Each morning, Millie would wake for her shift in one of London’s Accident and Emergency departments and dread the WhatsApp messages waiting on her phone. The team were three nurses down, or five, or eight, ’Could anyone do an extra shift?’ a manager would ask.
Each night, she would end the day in tears – and fall asleep dreading the next. Until after four years in nursing and two in A&E, she left.
“I didn’t want to leave, I love being a nurse, but I was in tears every day,” she says. “The stress, the dread, became unbearable. I was physically and emotionally exhausted and just couldn’t do it anymore. Whatever the opposite of rewarding is – that’s what my job had become.”
Up to 100,000 nurses – a quarter of those in England, Wales and Northern Ireland – are set to strike this month.
The walkout, planned for December 15 and 20, will be the Royal College of Nursing’s (RCN) biggest ever as they look to force better pay. As RCN general secretary Pat Cullen put it: “We've had enough of being taken for granted and being unable to provide the care patients deserve.”
Millie, 27, joined the profession because she wanted to help people: “I felt that if I did medicine, became a GP, I wouldn’t be able to give patients the time I hoped nursing would allow me to.
“At first, I loved the fact that A&E was nurse-run, that I was part of a team and could constantly learn. When someone came in very unwell, then improved, you knew you’d been part of that difference. If they didn’t improve, you’d provided them with dignity at the end of life.”
“With every added hour, every new patient through the door, every delay, the pressure built. There were plenty of times when it felt unsafe.”
But the pressure, made worse by Covid, mounted. On Millie’s busiest days, there would be 400 patients coming through the doors. She might be managing 20 beds at a time or scrambling to find places on a ward for patients who’d been in the department for nearly 24 hours, far beyond the hospital and government targets. She would feel the anxiety rise through her body as she looked out into a full waiting room while ambulances were parked up for four hours at a time in bays, trying to deliver more occupants.
“With every added hour, every new patient through the door, every delay, the pressure built. There were plenty of times when it felt unsafe.”
Tensions grew among staff, too, with nursing teams often down by as much as one-third. Some 25,000 nurses left the profession in the UK last year, according to the RCN, and there are 47,000 unfilled registered nurse posts in England’s NHS alone. Meanwhile, A&E wait times for patients have exceeded 12 hours in some of the country’s busiest hospitals – three times the four-hour goal.
"We had one nurse on a break, leaving two of us with a man in his seventies who had a head injury. He suddenly went into cardiac arrest while we waited for a doctor."
In some of her worst moments, Millie remembers feeling helpless to improve things. She says: “There was one awful shift, at the peak of Covid, when we had one nurse on a break, leaving two of us with a man in his seventies who had a head injury. He suddenly went into cardiac arrest while we waited for a doctor. It was like a trauma scene, blood everywhere and just the two of us doing chest compressions for almost an hour til, eventually, he was pronounced dead. It was the first time I cried in A&E, but it was so busy and so high-pressure that we were just expected to move on. I was sent on my lunch break. There’s no support available after something like that.
“On another occasion, I was the most senior nurse in the resuscitation area. We had six patients; one was about to go into cardiac arrest, another had internal bleeding, and one had seizures. We were stretched to the max, and the one doctor was shouting me down because I thought we should send for another to help. When I was called in by a manager the next day I was told, ‘Sometimes you just need to know the hierarchy.’ Nurses find that soul-destroying.”
"You can't wait until life isn't hard anymore before you decide to be happy."
Nurses were paid £35,680 on average in the year to April 2022, which, due to inflation, left them worse off, in real terms, than a decade ago, say the RCN, which is demanding a rise of 5% above inflation. The government has so far refused formal pay negotiations, and this month’s strikes are set to affect just over half of NHS trusts, including cancer care and children’s wards, although emergency care will still be provided.
“Morale became very low,” says Millie of the months before she left, in November 2021.
“We were threatened, by patients or visitors, every shift. Racism and antisemitism, violence, and abuse towards us became part of the job. One abusive patient followed a nurse home. Another threatened to fight me outside.
“At one point I took two weeks off with anxiety; prior to that I hadn’t even taken time off when my dad died.
“The worse was when I didn’t feel like I had the support of colleagues or the doctors anymore. I lost trust in the organisation that was meant to support me and I stopped believing I was any good at my job.”
“I still think about returning to the NHS, but I can’t face those feelings of dread again or the fear that something will go horribly wrong.”
Her job now – doing disability assessments over the phone – is a long way from the busy demands of A&E that she trained for. Meanwhile, the NHS is paying agencies almost £1 billion a year for locum staff to fill the gaps left by people like Millie, who felt too depleted to carry on. “My job now is not one I ever wanted. I still think about returning to the NHS, but I can’t face those feelings of dread again or the fear that something will go horribly wrong.
“On Christmas Day, two years ago, a colleague and I ate our dinner in the department. On a 12.5-hour shift, toilet breaks were few and far between.
“It’s not a job where you can press the ‘stop’ button or limit who comes in. I’d go to call someone’s name and fear the looks of every other patient who was still waiting.
“Sometimes, the dread started the night before, when I’d see the holes in the staff rosters for the next day.
“The strike is being put down to money, but nurses just want to be paid fairly. I miss doing the job I trained to do, the job I’m good at. I miss being a nurse. I just wish there was a safe way back.”
