Posted 22 May 2021 - 22:00
Posted 22 May 2021 - 22:00
Analysis
Demoralised and let down: your response to pay offer ‘insult’ after year of COVID sacrifices
What nurses told a Nursing Standard-Sunday Mirror survey about pay, staffing and the pandemic
What nurses told a Nursing Standard-Sunday Mirror survey about pay, staffing and caring for patients throughout the pandemic
- More than nine in ten respondents say they don’t feel valued by politicians in power and many feel the pandemic has done little to change perceptions of their role
- Results show risk of exodus from the profession is very real, warns RCN, unless ministers respond to calls for a significant pay rise across the UK
- Respondents say with too few nurses care is compromised, further contributing to a demoralised workforce
Nine out of ten ‘demoralised’ nurses don’t feel valued by politicians in power, a joint survey by Nursing Standard and the Sunday Mirror suggests.
More than 1,600 people took part in our joint poll, which reveals a profession pushed to the brink amid the pandemic, with respondents describing long hours, staffing shortages and feeling ‘insulted’ over their level of pay.
Pay rise suggestion ‘a kick in the teeth’
The RCN said the findings of the survey should send shockwaves through the government, while Unison said nurses have been ‘betrayed’.
After working through the COVID-19 pandemic, respondents described the Westminster government's suggestion of a 1% pay rise for England in this year’s pay round as a ‘kick in the teeth’.
‘After all the pressure at work and the personal sacrifices, the pay rise proposal felt like an insult to my profession’
Survey respondent
Some 77% (1,237) described morale as being poor or at rock bottom, and only one in ten nurses (12% or 190 ) felt they were paid what they deserved.
One nurse said simply that they were broken, another that the profession was tired and burned out.
The publication of our survey findings come just days after nurse Jenny McGee, who cared for prime minister Boris Johnson when he had COVID-19, resigned, saying the 1% offer showed a lack of respect for the profession.
Early retirement an increasingly attractive option
Nurses describe struggling to pay essential bills, including rent, mortgage, food and heating, and having to work hours of unpaid overtime to try and complete work.
Almost half of respondents (43%, or 697) admitted they are considering quitting the NHS. Many said taking early retirement was an increasingly attractive option.
One nurse told the survey: ‘Have given 45 years to the NHS and would like to give up nursing.’
While some respondents said they have decided to take retirement earlier than they had initially planned, others are considering moving to Australia, Canada or Dubai post-pandemic on the promise of better pay, or considering a career change.
The NHS was already facing a huge shortage of nurses before the pandemic; in 2020, the RCN estimated there were 50,000 nursing vacancies in the NHS in the UK.
The twin pressures of COVID-19 and pre-existing staff shortages is putting an extra strain on those still there, nurses said.
‘We are a small ward but have lost over ten nurses and more than 100 years of experience,’ one respondent said. ‘This leaves the remaining nurses stressed and exhausted trying to train up new staff and cover shifts. I and most of my colleagues are looking to find new careers.’
Visit our well-being centre‘Risk of an exodus from nursing is very real’
When it came to what would stop respondents leaving, the highest score was for fair pay, chosen by 70% (992) of respondents. This was followed by safe staffing, at 61% (868), a better life-work balance, at 54% (770), and better career opportunities, at 31% (438).
RCN acting general secretary Pat Cullen says the survey findings should force a ministerial rethink on respect for nurses, who have given so much during the pandemic.
‘Ministers have shown gratitude, but unless they start to demonstrate respect for our nurses, the risk of an exodus is very real,’ she says. ‘This has to start by giving them the pay rise that finally recognises their skill and professionalism, and realising health and care services need people and not just beds.’
Many of our survey respondents suggest the 1% pay deal proposed by the government for nurses in England is the final straw after an exhausting year. It was repeatedly described as insulting, devaluing, shameful, derisory, appalling and demoralising.
Many found it particularly troubling as they had put their own health at risk while working on the front line during COVID-19.
‘Personally, I felt very offended about it,’ one said. ‘The conditions we have to work [under] during the pandemic have not been great, and after all the pressure at work and the personal sacrifices, the pay rise felt like an insult to my profession.’
Another said: ‘Disgusting. Facing what we have this last year. Looking someone in the eyes as they gasp for every breath, knowing it could be their last and doing that over and over again. Only nurses know how that feels.’
Personal risk ‘taken for granted’
Respondents described how they felt they had put themselves and their loved ones at risk while working in difficult and traumatic circumstances.
There was a strong feeling of nursing being entirely undervalued and underappreciated by politicians. ‘I feel like a disposable human being, they do not even care if we die while at work,’ one said.
‘A real kick in the teeth for the tremendous hard work we have done this year,’ said another. ‘Nurses put their lives on the line to save others and for this not to be recognised is disgraceful.’
Another said the 1% pay suggestion ‘makes me feel that everything I have been through in the last year has been taken for granted’. They added: ‘I caught COVID-19 early on and my family suffered as they all got it from me. My mum ended up in hospital for four months and is now on oxygen. Just because I went into a patient’s home with unknown COVID-19 and shortage of PPE in April last year.’
How Nursing Standard conducted the survey
Nursing Standard and the Sunday Mirror asked UK nursing staff their views on pay and their experiences working through the COVID-19 pandemic.
The questions were asked using online tool Survey Monkey and the survey ran from 24 April to 9 May 2021.
It was promoted via email to registered users of RCNi.com, in our online news articles and on social media.
We received 1,621 responses and the initial findings were analysed by Nursing Standard staff.
