One in four nurses would strike as job fears increase

27 July 2010 | By Ben Clover, Charlotte Santry

Nurses have become so concerned about their job security and working conditions that more than a quarter say they would go on strike, Nursing Times’ largest ever survey has found.

Out of more than 5,000 respondents, 26 per cent would consider striking if they were unhappy with their working conditions.

I don’t think nursing has a history of taking industrial action. But people are incredibly worried about their jobs

Only 15 per cent would not consider any industrial action. The majority - 67 per cent - said they would work to rule by, for example, leaving work the minute their shift ended or breaks started.

There has never been a national all-out nursing strike in England, but Nursing Times’ survey demonstrates the extent of nurses’ insecurities and determination to protect jobs and services amid plans for a massive NHS shake-up and efforts to save £20bn.

Asked to rank a series of statements according to the extent they agreed or disagreed, the largest proportion -38 per cent - agreed most strongly with the statement “I feel insecure in my job - I feel scared I will be laid off”.

In contrast, the largest proportion to disagree strongly were the 50 per cent who said they could not sign up to the statement “I feel optimistic about the future of nursing in the NHS”.

Ealing and Harrow provider services nurse consultant Linda Nazarko said the scale of change planned for the NHS had left nurses “very fearful”.

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“I don’t think nursing has a history of taking industrial action. But people are incredibly worried about their jobs,” she said.

The difficulty of organising effective action without compromising patient care was laid bare by the survey.

Mental health and intensive care nurses were most likely to consider going on strike, with 40 per cent and 39 per cent respectively saying they were prepared to do this.

Practice nurses, healthcare assistants and nursing directors were the least likely to say they would take any form of action, including protesting outside working hours.

Overall, approximately half put “industrial action should never affect patient care or services” at the top of a question asking respondents to rank a series of related statements.

However, more than a quarter said the statement they most agreed with was “Industrial action will only work if patient care and services are affected”.

The survey also revealed that while the majority would consider industrial action, 44 per cent were prepared to sacrifice a pay rise to protect their job.

Overall, 70 per cent of respondents said the change most likely to push them towards industrial action was if spending cuts compromised patient care.

Other inflammatory issues were pay cuts - which would lead to 58 per cent taking industrial action - and a worsening of pension terms, which would trigger 53 per cent to take industrial action.

Royal College of Nursing head of employment relations Josie Irwin said: “The findings chimed with what our reps have been telling us. The concern was about jobs and restructuring and your survey has highlighted the fact that pensions are a real point for anxiety.

“When there have been these culls before, there has been so much skill and so much experience lost.

“Clinical nurse specialists seem to have been targeted by the more gung-ho, slash and burn managers. It is so shortsighted because all the research shows their contribution, not just to readmission and patient care, but economically.”

RCN critical care forum chair Rachel Binks said senior nurses had an important role in ensuring staff were kept aware of any changes under discussion.

She said: “We’re the eyes and ears of the hospital for the managers and are in a position to pick up feelings of unrest among the nurses and domestic staff and feed back any questions.”

A DH spokesman said efficiency gains would not result in cuts to clinical posts “unless costs rise without productivity gains”, but nurses may need to work in different trusts or in new roles.

He added: “We are committed to supporting nurses and their clinical colleagues to deliver better, more effective and efficient care.”

As revealed previously in Nursing Times, trusts are already withholding pay increments to nurses with poor sickness absence records or asking staff to consider pay cuts in return for job security.

Last week all 3,000 staff at Liverpool Primary Care Trust were offered options including voluntary redundancy or working part time as part of a savings programme.

Readers' comments (66)

Anonymous | 27-Jul-2010 8:53 am
As an employee of the above named LPCT i feel as reflected less secure about my future than ever. A real sense of downdrading seems to be the PCT way forwards. I like my colleagues have offered years of service to this employer only to find reduced terms for MARS and likewise fears over pensions. With this in mind most of the service i work with have concidered altermative employment so far as outside nursing or the NHS. The future once so clear has become clouded. The treatment of staff, in my opinion, by LPCT or as it is now called Liverpool Community Health makes it hard to believe it managed to pull out of the bag the BEST national PCT. When asked if i would recommend nursing as a career now i tend to say NO. Whilst it certainly has its rewards it terms of actual nursing care it offers no other job security or satisfaction. if asked now would i strike the answer sadly would be a definite YES.
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Anonymous | 27-Jul-2010 8:54 am
I do not agree that going on strike will achieve job security. Where ever strikes have taken place there seems to have been even greater loss of jobs.
Demonstrations and working only your contracted hours I feel are the best ways of getting messages across to the government. Problem is some nurses work well above their contracted hours at the moment which gives nhs management the opportunity not to fill vacant posts.
I remember a nhs strike in the 80's and it brought out the worst in nurses and ancilliary staff. How can you strike without some knock on effect to patients, waiting lists, operations etc. Remember it could be you wanting a hospital bed!!!!
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Anonymous | 27-Jul-2010 9:23 am
I believe it is time for nurse to band together. Its not just about job security, its about ensuring nurses have a voice [finally] within the NHS family and patient services are secure. Our needs as professionals need to be maintained. Sometimes the hard things affecting patients services etc in the short term is the right thing to be done for furture change and benifit of patient care. The BMA would support their Drs no mater what! it is about time that the RCN or such like did the same.
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mike | 27-Jul-2010 10:03 am
Just a quarter? One in four? I am seriously, seriously disappointed in that number!

