the NHS now.

    Anonymous 12.31hrs. Wake up and smell the coffee; you haven't the first idea what it is like now.

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  • Check out this site:
    It is worth noting that the average nurses salary is virtually double the salary of someone considered to be living in poverty. That is a combined salary for a couple with 2 dependant children under age 14, £13,824.

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  • Anonymous 6-Dec- 2011 6:01pm

    Two things to say.
    1: i want to work in your Hospital as conditions are obviously far superior to those where i work.
    2: When i was a single parent of 2 on a band 5 i can assure you i was living in bloody poverty!!

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  • Will you please stop referring to 'average' salary (I assume you mean the arithmetic mean of all nurses on agenda for change in the whole NHS) as it is meaningless, these figures can be distorted by the highe band salaries. What is more accurate is the median or fifty centile (the salary 50% fall below and 50% fall above).

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  • Sarah Stanley | 6-Dec-2011 8:32 pm

    Starting salary for a band 5 nurse is just over £20,000 so even presuming you are a single parent with 2 children you are still over 6 grand better off than the example shown with one less person to feed/cloth etc.

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  • Nurses should never have to strike under any circumstances whatsoever.... To do so is in conflict with their moral code of ethics.

    The government is fully aware of this and will continue to exploit them as long as they can get away with doing so.

    Nurses should be entiltled to the highest standard of working conditions possible, and, be supported by our government at all times, with pay index linked to prevent a declined in their wages.

    When I retired 14yrs ago, after 30years of employment in the NHS, on far less than what the so called average nurse is earning today. It was a disgrace rhen, and it's still a disgrace now!

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  • This debate has been somewhat dragged off track. I don't accept that idea that nurses who went on strike on November 30th had any less morals than those who went to work. I am proud to say that I took strike action on November 30th and I would do so again. In every workplace there were serious discussions to ensure emergency cover so it simply not true to say that we walked away and left patients to die of Myocardial Infarctions.
    I love the NHS and I think it worth fighting to maintain as a universal service, run in the interests of patients not in the interests of profit. That means rewarding the hardworking staff adequately and running the service with appropriate staffing levels.
    I think its a much better moral stance to take collective strike action with my colleagues to win improvements to the service and to my terms and conditions, than to do nothing and then end up leaving the profession as it no longer pays my bills. That would remove my skills forever from patient care, not just for one day.

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  • Latterlife Midwife

    I have a big problem equating striking or not striking with a "moral code." Strikes come only after a long period of dissatisfaction, during which administrators fight tooth and nail to avoid improving workers' conditions and pay structures.

    Nursing has always come under the realm of "too sacrosanct" to take job action, or indeed, to even unionise. This has permitted relatively low pay for the level of knowledge/professional skills/work rotas required; poor scheduling practices; unreal patient ratios in a time of much sicker patients requiring more meds, procedures, and technology, to persist. That's what is immoral!

    When nurses from unionised American hospitals go so far as to take strike action, management staff has to get on the floor and do real nursing. It's all hands on deck, and few, if any, patients are *seriously* affected. The nurses who do put their necks on the line and actually march for the rest of us are to be commended, not termed immoral!

    It's a hugely brave thing to do for the benefit of the profession and the patient population. They could actually get better care in the end from nurses who have the opportunity to give proper attention to them for a change, as a result of improved working conditions and pay. Yes, being appropriately paid for the work I do (conduct some proper acuity studies to actually validate what nurses/midwives do hour by hour!), including fair pension terms, seems only right.

    I was actually out of the country that day and away from the news, so was not very aware of what actually occurred. It's no wonder nursing in Britain is so many decades behind. The NHS system is absolutely wonderful for patients, which I have personally experienced. But for nursing staff, it is horrible. It's kept us from being treated as the professionals we are, and has only encouraged the public and media to see us as drudges who are over-aspirational in wanting/requiring higher education and pay. The current mantra, "too posh to wash" is a perfect example. The general public does not understand what being an excellent nurse entails until they are face-to-face with a health crisis themselves. Then they can't praise us highly enough (or take their dissatisfactions to the Daily Mail).

    For the other nursing dinosaurs out there getting their knickers in a twist about this, I am one, too. 40 years qualified has shown me that though the basics never change, the acuity does and we deserve to be treated with more respect. The trolls who labour on about "morals" are only trying to keep nursing conditions in the Dark Ages.

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  • Latterlife Midwife
    I wish there was a "Like" button on here because i like your post!

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  • Yes I am a nurse and I am married with 4 children. I had 3 children when I strarted my training and had the 4th in my final year. I had a mortgage and managed on the bursary with a small handout from the social (supplementary benefit) which was stopped for the last 6 months of my training because I was told that I could only receive one payout from the government at a time, so for that last 6 months I lived at under the official breadline. I still managed. I have raised all of my children with only my wage as my wife has remained at home to look after the children. We have had and continue to have a very happy life and I have enjoyed my career in nursing where I gain a huge amount of job satisfaction. Money isn't everything. The planet I am from is the "real world", you should visit sometime.

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  • Anonymous | 7-Dec-2011 3:51 pm

    I'll bet anything you live in a shoe box....without a lid, and make shoes for the kids from discarded newspapers and plastic bags (to keep the rain out).
    The planet you are living on doesn't orbit the same sun as us here on the planet Earth.

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