I did it- I qualified as a mental health nurse. Officially on the register as of approx 10 days ago, and my cohort graduates later this week. The past year has been so hectic that blogging has fallen by the wayside; I had a total of two days off during my final, three-month-long placement, but it was all worth it and I'm graduating with the degree classification I wanted. My current post is in a male rehabilitation unit that isn't yet open, so I have very little nursing to report on (I mean, literally none), but I do have a lot of other things. Brace yourselves, this has been building for a while.
After my penultimate placement, the university planned a mini recruitment day, where several nursing agencies and care providers came in to try to lure us away from the NHS. I was always adamant that I could never work in the private sector- I believe too strongly in the NHS and hate seeing what's been happening to it throughout my training. One of the people who came to speak to us was a likeable guy, and engaged me in a little debate about whether or not private care was contrary to the ethos of the provision of healthcare, and he, in that moment, won me over- our jobs as nurses are about caring for people, and it shouldn't really matter how a patient comes to receive your care.
The company was opening a new unit relatively near to where I live, and he buttered us up with talk of benefits (meals provided on shift! training! hotels!) and I was intrigued. When I encountered him again at a later nursing fair, I laid into him again- surely everything he was reporting was too good to be true? Patients actually moving on from rehabilitation units? Being a person, not a number, to our employer? Ever-expanding opportunities in virtually every area of mental health? I was sucked in, and applied for a newly qualified nurse post.
The unit dazzled me, even with the builders still working away on it- everything was shiny and new and it was obvious that massive amounts of money had been invested in it. It seemed like a good fit for me- the trust I trained in was only offering acute inpatient posts to newly qualified nurses (I had always wanted a community role), and it was closing most of its rehab units. Rehab was the only inpatient setting I imagined I'd want to work in, and it was offered to me on a shiny, new, lucrative plate. I was thrilled when I was offered a job, even though at the time I imagined I'd only stay for a year or two before moving elsewhere.
I'm passionate about the NHS. I'm passionate about social responsibility and I became a nurse to contribute to that, not to work selfishly purely for my own benefit. I've watched, aghast, as the NHS has been slowly dismounted under the Conservative government, and I wear my Never Kiss a Tory t-shirt with pride wherever I can. Being a nurse is a political role- working with people, in any capacity, is more inherently political than it has ever been before- and I've struggled to maintain friendships with people I know voted Tory in this year's election, because I cannot reconcile being human with choosing to destroy people's lives. This may be extreme, but I've worked in social care for several years, and seen, every day, the impact of government decisions on people's lives. Being a nurse isn't going to change the world, but it is going to change people's lives, and that- and that alone- is my motivation for what I do.
Undoubtedly, I will get to do this in my career. I have the opportunity to provide high quality care (with enough staff, with resources, with enthusiasm and motivation) to the patients that pass through the unit I'm working in. I'll get to develop in ways I can only dream of- we're not even open yet, and the hospital director is already speaking of my future as a ward manager. I have everything I've ever wanted out of my career at my feet- and yet I feel uncomfortable, I feel like I'm cheating the system, and that this isn't how healthcare is supposed to be.
I'm not naive enough to believe that I make a difference. In the grand scheme of things, me choosing to work in the private sector or the NHS makes no difference to anybody but me. I am not responsible for the cuts the government is making to mental health services, my choosing to work for a private care provider over the local NHS trust doesn't result in beds being cut and services being tendered out. But am I not complicit in this process of dismantling the NHS by working here? Am I not helping to line the pockets of the fat-cats of boardrooms across the country by walking away from the NHS? I take some comfort in knowing that I don't work in a service where patients themselves choose to take their business, to pay to jump ahead of people in need purely because they can afford to, but is that enough to keep me here?
I'm in a fortunate position. Though patients haven't yet come through our doors, I already know I'm going to have the time and resources to be part of massive, positive changes in people's lives. I'm going to see people get better and move on to happier places, and I feel very lucky- I spent two months as a student in an NHS rehab and couldn't process that some patients had been there since the unit opened fifteen years ago. It largely seemed like a doss-job- most nurses didn't seem interested in motivating patients, and focused their efforts on the handful that had prospects and skills. Those people who were older, or struggled to engage, were left to languish. The unit, and several others like it, is now closed, with patients moved on to more appropriate (and, incidentally, private) placements in care homes and residential units.
Of course, there's a part of me that feels what is happening is inevitable. It was pointed out to me that private care homes for the elderly have existed for heaven only knows how long because the NHS has never been able to keep up with the demand for its services; that the notion of providing healthcare from cradle to grave is outdated and impossible to achieve, even with the most well-meaning of intentions. I don't want to have to agree with this, I want to see a state-funded health service that meets everybody's needs as and when they arise. I want to live in a society that protects everyone, without an upper-tier of benefactors who believe that healthcare should be a paid privilege. Maybe I'm asking too much. Maybe I'm an idealist.
Part of me thinks- if you want to work in the NHS so badly, just go and do it. It would make no difference to anyone but me, after all. But after spending three months on placement with a Crisis Resolution team, I think it would break me. Staff are burned out everywhere you look, and the workloads only increase. I regularly went 8 or more hours without a hint of a break, dashing between assessments and medical reviews and trying to make sure that everything was documented properly- part of me thrives on being pushed, on being busy, but how long is anybody supposed to sustain that level of activity? Whilst I never saw the quality of care slip, I did feel that with more staff, or more time, things could have been that bit better- we could have gone from adequate to excellent care, we could have given people that little bit more of ourselves. There are other services that don't keep their heads above the water like my team did, services that can't even provide the bare minimum for people in need. And this is all part of the plan, of course- make NHS services look bad, reduce funding further (because tax-payers deserve 'more'!), reduce tax for the people it makes no difference to because they can swan off to private services… It makes my head hurt. It makes me feel sick.
My choices are these- stay where I am, develop, provide excellent care for patients, and feel guilty; or move back to the NHS, be crippled by what's happening, but maintain my integrity. I suppose what I do doesn't make any difference either way, but watching from a distance hurts almost as much as being in the fray.
0 comments:
Post a Comment