No wonder the profession is in so dire straits when so few of you out there are willing to fight for it!

It is slightly heartening to read that 67% at least are willing to work to rule.

The simple fact is, Nurses NEED TO STRIKE!!!
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Yvonne Bates | 27-Jul-2010 11:22 am
I gree to a point that Working to Rule ( and making sure the majority DO work to rule ) can be very effective and crippling without patient compromise...striking should only come further down the track if working to rule failed. As has been said before on numerous occasions Im sure there is NOT ONE NURSE that would really feel comfortable about striking...but it can be done with effect as proven.
I believe with the survey that the figures are probably higher than 1:4 in reality, as although confidential there would still be a large amount of nurses out there just too scared to voice their opinions, and how many nurses did not complete the survey? What goes through ones mind may not be what they put on the survey.( amazingly! )
BTW Anon 8:54
This is not the 80,s....most nurses in Aust/ /Canada and now USA are getting what they want with a strong backup.Appears UK is going backwards and you are all now worried that you will have a job? Disgraceful!
Get that new nurses union formed
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Anonymous | 27-Jul-2010 2:13 pm
I agree With Mike Nurses need to stick together and if strike means that our voice is heard then so be it! something needs to be done and soon. i am nearing the end of my nurse training and yet after 3 years hard slog (dont get me wrong i have loved every second) but i may not be able to get a job and if i do is it going to be secure????????
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Anonymous | 27-Jul-2010 3:04 pm
Only 5000 replied out of how many nurses in the UK? Doesn't that show the level of disinterest/apathy?
Working to contract is an extremely effective tool. It is difficult to do and everyone MUST agree and follow the rules. It doesn't take long for the management teams to realize the loss.
Plan it, cover patient care and you are carrying out your role as per your contract and still acting in a responsible and professional manner.
Stop complaining and get on and do it!
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mike | 27-Jul-2010 3:12 pm
I would also like to adress this issue of any strike action 'affecting patient safety'. This is the mainstay of the emotional blackmail that is aimed at us and should be stopped.

Basically the argument is that if we strike, there will be noone there to give care and patients will suffer.

Fair enough, that is not wrong.

But the sheer fact that it is not wrong is the exact reason that a strike would work! We are essential, noone else can do what we do!

I would argue that patients are ALREADY suffering with poor staffing levels, inept management and Nurses not being allowed to care for patients the way they want to, etc etc etc. By allowing this to continue, accepting the status quo and NOT striking, I think we are failing in our duty of care just as much as those in charge would accuse us of doing if we went on strike.

The fact is we would be fighting for patient safety and care as well. Better working conditions would mean more staff on the wards, that would mean better patient care and better patient safety.

So patients are ALREADY suffering by us NOT striking, striking would mean they would get better care!
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Anonymous | 27-Jul-2010 3:19 pm
Working to rule i agree works well so long as the rules do not change. in the current climate with the end of PCT and foundation trusts set to rule the land do you think it is not impossible in this new climate for the re writing of job specs as they are permitted to in times of economic change and crisis. if we dare disagree its 90 day notice time or moved under the clearing house system to another job which may be less well paid or dare i say been left vacant for a reason. i would suggest nurses need to band together and in the mean time make sure you understand your employers Operational Change Policy. We all are aware our Unions when it comes to the fight on our behalf are as much use as a chocolate tea pot, but we do pay our subs for something. I say band together and then approach your area union rep. perhaps its time for a new union who like the rest of us are 'fit fpr purpose'.
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Anonymous | 27-Jul-2010 4:23 pm
25% is pathetic! I'll be one to strike if needs be... what's the worst thet can happen, really?
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Louise | 27-Jul-2010 5:02 pm
I think work to rule could be quite difficult in a multi-disciplinary team where you may be the only nurse (community team for example) and easier perhaps on a ward. And I suspect agreeing/adhering to rules would be quite tricky. I voted for both work to rule and strike action (in that order) though actually I think strike action would be easier to achieve.
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Anonymous | 27-Jul-2010 5:40 pm
Mike is so right! Patients are already suffering due to appalling staff shortages. Striking would, in the long term, lead to greater improvements in direct patient care.

