Many nurses have struggled to pay bills, missed rent or mortgage payments and say they cannot sleep at night due to money worries, reveals a major survey by the Royal College of Nursing, which paints a stark picture of the personal financial pressures weighing on the profession.
Just over 70% of nurses who responded to the college’s 2017 employment survey said they felt worse off compared to five years ago, while 23% said they had been forced to take on an extra job.
“I really feel for the patients, but I have nothing else to give”
Band 5 staff nurse
Many revealed they were thinking of leaving the profession altogether and fewer staff than at any point in the past 10 years said they would recommend nursing as a career.
The findings – based on responses from 7,720 RCN members – come ahead of next week’s budget when the chancellor is being urged to address the issue of public sector pay.
The RCN said the survey clearly showed the impact of pay freezes and the 1% cap on pay rises, which – according to the college’s calculations – means a typical staff nurse has seen their pay cut by 14% in real terms since 2010-11.
“I have a lot of responsibility caring for end of life patients… An important job for rubbish money”
The survey, which was conducted on behalf of the RCN by the Independent Institute for Employment Studies, found nearly 61% of nurses who took part felt their job band or grade was inappropriate for the work they do, feeling it no longer matched the responsibilities or intensity of their role.
This is a big increase since the RCN’s last employment survey in 2015, when 39% said this was the case.
“I have a lot of responsibility caring for end of life patients, and meeting all the family and other loved ones’ needs. An important job for rubbish money,” said one community nurse who provides live-in palliative care.
Meanwhile, a hospital staff nurse said they also felt they had “too much responsibility for little pay”, especially given “the hours and things we have to see and deal with whether that be rude public, clinical conditions, death”.
About half of nurses had worked extra hours in their main job in order to pay bills and meet everyday living costs. Just under 40% said they had borrowed money from family, friends or the bank, while 6% said they had taken out a payday loan.
Nearly a quarter – 23.2% – said they had taken on an additional job, with more than half doing bank nursing and nearly 30% doing agency shifts. Just under 16% even said they did non-nursing work on top of their regular nursing role.
“It is ludicrous that the NHS is losing valuable highly-trained staff, simply because they can’t pay the bills”
More than half – 51.7% – of those who did extra work said the additional income was “indispensible” and was necessary to keep them “financially afloat”. Nearly 40% said they worked more than 10 hours a week in these extra paid jobs.
In additon, the survey showed many nurses had been forced to cut spending on essentials or got into financial difficulties. In all, 56% reported cutting back on food and travel costs, while more than one in five – 20.9% – said they had struggled to pay gas and electricity bills.
Just over 11% said they had missed or been late with rent or mortgage payments and 2.3% said they had turned to charities or food banks for help.
Money worries had caused nearly 41% to lose sleep, while nearly a quarter said this issue had prompted them to think about leaving their job.
Nearly 16% said they had had to spend time at work dealing with money problems, while 13.6% said worrying about money made it harder for them to concentrate or make decisions at work.
The survey, which has been carried out regularly by the RCN since 1986, found 36.8% of nurses who took part in 2017 were currently looking for a new job – a figure that is up from 24% 10 years ago.
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Of those, nearly a quarter said they were looking for a similar role outside the NHS, while about 34% said they were looking for a different role outside the NHS and nearly 14% said they wanted to work abroad.
Responses from individual nurses showed many were keen to get out (see attached PDF below). “There are seven years til I can take early retirement at 55, then I will leave nursing and get a little job in a supermarket,” said one band 5 staff nursing working in north west England.
“The pay, terms and conditions of working 12 hour shifts eventually wear you down and demoralise you. This is not what I came into nursing for. I really feel for the patients, but I have nothing else to give,” they said. “We have two generations of nurses in our family, but I am so glad my daughter has not followed my profession.”
Questions included whether or not respondents would recommend nursing as a career – only 41% confirmed they would, which is down from 51% in 2007. More than 18% said they regretted choosing nursing as a career.
“When my daughter told me she wanted to be a nurse, I was actually disappointed and thought: ‘why would you want to do that?” said one band 8a nurse manager from Scotland.
RCN chief executive and general secretary Janet Davies described the survey finding as “shocking”. “It is ludicrous that the health service is losing valuable highly-trained staff, simply because they can’t pay the bills at the end of the month,” she said.
“The Safe Staffing report we published in September laid bare the terrible impact nursing shortages are having on patients; today’s survey findings, in contrast, show how badly nurses themselves are suffering from the continued underfunding of the health service,” she said.
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“The chancellor must therefore give a clear signal in the budget next week that the government will award an above-inflation pay rise to hard-pressed nursing staff in the NHS,” said Ms Davies.
Fellow union Unison said the survey findings echoed the plight of staff across the NHS, with employees as a whole “struggling to survive on just their basic pay”.
sara gorton unison
“With inflation and interest rates on the rise, all health employees want is to be able to pay their bills, feed their families and live without constant financial worries,” said Unison head of health Sara Gorton.
“The NHS is already facing recruitment challenges,” she said. “Giving all NHS staff an above inflation pay rise would ultimately be good for the health service and for patients everywhere.”
Phillippa Hentsch, head of analysis at NHS Providers, which represets health service organisations and is part of the NHS Confederation, said: “Recruiting and retaining the staff that the service needs is now the most pressing issue for trust leaders.
”We need to do all we can to support trusts to make themselves great places to work – pay and job satisfaction are key components of this,” she said. “In our latest workforce report, we urged the government to set out a fully funded plan to end the pay cap during this parliament.
Phillippa Henstch 3x2
“We welcome the reassurance from the health secretary that the cost of any pay increases recommended by pay review bodies will be funded with additional money so that trusts do not face a further squeeze on existing budgets. We hope to see this commitment honoured in the upcoming budget,” she added.
The survey also prompted criticism of government policy on public sector pay from opposition politicians.
“It’s shameful in this day and age that nurses struggle to make ends meet and are pushed out of the careers they love because they can’t pay their bills at the end of the month,” said Labour shadow health secretary Jonathan Ashworth.
“So far ministers have offered only warm words while expecting any lifting of the pay cap to come from productivity gains,” he said. “In the budget ministers must fully fund ending the public sector pay cap. Anything less would be a betrayal of hard-working nurses who care for all of us.”
The survey asked questions about five key areas: pay and grading; income and additional work or hours; career satisfaction; development and progression; staffing levels and workloads; and abuse, harassment and bullying.
The RCN said it was sharing its initial findings (see attached PDF below) on pay, hours and career satisfaction ahead of the budget on 22 November.
A full report based on responses across all five areas will form the basis of its evidence to the independent NHS pay review body in December.