The NHS front line

When I moved to the UK in 2019 I was excited and optimistic about working for the NHS. My living costs were manageable, my shifts were reasonable and working conditions generally felt safe. But since the pandemic, working here has become a nightmare. I was inspired by my mum to become a nurse. She’d worked as a community nurse in my home country, India, and despite ten-hour shifts, a poor salary and not always receiving the respect she deserved, she always put her patients first. I thought that things would better in the UK. When I came here I’d already been working as a nurse for two years but I still had to start from scratch as an assistant practitioner, and essentially retrain for six months. After a year working on a pre- and post-surgical ward in Cornwall, I moved to London in November 2020, at the height of the pandemic. I was transferred to an intensive care unit (ICU) to work as a critical care nurse for very sick patients, many of whom were on ventilators. [See also: How to save the NHS] It was like a warzone. I had no previous experience of ICU and didn’t know what was happening or who to turn to for advice. The chaos and number of critically ill patients meant that senior nurses were extremely overworked and couldn’t train me. At any one time I had to care for two or three patients who were either on ventilators or intubated. A critical care nurse should ideally only care for one patient at a time. Looking back, I don’t really know how I survived, and I’m still traumatised from the sheer number of deaths and how overwhelmed I felt. Since then the death rate has come down and I’ve done more training, so I feel more confident as a critical care nurse, but the staff-to-patient ratio is still very unsafe. Managers keep telling us that staff shortages are due to “short-term sickness” but I’m fed up with hearing this excuse, because when things go wrong doctors and nurses take the blame. I’m meant to work three 12-hour shifts a week but recently this has gone up to four or five. Since the pandemic caring for two ICU patients at once has become the new normal, but the sickest patients need 24/7 monitoring, so one patient inevitably gets neglected, which is extremely stressful for me. Cardiac or respiratory arrests can happen within a matter of seconds, but I can’t be in two places at once. Yet our managers seem to think we can and still expect an unreasonably high standard of care. We have been grilled on why our patients have not been washed during our shift – the answer is that my priority is to keep my patients alive. In 12 hours I barely stop for ten minutes. Despite advising my patients to stay hydrated, I rarely get a chance to drink water or go to the toilet myself. How can we be expected to work under these conditions without a compromise in care? [See also: The truth behind the worst NHS crisis] I am mentally and physically exhausted. Working for the NHS has taken its toll on my health, and on my relationships. Sometimes I go 72 hours without seeing my husband, despite living under the same roof. I reached crisis point in December, when a patient pulled his own breathing tube out. He was thrashing around and being aggressive to staff who were trying to keep him safe, because he was at risk of bleeding to death by pulling his intravenous lines out. One member of staff was bitten and another sprained their wrist. These are people who come to work every day to help others, then leave traumatised and abused. Yet they keep doing their jobs because they care. I want to quit, but because I’m on a skilled worker visa I must work full-time in the NHS for five full years or I face deportation. Next year I will apply for my indefinite leave to remain, then will probably quit my full-time job and just take locum shifts, which are better paid. As I work in critical care, I haven’t been able to strike due to patient safety. But I voted for the strikes, and strongly support all health workers who are striking. I am currently doing two nurses’ jobs but only getting paid for one, and our pay is not matching the increased cost of living. When I moved here in 2019 I managed to save money every month while regularly sending money to my family in India. Now I barely have enough for myself and I am constantly taking on night shifts and weekend shifts to increase my wages. Like me, many international nurses come to the UK so that they can support their families back home, but this is no longer possible. [See also: Focus on prevention to keep the NHS true to its soul] Poor pay is seriously affecting staffing. People are leaving the NHS in droves because the remuneration is so poor. The government has set a target of recruiting 50,000 more full-time nurses, but many will not stay. Many foreign health workers come to the UK for just one or two years because they see it as a steppingstone to work in better-paid countries like the US, Australia and New Zealand. The UK is no longer an aspiration, and I don’t know if it ever will be again. The public might think that we’re selfish or greedy but striking is not all about pay – it’s about patient safety. Day-in, day-out, we’re seeing patients neglected and suffering, and not receiving the care they deserve. The NHS is a sinking ship, and we are running out of time before all the patients and staff drown. I think that everybody, especially politicians, should have to do a few voluntary shifts in A&E to fully understand the horrendous situation we find ourselves in. A hospital should be a place where people feel safe, where death is the exception. Instead, people are dying while waiting hours for care, and suffering from unnecessary medical complications. Sometimes I wish I could wear a camera on my chest and record everything. So, I ask the Prime Minister – come see what it is really like in the NHS. Do a shift as a healthcare assistant in A&E. Come experience the chaos, the death, the critical illness, the overworked staff, the severe lack of resources. Then tell nurses that they do not deserve better. The author is a critical care nurse who lives in London. Read more: I'm a civil servant - here's why I'm striking on Budget day A doctor’s prescription for saving the NHS - Audio Long Reads Just repeating “Reform!” won’t magically fix the broken NHS

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