STRIKING is the ONLY way that nurses will ever get a voice in the NHS (even then it won't be as loud as the GP's) and to be treated with respect - instead of the easy push-overs we are now considered to be.

Doctors have done it and have been taken very seriously since. Let's emulate this aspect of the medical model.

I siscerely hope the RCN will ballot it's members over this issue to get a better picture than that revealed by the NT survey. I have been in nursing for 35 years and am nearing retirement but I despair at the thought of future generations of nurses being treated so shabbily. Nurses need to STRIKE; both for patients and the future of the nursing profession.

STRIKE - NOW!!!!!
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Janet Edwards | 27-Jul-2010 10:42 pm
I feel that if we do not strike now for better working conditions thus ensuring better care for our patients then we have only ourselves to blame when more than a 1/4 of us will lose our jobs thus leaving the rest of the workforce to carry the workload. I remember the tory government the last time they were in power and all I can say is GOD help us and more importantly GOD help the patients.I am at present being told that I must apply for a band 6 post that has become vacant on the ward where I work, despite the fact that I am already a band 6 but am being told that my job may be restructured,I appealed and won to get my band 6 and now am being told that they will take it from me after 6 years, this is just the tip of the iceberg, come on nurses lets show them we have a backbone (that may be bent due to years of abuse) but show them that they cannot walk all over us as we have allowed them to do in the past.
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jjjez@hotmail.com | 27-Jul-2010 10:51 pm
I wholeheartedly agree!!!!

We must release our chains and scare this government into shutting the hell up with giving complete power to the Doctors, who live well and have enough already. It's like a conspiracy; they want to control everything and it's clearly for financial gain.

I just want our politicians to do the right thing but it messes withthe whole 'New World Order' ...
(GOOGLE IT!!! and please.. we face more unlikely stuff than this and have seen millions of cash thrown away on weirder stuff so.....READ UP!!)
... so all of our politicians are unlikely to effect real growth and change in the NHS unless we make it implausible for them to push through their thoroughly un-economically sound ideas.

They mean to turn the NHS debt into spendable money by simply allowing deficit funding for private concern. It is the basics of contemporary capitalism where debt creates wealth but what they envision is to more or less sell the debt to individual (but most likely closely connected) private companies and corporations.

The public think they'll get a Franco-German version of work paid health insurance with a free choice of state collaborating practitioners.
Instead they will get the US version with 'some' European advantages.

If everything is more expensive in Britain, how expensive will health insurance be, if the NHS cannot set the lowest price already?!?!

Is it not just striking that will get us there. We cannot do it with a docile and redundant leadership. We must forget those who do not wish to rock the boat and it is hard to do that. But like all political movements; what is the gain? And what is the ultimate benefit?

For us it must be a minimum starting wage of £25,000 (preceptorship Staff Nurse)
(£44,000) Ward Sister (Band 7)

plus more competeive rater for nights.
plus either bonus for days worked with shortage of staff (e.g. £1.00 per hour more) or guarantees of better use of bank staff e.g an on call system (DUHHHHH!!!!!!!!!!!!!!!!)

then just continual capital state funded hospital enlargements for the next 10 years with no budget cuts.

It's not unlikely because we've all been subject to much more absurd and ridiculous things that what i just wrote. Havent we??
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Anonymous | 28-Jul-2010 7:32 am
STRIKE!
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mike | 28-Jul-2010 8:29 am
Exactly Janet!

Nurses will not have the right to complain that their pay and working conditions are crap and they have no status or power or say in looking after their patients if they are not willing to show a bit of back bone and fight for it!
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mike | 28-Jul-2010 8:38 am
Jjez, I mostly agree with what you say mate.

£25,000 for a newly qualified AT LEAST!!! That will at least bring us into line with other comparable public sector key workers, it will also help with recruitment, moral and retention.

Also we must demand a legally binding Nurse patient ratio. Not only will this improve care, but it will also ensure that the jobs are there for us to go into. Jobs are scarce at the moment, there is no point in having a job or getting extra quals if there are no jobs to go to and trusts 'restructure' pay bands to wriggle out of paying AFC band rates (the cheeky shits)! It is just gobsmacking that we have allowed this situation to occur!

