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Working in the face of adversity: how will you cope?

Marilyn Eveleigh
Consultant Editor

It looks likely that there will be significant changes in the NHS over the next year in response to the economic downturn. So how will we all respond to the challenges we face?

Happy New Year! I sincerely hope the rising concerns and gloom the economic downturn has inflicted upon many of us, our families and our patients, will lighten in 2009.

The coming year does not auger well for many in society. I'm prepared to bet every one of the Nursing in Practice readership knows someone who has looming anxiety, is in present difficulties or has made significant changes in their lives brought about by the recession and rising fuel costs. It might be the pensioner who won't increase their heating for fear of the bill; or you might know one of the many who have been made redundant, with the risk of their home being repossessed by a mortgage company.
It is not just the loss of a job that brings about the stress and hardship endured by many at this time – reduced hours, reduced remuneration, and reduced options to keep financially viable have a significant effect on physical and emotional wellbeing. A recent report highlighted an increase in the breakdown of family units as the strain of financial hardship impacts upon relationships.
An eminent healthcare opinion leader has predicted the NHS will begin to feel the effects of the receding economy and subsequent public borrowing towards the latter part of 2009. With an election due within 18 months, there is unlikely to be a tax increase, so public services are potentially to be the targets for cuts. Already, some healthcare services provided by charities, private partnership projects and suppliers have become the victims of funding cutbacks and collapsed.

For the NHS, cutbacks are likely to affect the acute sector most where economies of scale are easier to generate savings through service redesign and redundancies. Primary and community services may not lose budgets, but what money they do have will need to go further as levels of depression, anxiety, suicide and terminations increase with the stress of the economic situation. Earlier hospital discharges needing patient management and support will reflect the strain of budget cuts on acute units.

All this makes for depressing reading and the media have been accused of hyping up the problems and missing the positive elements of a recession. Apparently, among positive outcomes is the appreciation of those with a job being grateful to hang onto it. There are fewer wage increase demands, we have an infertile culture for strikes and the armed forces have a waiting list for recruits eager to secure a secure job. The high attrition rate in nurse training is already improving. Applicants for public service jobs are at an all-time high, as lower remuneration but a secure post and pension appear a better bet – even for city traders and hedge fund managers.

The population can get physically fitter and emotionally supportive in a recession. They sell the car and walk to save petrol; could this help the national childhood obesity challenge? They eat out less, cook homemade foodstuffs and cut back on comfort treats such as alcohol, cigarettes and chocolate. There is a return to a Dunkirk spirit of support and consideration.

In these tough times, Nursing in Practice will continue to bring you the free journal, eight national conference events, 12 Awards for excellence and the NiP website ( We depend on our links with sponsors in the pharmaceutical industry, equipment companies, charities, educational establishments and government departments – all potentially feeling the economic squeeze. We thank them for their continued support to supply the FREE NiP range – rare, but welcome, in today's economic climate.

NiP is interested in how the recession impacts on your professional role. Please tell us about the upside, the savings you've made, the surprises and the bad news – and where you've found that fighting spirit in the face of adversity!
Best wishes for a challenging 2009!