Health

Nurses: ‘We need to tell the people of Ireland we are suffering’

We invited nurses and midwives to submit views on Wednesday’s planned strike action

Damian Cullen's face
Damian Cullen Health & Family Editor
Mon Jan 28 2019 - 15:01

The Irish Times invited nurses and midwives to submit their views on Wednesday’s planned strike action. We asked about their experience of working in the Irish health service, why they felt strike action was necessary, and what could be done to address various difficulties, including recruitment and retention. Thank you to everyone who replied to the callout.
Here are some of the submissions.

1- This strike is different

“I work in the accident and emergency department of one of Dublin’s main hospitals. The post I hold is the same one I left 20 years ago after the nurses’ strike at that time. I realised there was no relief coming. At that time I felt frustrated and emotionally distressed at the conditions my patients were forced to endure. Long wait times, days on chairs and trolleys waiting for beds and little if any action to resolve it. That issue has been largely remedied but not cured. Patients are moved in rapid fashion to wards and ‘extra’ beds as the time approaches to submit the numbers at the end of the shift. It is simply a numbers game and does not represent better care or improved facilities.

“Twenty years ago nurses striked out of frustration born out of an inability to deliver appropriate patient care. This strike is different. This is nurses speaking out for nurses, not their patients. In an area that is supposed to be staffed by four nurses we often have just two. On a 13-hour shift the nurses need to take a break which can result (on a busy day) in one nurse being responsible for up to 25 patients in a given area. That nurse then takes a lunch break, leaving the other nurse in the same position. It is not only dangerous for the patient but for the nurse. One mistake can lead to injuring a patient, losing a license to practice and ending a career.

“New staff will not come to work here. Agency staff have all but vanished. Nurses can go to the Middle East and earn twice the salary they do here. Senior and junior staff are leaving each month due to frustration and fatigue. They are not being replaced. Equipment failures, stock shortages, old and inappropriate facilities, promises of new this and new that are never realised. Pay and conditions have actually degraded over the 20 years since I worked here. As part of the last pay agreement, nurses took on more responsibilities, tasks, training, additional hours per week and now work ‘a day for free’ roughly every five weeks. This leads me to conclude the unions must be representing the HSE and not the needs of their members. The only other explanation is that they are weak, ineffective negotiators. Nurses want to work. They want to deliver world-class care to their patients. They are incredibly angry with the current situation and this strike is definitely about pay and conditions but not for the patients sake. If the outcome of this action is not decisive and immediate, many of my colleagues have voiced their plans to leave public nursing for the private sector.”

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2 - Nursing isn't a vocation

"I love being a nurse. Sometimes I feel the need to put 'unfortunately' at the start of that sentence. Unfortunately, I love being a nurse. I work in emergency and love the diversity of all patients of all ages. I love the adrenaline rush of the emergencies. I love that in a few hours I can make a difference and send you home feeling better than when you walked in. I have a four-year undergraduate degree in general nursing and a postgraduate diploma in emergency nursing. I don't love living at home because I can't afford to save and pay rent. I don't love that my brother makes more money as a waiter. I don't love missing breaks because we're short staffed. I don't love having to cancel any plans I had after work because I'm so exhausted. I don't love telling my patients there is a 10-hour wait to see a doctor. I don't love telling an 80-year-old woman we have no spare trolleys and I have to sit her on a chair. My friends in Australia won't come home because they can't justify my salary and Dublin rent prices. Every few months another one of my colleagues cracks and hands in their notice to go abroad or quit nursing completely. Nursing isn't a vocation - it's a highly trained and skilled job. We shouldn't have to put up with poor wages and working conditions just because we chose to pursue a career in nursing.

3 - This is wrong

"Why do nurses start on just €1,000 (per year) more than level 5 qualified healthcare support workers, and €6,500 less than equally qualified (level 8) health care professionals? Why do nurses have to work for six years to get to the starting salary of that healthcare professional? Not all nurses get allowances, not all nurses work unsocial hours to make up the difference. And even if they do, they are working dreadfully antisocial, unfamily-friendly shifts to do so. It's abuse of a group of a critical mass, and just because there is a large number of nurses and the wage bill multiplied by the mass is big, it doesn't make it any less fair. I know of two nurses, recruited from Italy, who are unable to pay their union membership to protect themselves through the strike, because they can barely afford rent and utilities, never mind have a life. This is wrong, and it's time for the government to accept it is wrong. I'm nursing nearly 30 years, this is my second strike, I hated the last one, I hate this one, but I also hate the constant struggle to provide the service with ongoing vacancies, loss of young staff and fighting to attract the next applicant who will hopefully be willing to give us a go, before we lose the next one, two, three or more."

