Fabulous pay rates. Generous cash bonuses. Access to the latest technology. The chance to enjoy world-class skiing, tuck into exotic foods or just enjoy a romantic walk along a beach at sunset. Welcome to the new career structure for the British nurse.
Sadly, it is not in the NHS. It's offered through proliferating recruitment web-sites such as ogradypeyton.com or the interestingly named hotnursejobs.com. Hawaii, Florida and San Francisco are the enticing replacements for Huddersfield, Faversham and Southampton.
The promises seem to be working. The latest figures reveal that the number of UK nurses who leave to work abroad has risen by a third. The number going to the US has doubled in a year.
Who can blame them? Here, they get vomit-strewn wards, violent patients and assurances from the Royal College of Nursing that the new Channel 4 drama No Angels represents just "a missed opportunity to tell people the truth about nursing". The RCN doesn't seem to understand that if nurses aren't having fun shagging in linen cupboards, spiking doctors' drinks and running rings around the patients, then it will be hard to attract anybody to the job.
The government has made efforts. The NHS has recruited 55,000 extra nurses since 1997. And, last year, nine out of ten nurses voted for the new NHS pay system, terms and conditions known as Agenda for Change, with a 16 per cent pay rise over three years. Yet the NHS still needs to find 35,000 more nurses during the next five years--while at the same time a quarter of the workforce is due to retire, and up to one in five nurses drops out before the end of training.
Speak to those who've gone into nursing, and their enthusiasm shines through. "Tell me, in what other job could you look after a professor and a prostitute on the same day," said one imaginative recruit.
But the RCN claims that nursing is still seen too often as a low-status, "doctor's little helper" job, with dreadful shift patterns. A recent MORI poll found that more than one in ten nurses plans to leave the profession in the next two years, chiefly because of those shifts.
Others say that, thanks to changes going back to 1966 (when the Salmon report led to the reorganisation of nursing structures, including doing away with matrons), the real problems go even deeper.
Nursing, they say, has become divorced from caring, sisters have been reduced to ward managers, and degrees and diplomas have become more important than bedpans and bedside manners.
What's the solution? People aren't ill just between the hours of nine and five. Shift patterns are an occupational hazard of hospital life--though more employers, as King's College London has done, could allow nurses to decide among themselves which shifts to cover.
The truth is that it is mostly migrants who tolerate the antisocial hours. Nearly a third of London's nurses now come from abroad, while home-grown graduates opt for more family-friendly jobs in schools or GP practices.
Although Agenda for Change, with its discretionary fringe benefits and weightings, is a step forward, the RCN and the government should take it further and look at a proper system of arranging pay more explicitly by region.
This should not be about setting trust against trust, but realising that regions have very different needs. Paying nurses the same in Southend and South Shields doesn't mean an exodus by Essex nurses to the north-east, where their money goes further. It just means Southend nurses don't stay in the profession--or go into it at all. Until we get to grips with that, more trusts will follow the one now trying to recruit in Dubai, and more British nurses will sign up with hotnursejobs.com. Or become script consultants on No Angels.
COPYRIGHT 2004 New Statesman, Ltd.
COPYRIGHT 2004 Gale Group
