July is Good Care Month, a campaign spearheaded by the Hertfordshire Care Providers Association to raise the profile of the social care sector. It’s an important initiative. The UK population is ageing, with a greater proportion of people aged 65 and over than under 16. That adds up to more people needing care than those able to provide it, and it’s not just the social care sector. We are dangerously short on nurses, a fact that has only been exacerbated by the recent coronavirus pandemic. We currently have 7.8 nurses per 1,000 people compared to 12.85 in Germany, 11.61 in the USA and 10.46 in France. As the population ages, the need for nurses will increase and the issue will worsen. Add to that the likelihood of another pandemic and we’re in trouble.
In 2019, an investigation by the Labour Party showed that 97,000 nurses had quit the NHS between 2010 and 2018. Full Fact further elaborated on this investigation and noted that with recruitment, the number of nurses in the NHS is going up overall; however, the number of nurses has only increased by 1% while the population has increased by 6.9%, so we still have a problem.
In 2018 the acting Chief Executive of the RCN, Dame Donna Kinnair, said that ‘the answer to the problems [facing nurses] is a comprehensive workforce plan focused on recruitment and retention that links population need to staff numbers.’ If we are going to address the nursing shortage, we need to make nursing a more attractive career proposition, and we need to make the training more accessible.
Reward nurses with more than applause
For ten weeks during the coronavirus pandemic, on Thursdays at 8pm people across the UK stood outside their homes and clapped or banged pots and pans. The ritual was started by Annemarie Plas as a way for ordinary people to show appreciation for NHS and key workers. Plas has since called for the ritual to be stopped, as she feared that it was becoming too political. She said that ‘a clap is something normal people can do, showing our appreciation. But the power is not with us. We can give them respect but we are not signing the cheque – that falls on another desk.’
According to Payscale.com, the median salary for a registered nurse (RN) is £23,000, which is well below the UK average salary of £36,611. Many nurses are struggling to get by, and it’s even been reported that nurses have had to resort to using foodbanks to feed themselves. It’s easy to see why people would choose alternative careers, as people are being asked to choose between their vocation and the quality of their own lives. If we really want to show appreciation for the nurses who have kept the country alive during this pandemic, encourage nurses not to quit and new nurses to train, then we need to pay them a fair wage.
Improve day-to-day working conditions
Nurses are routinely expected to work incredibly long and grueling shifts with no opportunity for a break. Many nurses go the entire shift with no chance and there have even been reported instances of nurses wearing adult diapers because they do not have time to go to the toilet. This contravenes nurses’ fundamental human rights to sanitation. If we had enough nurses for the number of patients, this wouldn’t have to be the case, and our hospitals would be a better environment for patients and staff.
Make nursing training accessible
As of September 2020, nursing students will be eligible for a £5,000 grant to help with living expenses while they study. However, they will have to pay their tuition fees, which, under the previous bursary scheme that was scrapped in 2017 by the Tories, they wouldn’t have had to. If nurses use the £5,000 solely for living costs, they will still graduate with £21,000 in student debt.
Student nurses who had volunteered to go into active service in hospitals were recently insulted by the Minister for Care when she said they were ‘not deemed to be providing a service’ in response to a letter from a student nurse asking if there was any plan to waive tuition fees for the time period they had been working rather than studying.
These factors, combined with the difficulty of accessing higher education for those with caring responsibilities or who are unable to relocate, make studying nursing an unattractive proposition. In response to the nursing crisis in Texas, Baylor University now offers online ABSN programs which allow people for whom on-campus learning is difficult to qualify as a nurse. This sort of initiative, coupled with an improvement in prospects and fees for student nurses, could make studying nursing a much more attractive proposition.
Be prepared for global events like coronavirus
Nurses’ lives have been put at risk during the coronavirus pandemic because of the shortages in PPE. A story broke in April about three nurses who had all contracted coronavirus after being forced to wear ‘bin bag’ style makeshift PPE when the proper equipment was unavailable. If we want people to be attracted to a career in nursing, we have to show them that we are taking every possible measure to protect them. Policy and manufacturing experts at Manchester Metropolitan University have suggested three ways to prevent PPE shortages for future outbreaks: designating the manufacture and distribution of PPE as a sub-sector of one of the UK government’s Critical National Infrastructure (CNI) sectors, meaning that it is recognised as being essential for the functioning of the state; ring-fencing PPE production in the same way as the US does with the manufacturing of uniforms for its armed forces; and implementing a task force to make sure that the first two recommendations are followed.
We could also follow the example of post-war Britain and create a reserve of trained nurses for responding to future pandemics. After the war, nurses that were part of the CDC (Civil Defense Corps) trained volunteers in the community to be prepared for emergencies. Implementing something similar to this could help us to mobilise in the face of future national emergencies.