What would be so bad about striking? Why do some Nurses seem not to want to secure better pay/working conditions and status for their profession? Is it apathy? Cowardice? What? Please explain it!

We are one of the biggest workforces in the country. We have so much power, so much leverage, yet we just do not use it? If we stood up and even THREATENED to use the power that we have as a unified workforce, it would FORCE the government and the NHS to listen. We have them over a barrel and they bloody well know it!

We can do so much, if we just had the backbone to STRIKE NOW!!!!
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Louise | 28-Jul-2010 10:18 am
Dubious about increases in night pay - in some areas there can be a problem getting staff to work in the day! Working nights is very attractive to many nurses because they don't need to pay anyone to look after their kids (assuming they have a partner/family member to do it), they get paid more and the work load is lighter (generally and in my experience). But lets not digress from the very important issue of work to rule and strike action. Bring it on.
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Steve Williams | 28-Jul-2010 10:49 am
Good luck mike et al. Alas, one in four is probably a realistic assessment. We – CoSHE and NUPE tried striking back in 1982 when Thatch was riding high and hard on our arses.

Ah, actually we didn't strike – we just did a WORK TO RULE... no patients suffered... and the RCN couldn't even bring themselves to support that action.

Nurses are, by nature, generically and clinically dumb fuggers. They automatically shoot themselves in the foot at the first instance.

One example... In 1982, when the porters in our hospital worked to rule... nurses went down to the laundry to collect fresh linen. Dumb or what?

Oh yes, totally altruistic. Wonderful female “angels of mercy” looking after their charges. Unfortunately, over the ensuing 28 years, the reality has proven to be the exact opposite. They totally played themselves into the government hands who knew the negotiators were playing cards with a fixed deck.

We were initially offered an increase of 8% for one year. In the end we were forced to settle for 6.4% over a two-year period... You may say “WTF?” and you'd be perfectly correct. Who in hell turns down an 8% increase as opposed to a 3.2% one? Dohhh! The RCN basically – the twin-set and pearl brigade of predominately middle-aged females that hijacked our supposed “profession” from the year dot.

Maggie, Ken Clark and the RCN collectively screwed us over. Not only did we NOT get a fair wage but we lost public and government credibility. We also lost our own self-respect. Look at us now! Deeply divided or what?

It saddens me to read these replies where General Nurses, Acute Care, A&E, Paediatric, Palliative and Psych nurses (et al.) are having a pop at each other about who is more “important” - get over it people. The truth is that “Joe Public” doesn't give a toss about you until they need you.

When they DO need you then suddenly (and somehow inexplicably) you are “wonderful” and they say that you should be paid more. Once they go out of the door they couldn't give a fig. That's called having a “convenient memory” - something that only (purportedly) males are blessed with.

Profession? Don't get me started. You can take all the degrees and specialisations you want but, sadly, in the end the government and the public perception of us is the one from the 60's film CARRY ON DOCTOR with “Barbara Windsor” “Hattie Jakes” and “Kenneth Williams”..... “Ooooh Matron!” Sid James is alive and well... Hehehehehhhhhheeee....

Sorry chums but “Industrial Action” and “Nursing” in the same sentence is an oxymoron.

Like I have said before (multiple times) the only problem with “Nursing” is that there are too many females in it. Yup – you read it right “females” obviously I am a sexist bar-steward. All the nurses without testicles may now immediately ramp up their “hate” factor to eleven and begin to scream, on these pages, that I am a deluded

You'll never ever get a fair and equitable recompense from the UK government of the day while the public (and the nurses themselves) regards “Nurses” as toilet-tissue – e.g. instantly necessary at the time but flushable and forgotten afterwards.

Just do like I did several years ago.

Vote with your feet.

Relocate to another country that actually values your training and experience. I am currently earning three times (quid pro ro) an hour more than UK nurses in a similar position are... Does that make me stupid or rabid?

Methinks NOT!
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Anonymous | 28-Jul-2010 1:02 pm
Work to rule, and withdraw the 'good will ' (if any still exists out there') regarding unpaid overtime that is never paid back. This Trust (a mental health trust in Lancashire) has just introduced a 12 hour compulsory shift system,m that requires all staff to have 1 hour 32 minutes break on a shift........this means that one member of staff is almost permanently off the ward having a break.

On units where there are 3 or 4 wards, at night with only 1 trained nurse it means that the trained nurse does not get a break (I am talking about acute mental health units here)

If they leave the ward they could be disciplined.......

It's about time nurses get their act together....otherwise we will be down the road and crushed like the miners......come on folks get a grip and be prepared to fight.
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