4 - Look after us like we look after you

"I have been a nurse for over 10 years, I have a degree in general nursing, a degree in nursing management and a masters in nephrology nursing. I have worked in Saudi Arabia, Australia, and the UK. I returned home to Ireland due to family illness. If this had not been the case I would not have returned home. Irish nurses are greatly respected and sought after overseas due to our work ethic and dedication to our patients. We do not receive the same respect here at home. We need our nurses to stay in Ireland, we need our nurses to return home to Ireland. The healthcare system is not meeting our patients needs now, it will definitely not meet our patients need in two, three, four years' time. Our health system is not fit for purpose, the cervical screening, the overspend on the children's hospital. Nurses are the backbone of the HSE. Look after us like we look after you. Stand with us and support us."

5 - At least none of the patients died

“Patient needs are just growing. One nurse cannot safely look after 10-12 patients - it’s just bizarre. When I started out in nursing my colleagues and I used to say jokingly, ‘well we got through that shift, at least none of the patients died’. But this joke is a daily reality for some nurses. People do die and that’s the reality. But they shouldn’t die as result of burnt out nursing staff who just simply cannot provide the nursing care that is required. That’s why nurses need to strike. To tell the government and the people of Ireland that we are struggling and that we need to be recognised like others professions are. The pay we receive does not reflect the sheer physical and psychological hurdles we have to overcome everyday. I’m not doing it for myself, I’m doing it for my colleagues.”

6 - I miss being a nurse

“I’m a highly trained ICU nurse with a post grad in cardiovascular nursing and eight years experience. I left nursing six months ago to manage a hair salon and I am more than happy with my decision. I always knew nursing was a stressful job but it’s now I realise the extent. The people I work for care about me - I’m not ran into the ground or just a number. I miss being a nurse but my life has improved greatly and I earn the same wage without having to work myself to the bone. The management system in the HSE is appalling and there is no support for nurses.”

7 - Management don't come near the patient

“I am a senior staff nurse with 20 years experience in the acute hospital setting, specialising in theatre nursing. I am cheap labour. I do the work of two nurses daily. I deal with angry and distraught patients because, more often than I would like, I am the one who tells the patient that their surgery has been cancelled because there are no beds. Hospital management don’t come near the patient! It’s me! I take their anger and their tears and their frustration. And it has taken it’s toll. I am done making excuses for our health service and apologising to very sick, scared people for the hospital cancelling their surgery because of something I have no control over.There are no beds, there are not enough nurses. I am helpless to help them. Enough is enough.”

8 - This can't be real can it?

“I would love to say I’m striking solely to restore pay so that I have more money at the end of the month (because I badly need this). But the real reason I’m striking is in the hope that a restoration in pay will result in better staffing levels in our hospitals. I qualified in 2016 and it has honestly been a battle every day. There have been too many days or nights in work where I’m left thinking, ‘this can’t be real can it, surely this is just a bad dream’? Because the staffing is just that bad that you wonder how you’ll ever get to all of the jobs on your list. Breaks, toilet breaks, or even getting out on time become so low on your priority list. I’ve driven home in floods of tears too many times. Without restoration and better conditions I cannot continue in this profession.”

9 - A pay increase won't halt the flow

“The suggested pay increase won’t halt the flow of Irish nurses out of the continent to places such as Oz and UAE, as one attraction to nursing for many people is the opportunity to travel. It might stem the flow somewhat by reducing some graduate’s beliefs that in Ireland they are not respected nor properly paid for the work expected of them and that to obtain the respect and pay deserved they must emigrate. The main goal and likely outcome of this pay restoration/increase is to make ‘coming home’ a realistic and more attractive option for people who have completed their year or two travelling and working abroad. At the moment more and more talented Irish nurses are found to be of the mindset that while they would love to come home, why would they leave the country where they make more money for doing the same work in a safer work environment. Countries where the native nurses are perplexed at the idea of nurse-to-patient ratios above 6:1. In the past six years I have not met anyone from the public who doesn’t think nurses should be paid better. I’m sure one or two of these people exist however they have likely never been in a hospital themselves. We are not looking for an increase in wages for the sake of the money. We feel this is the best solution to both retaining more graduates and encouraging our own people to come home. It also will hopefully give current staff more incentive to tough out these unsafe times with hope of a better future.”

