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Striking a deal for nurses

Nurses across the country are struggling with heavier workloads and stagnant payIf I had my time again, nursing would still be my chosen career.

It is an honourable profession that supports and cares through the full spectrum of life from birth to death and all that is in between. It adapts to the rhythms of patient needs: over day and night, in calm or frenzy, with emotions as well as evidence. In my extensive professional experience, nursing has responded to public and political demands, patient needs and professional challenges.  

However, the profession is being sorely tested like never before. We are groaning under heavy workloads, inadequate staffing, declining job satisfaction, a tarnished image gained by instances of dire professional practice, static pay levels and poor professional leadership - and are now required to pay £120 per year - a 20% increase -for being registered.

Amazingly, strike action looms in October over pay after the government rejected the independent NHS Review Body's recommendation of a 1% increase, after years of a pay freeze. It is 32 years since nurses have taken such action and it is the first time ever for midwives, who have been supported by a public survey endorsing their strike action.   In this time of austerity, evidence that senior NHS managers pay has increased by 3%, and an individual chief executive received a whopping 15% increase, sends a message that nurses are not valued or the government has got its priorities wrong.  

Yet nurses are needed like never before. Minimum staffing ratios are now a measure of quality and safe care in acute units. The world has been wooed by 75% of NHS Trusts for overseas nurses that will meet the required ratios and fill current vacancies. And the increased numbers of nurses needed for the transfer of care into the community has not yet been published nor has the shortage of mental health nurses and midwives been realistically addressed. With the retirement of many experienced nurses, workforce experts estimate there are around 12,000 whole-time equivalent (WTE) nursing posts vacant in England and there is likely to be a national shortfall of 48,000 nurses by 2016. 

Nurses are a precious but diminishing commodity. The message is clear: more of us are required yet 'thousands and thousands' of us have allowed our registration to lapse. It is hoped these nurses will return to practice through the revamped Return To Nursing (RTN) schemes just launched. RTN schemes in the past became shambolic with wide national variations in content, quality, cost and placements. Indeed, many nurses failed to complete the course as they were ridiculously expected to arrange their own placements.  

Will RTP schemes fare better this time? Under the Come Back to Nursing campaign, no longer will nurses have to pay for their own course as fees will be covered by Health Education England, plus they provide £500 travel bursaries, local practice placements are arranged and there is the promise of a vacant post on completion. The new RTN scheme is a major improvement - and I really hope it will be successful. The thought of caring, mature, life-experienced and motivated colleagues returning to the profession fills me with hope and delight. We must welcome, encourage and support them.

Yet the cynic in me wonders why they let their registration lapse in the first place. Yes, I understand the logistics of family commitments, illness and other distractions or interests.  But I know many nurses personally and through nursing networks that have left because of the low pay, poor job satisfaction, inflexible management and consequent stress. And these elements are still a reality in nursing today.

Ed Miliband has promised a Labour election victory next May would fund 20,000 extra nurses and 5,000 healthcare support workers. Where will they come from? Why would registered nurses come into a profession many are eager to leave if they had an alternative. Paying a decent and realistic wage could do much to encourage nurses to stay - and to return. Increasing the workforce through pay improvement will impact on staffing levels and reduced stress and poor job satisfaction. It will let nurses do the job they aspire to and improve patient safety and the confidence of the public. Forget tinkering around the edges - the political party that promises a pay rise that indicates nurses are valued, gets my vote.