Unequal pay across the UK
There was deep frustration that nurses across the UK were not getting the same deal, with those in Wales and Scotland having received a £500 bonus. Now a 4% pay rise for nurses in Scotland is to go ahead, despite the offer being rejected by two nursing unions, whose members say they want a fairer deal.
Survey respondents say their pay is lagging behind that of other public sector roles, and among those at the top of band 5 and 6 in particular there is anger that without incremental increases their pay is slipping further behind.
One said: ‘Being top of band 6, I do not get annual pay increases and have not for years. In the last eight years my pay has hardly changed, but my bills and cost of living have risen significantly.’
The RCN says the pay of an experienced nurse has fallen by 15.3% in real terms over the past ten years, and is calling for a 12.5% pay rise for the 2021-22 pay round.
‘It is a joke that after three years at university and over 15 years’ experience as a qualified nurse specialising in critical care, I get £15.50 an hour. There is no chance of a pay rise as I am at the top of band 5’
Survey respondent
Many respondents voiced despair at the constant financial struggles they face living on their income, and frustration that the skills, training and education the profession demands are not better rewarded.
‘I’m struggling to afford rent and council tax,’ one said. ‘The food prices grow day by day, often cannot afford healthier options.’
Some said despite their experience and education, they earned little more, and sometimes less, than family members who are cleaners, work on supermarket checkouts or in hospitality.
‘It is a joke that after three years at university and over 15 years’ experience as a qualified nurse specialising in critical care, I get £15.50 an hour. There is no chance of a pay rise as I am at the top of band 5,’ a respondent said.
Some general practice nurses said that their experience, outside of the NHS Agenda for Change pay scale, was even worse. ‘I've not had a proper pay rise in 20 years, and our terms and conditions are abysmal,’ one said.
Pay rise to boost post-pandemic recovery
Unison says the survey findings underscore just how much nursing staff need – and deserve – a pay rise.
‘Nurses and the wider NHS workforce feel betrayed by the government after giving their all during the pandemic,’ says head of health Sara Gorton.
‘As these results show, many are considering walking. That would worsen the already huge problem of staff shortages and make the post-pandemic recovery even tougher.
‘A significant pay rise is essential to show NHS staff they’re valued, lift morale and help the entire health service bounce back.’
However, a small minority of respondents said that, in light of the economic impact of the pandemic on the country, they understood why proposed pay increases were small.
‘How can this be safe?’: the extreme pressures of short-staffing
Nurses are often unable to give the quality of care they want to, as they continue to struggle with staff shortages, the survey heard.
For those who said they were considering quitting the NHS, safe staffing ranked second only to fair pay in terms of what might convince them to stay – at 61% versus 70%.
Seven out of 10 (1,120) respondents said they sometimes or never have the time to deliver safe patient care. Many said they had to work hours of unpaid overtime and skip breaks to try and complete care.
‘Most of the time nurse-to-patient ratio is unsafe. We are always working against the clock,’ one said.
Another added: ‘I always ensure safe care, even if that means late breaks and remaining on ward after shift to carry out paperwork.’
Care is inevitably compromised
One nurse said they often had to care for 12-14 patients alone, so felt unable to give the safe, personalised care that patients need.
An emergency nurse said they had often had to single-handedly care for three very seriously unwell patients in resus at one time, one of whom might be a child. ‘How can this be safe?’ they said.
The shortage of staff means that patient care is inevitably comprised. ‘Pressures are enormous,’ one respondent said. ‘You have to spend as little time as possible on each patient to get the priority workload done only.’
The RCN is running a campaign calling for UK-wide legislation to ensure that there are sufficient numbers of skilled nurses to provide safe care.
In Scotland, the Health and Care (Staffing) (Scotland) Act became the first legislation of its kind in the UK to apply to all clinical groups in health and social care services. And in Wales, a consultation on extending the Nurse Staffing Levels (Wales) Act 2016 – which currently applies to adult acute surgical and medical wards – to paediatric inpatient wards closed on 16 December 2020.
But no such legislation exists in England and Northern Ireland.
Little understanding of nurses’ true role among politicians
After all the clapping and being feted as heroes by politicians during the pandemic, the majority of survey respondents felt little had changed in appreciation or understanding of nursing as the crisis eased. A number suggested that more politicians spent a day with front-line nursing staff, to understand the role and the pressures staff work under.
Frustration and anger was expressed at shortages of personal protective equipment during the first wave, initial difficulties with testing, the shortcomings of NHS Test and Trace, and the point at which the government began lockdowns.
‘I feel like a disposable human being, they do not even care if we die while at work’
Survey respondent
Nurses were ‘lambs to the slaughter’ during the first and second wave, one remarked.
‘Words and claps don’t pay bills,’ another observed. ‘We have been badly let down.’
The proposed pay increase and lack of understanding of the impact of working through the pandemic unsurprisingly factored in nurses’ sense of the profession being demoralised.
‘My experience is nurses are worn out, feeling devalued and worthless, emotionally drained, empty and numb,’ one respondent said. ‘I caught COVID-19 and now have long-COVID and battling to keep my job. The pandemic has changed my life permanently.’
While respondents often suggested that they had been pushed too far by recent circumstances, many spoke of their sadness at feeling driven away from or undervalued in the job they have loved.
‘Love being a nurse, the smile I put on patients’ faces keeps me going after the last year,’ one said. ‘[But] it would be very hard to restore my faith in the NHS and the government. We have been used terribly.’