10 - I have chosen to stay in Ireland and I am being punished

“I love my job and cannot see myself being in any other occupation. However, we are short nurses weekly. No extra cover for sick leave, nurses working overtime for nothing – hoping no one will fall or get hurt. Listening to people giving out that they have been waiting for the bathroom when you might have been holding your bladder since morning in order to assist the last few people out of bed and to wash and get dressed. Hoping family don’t come in and see their relative in bed at 11.45am even though you haven’t stopped or had a chance to get a cup of tea since waking. Not being able to spend any time with someone that needs your time because call bells are ringing and all staff are already tending to patients. Too many people requiring constant supervision and nobody to watch them. Going to work early so the night nurse will get home at a decent hour of the morning. Getting home much later than you should and not seeing your little boy for days. No extra pay and no thanks.“Expected to drop everything and put work first and try everything to make sure everyone is happy because God help you if anyone complains these days. Wishing you could do that little extra for certain people because they might be having a bad day or week or month, but you can’t because you do not have the time. No time because of all this crazy documentation to cover your back in the case of something going to court. Being upset about treatment from patients, threatened, punched, kicked, spat on, bitten, scratched, grabbed by the behind. No funds for security. Nobody cares. I feel like a slave some days and belittled. I question why I am in the job I am in. Why didn’t I pick an easier one. I am working hard full time with an infant at home, trying to pay a mortgage and bills. Just about meeting them every month. Do I not deserve more? I have chosen to stay in this country but see others who have travelled having a great time and talking about how much they love their jobs. I have chosen to stay in Ireland and I am being punished.”

11 - It's not surprising so many choose to go abroad

“The wage for nurses in Ireland is just not competitive compared to other countries, especially with the cost of living and trying to pay rent within a reasonable distance of most hospitals. Unfortunately, it seems the only way to get past the retention and recruitment issues is better pay – this is a bitter truth the government won’t accept. Most nurses will report staying late (unpaid) to get things done, working unsociable hours, the heavy emotional burden of the role etc, but all of this would be easier to stomach if there was enough of us to safely care for patients. Right now, there isn’t. It’s not surprising that so many nurses choose to go abroad and get better pay with half the patient caseload. The government are supremely unconcerned that nurses in Ireland have our nursing registration at risk on a daily basis by being placed in unsafe conditions. The unwillingness to listen to our concerns seriously shows an astounding apathy towards our patients across the country, and towards us as a profession.”

12 - I nearly had a nervous breakdown

“Three years ago I had to leave the job I loved. I worked in a busy A&E. I trained hard for my position there, I did endless additional courses and a post grad in emergency nursing. I truly loved the buzz and the pace of working in that environment. But I couldn’t do it anymore. I nearly had a nervous breakdown. The stress of watching patients suffer waiting on beds, the indignity they were forced to endure at their weakest hour just became to much to witness anymore.”

13 - I went 72 hours without seeing my babies awake

“I am a nurse. I have years of experience and qualifications coming out my ears. I work my ass off every.single.day. This week I worked 65 hours over a six-day period. I went 72 hours without seeing my babies awake. They are asleep when I leave for work and asleep when I get home. I spent one day with them and then I was gone again for another 48 hours. I got paid €1,000. I am worth more than this to my family, to my patients and to myself.”

14 - You never feel you can give them the care they deserve

“As a fourth-year student just after starting my internship in a very busy and demanding area, the question I’m asked numerous times a day every day is ‘will you leave the country now when you qualify because you should’. Imagine starting your career and hearing that on a regular basis. Patients know better than any man/woman sitting behind a desk in HSE head offices or in government what it is like to work in these places and, even though they are so grateful for the care they receive, you never feel you can give them the care they deserve due to the demands of the job.”

15 - There are not enough nurses

“I just want to be able to provide the best care for my patients. To do so more nurses are required. There are not enough nurses in this country, I don’t think anyone disagrees with that. To encourage nurses back to Ireland we need to change the conditions that we all work in. The first step in this is bringing pay in line with all other allied health professionals. The next step is to facilitate continuing education and encourage nurses who wish to obtain further qualifications and provide some level of work-life balance. All this will result in safer and more timely care for all the patients we look after.”

16 - Treatment of nurses here compared to Sydney is a disgrace

“I have moved back to Dublin last year from Australia after 20 years nursing there. I am back with my young family to help my elderly father. I do one 13-hour shift to keep my hand in at a big hospital.The treatment of nurses here compared to Sydney is a disgrace.The nurses here tolerate too much, they need and deserve financial and professional recognition.The HSE and government must listen. !This is unfortunately the only way for them to take us seriously. We are looking for justified pay resolution and parity.”

17 - The stress and I was under I will never forget

"I've been a qualified nurse for almost two years – working on a busy oncology ward. We are met with huge demands from patients, family members and managers daily, regardless of how understaffed we are. I was the most senior nurse on one weekend, where complaints and queries were all sent to me – this is completely unacceptable and outrageous, the stress and I was under that weekend I will never forget. Every month I hear of another colleague leaving for Australia and Canada for better working conditions and better pay. That will be me in September – as I fear for my mental health and my nursing pin I worked four hard years for – if I continue to work in these working conditions."

18 - I can not stress the danger of the situation

“I am a fourth-year nursing student who started internship on a 23 bedded surgical ward three weeks ago. Yesterday I worked a 13-hour shift at €9 an hour (by the time taxes are excluded), whilst being solely responsible for a case load of 11 perioperative patients because one of the two registered nurses rostered that day was pulled to another ward. I can not stress the absolute danger of this situation as a student who is seen as half of that of a staff nurse. By the time I reached first break (10.30am) one of my patients had suffered a major stroke, one with severe mental illness had threatened to kill me and another of my patients (who I need to protect) with a metal IV stand and my most recent post operative patient had begun to haemorrhage and deteriorate rapidly ending up in ICU. I am so far from equipped or trained to deal with any of these situations. I don’t know how I managed to put off my complete physical and mental break down until I got home that night. And I am counting down the days until I graduate and move to Australia.”

19 - Unlikely I will ever return to my midwifery career in Ireland

“After qualifying as a midwife I decided I could no longer work in a system where midwives where being burnt out from trying to support women within a service that was over medicalised and seeped in hierarchal power structures. I left for the UK and worked as a midwife, where I was given numerous opportunities to progress my career and specialise in an area that I was passionate about. Yes, the UK maternity services had issues with staffing and pay, but overall I felt happy there. I was able to practice midwifery in a way which was kind and compassionate to women and their families. Women’s choices were respected and midwives had an important role in advocating for those choices. On returning to Ireland I was offered midwifery jobs, however the work being proposed was very different – the contract was temporary; it was not made clear where I would be working; my previous experience was not taken into account and when I asked about career progression; specialising and upcoming trainings my questions were left unanswered. The hierarchal power structures of the past were very evident. I spoke to colleagues who have been understaffed working on the same ward for years, with little opportunity of career progression or having adequate supervision. My colleagues story’s reminded me of the system I had left and it became clear to me that I would not survive within it. I’ve come to a point now that it’s unlikely I will ever return to my midwifery career in Ireland and this upsets me deeply. For me, it is not so much about the pay but about the system.”

20 - Imagine my worst day in work

“As a prison nurse and my partner a midwife and mother of our two children, I believe we deserve pay parity. Imagine my worst day in work and my partner’s worst day – maybe a stabbing on a landing, an overdose, a miscarriage, emergencies, seven night shifts in a row. Now let’s look at the pay. As a nurse of of 20 years I have reached my full potential €47,568, but what about the extras, weekends, nights, overtime? As it stands ,both myself and partner have six days off together a month, although one of us would most likely be finishing a nightshift during that period. Both my partner and I have, like all nurses, worked countless hours for nothing. Our combined wage is embarrassing for our levels of experience. Enough is enough.”

21 - Nurses are exploited in every single way

“Why am I striking you ask? Because 20 years ago I trained as a professional, four hard long years, and I then went on to save lives, save children, save teenagers, save adults. I’m not a doctor, but I’ve taken a lot of their jobs on. I’m not a OT but I still do their job because they don’t work after five. I’m not a physio but I still mobilize my patients. I’m not a social worker but I still plan for discharge. I’m not a secretary but I still file and write and prepare mountains of notes. I’m not a phlebotomist, but bloods tell me how the patient is doing. I’m not a cleaner but I still clean the equipment, and the floors after someone has vomited. I’m not a chef but still prepare patients’ meals. Nurses are just a single job description. Nurses are exploited in every single way, and deserve far more than we get. Why does a teacher earn more? Do they save a life? Why do they get such recognition? It’s unjust and quite simply not fair. I’m tired, tired of feeling like this.”