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TEAM ZOELLA MAY 12, 2022

Celebrating International Nurses Day 2022: “It takes a lot of empathy, quick thinking and a strong stomach”

Here we’re celebrating the best of humanity and the life and soul of the NHS - the people behind the PPE and the moments that made them the remarkable nurses they are today. 

Today is International Nurses Day, a day observed around the world on 12th May – the anniversary of Florence Nightingale’s birth – to recognise the contribution nurses in the UK and around the world have made to society. 

On the frontline throughout the COVID-19 pandemic, they have faced the most unprecedented challenges over the past two years whilst leading patient care, and this day offers a chance to learn about the reality of the work they do day in, day out and the issues they face whilst simply trying to do their job just like the rest of us. 

Whilst the weekly applause and rainbow drawings displayed in windows may have disappeared, this annual day acts as a reminder to give thanks for the incredible work they do to put the needs of strangers before their own. 

Here we’re celebrating the best of humanity and the life and soul of the NHS – the people behind the PPE and the moments that made them the remarkable nurses they are today. 

Chloe’s Story 

My route to nursing wasn’t traditional. I didn’t do well in college and didn’t have a  career path/plan in place. I was already working in housekeeping in the hospital, then went on to work in care and radiology. I knew I wanted to make nursing a career, so I applied for an access course and then went to university. I am now a Nurse Practitioner in primary care, looking after patients with both acute and long term conditions, cervical screening, childhood immunisation program, travel health, COVID-19 vaccines, flu vaccines and palliative care. 

I was shielding during the height of the pandemic due to my own health issues so I worked from home throughout. It took a while to adjust. A visual assessment of a patient is key to nursing, as you can imagine. It helps highlight other ongoing medical/social issues, so not being able to see patients or how patients were presenting, and not being able to use visual cues to complete a holistic assessment was tricky. This meant that appointment times increased to try and pick up on things that would be easily identified face-to-face.

There is a very real issue with burnout and mental health issues following the peak of the pandemic and what was witnessed by front line staff.Chloe

I’d say the toughest part of my job is knowing how unwell a patient is and knowing that sometimes, despite my best efforts, the outcome isn’t going to be the one they wanted. Answering questions from patients that have had a life-changing diagnosis is also really challenging. It’s also hard leaving ‘work’ at work. I often worry about patients and find it difficult to switch off. Although, I think this has eased since moving to primary care, I often used to call the ward to check I had done something or that they were okay. Meditation really helps, as well as talking to colleagues and debriefing following stressful situations (not that the time for this is always available as it should be. Especially in fast-paced environments such as AED /AMU). Unfortunately, there isn’t a great deal of emotional support for nurses / MDT, although this has been improving throughout the COVID-19 pandemic. There is a very real issue with burnout and mental health issues following the peak of the pandemic and what was witnessed by front line staff.

In a  hospital, no amount of training will prepare you for being handed the keys for the first time or being the charge nurse for the first time. Whereas in the community I struggle with my own autonomy and not having that constant sounding board of the MDT at my fingertips. The dynamic between the MDT is much like any working dynamic. I think it has a lot to do with personalities and respecting what role people play. Nursing very often is gut instinct and sometimes you have to advocate for your patients and your instinct. There’s often a different rapport patients have with nurses vs doctors – patients tend to ask questions much more openly around us. I’d say This Is Going to Hurt is probably the most realistic representation of health care thus far. That said, there’s definitely some discrepancies (and inaccuracies) between TV shows and reality for sure.

The work life balance can be hard to manage as shifts don’t tend to follow a pattern. This was one of my main reasons for leaving acute medicine. I didn’t ever really mind night shifts themselves, it was the swapping back to days that was the struggle for me. My balance now is much better in primary care, despite the frequent late finishes.

The most rewarding thing for me is helping patients when they’re at their most vulnerable and unexpected moments. Also seeing a patient succeed on their health journey will never fail to make me smile!

Chloe

In terms of the future of nursing, looking at fair pay and retention of nurses needs to be addressed to protect those training now. I’ve often thought I’d like to work for a humanitarian company like Gavi vaccine alliance but right now I’m happy where I am. Knowing you can’t save everyone, as well as the verbal abuse, can be emotionally exhausting. It takes a lot of empathy, quick thinking and a strong stomach but for me, it’s more than just a job. Nursing was the best decision I made, there’s a lot of ups and downs but I wouldn’t change my path.

Rachael’s Story

After not getting into vet school at 18, I started working at my local hospital as a Porter whilst reapplying. After not getting a place for the second time, I went to study Zoology at university and continued portering in my holidays. After finishing uni and some travel, I continued working as a Porter and never really found a job I wanted to do that was relevant to my degree. I had started volunteering for The Cinnamon Trust walking dogs for elderly owners who were no longer able to themselves. I developed good relationships with the owners and enjoyed popping in for a chat as much as the dog walk. Combined with my hospital experience I decided to pursue a career where I could work with the elderly, and that is what led me to decide to apply to nursing school.

I am now a band 5 registered nurse working in A&E. Once patients have been triaged to the area I’m working in, I assess the patients, and perform investigations, such as taking bloods that are appropriate to the patient’s presentation. I also assess the patient’s acuity to see if the patient can wait to be seen in time order or if they require a doctor to review the patient as a priority. I liaise with the doctors to prescribe any treatment I feel they need in the meantime, such as pain relief or anti sickness, to make the patients more comfortable. Once they have been reviewed by a doctor or specialty, I am then administering and evaluating any treatment, continually assessing the patient and ensuring safe discharge from the department. This also encompasses meeting a patient’s needs, including hygiene, nutrition and hydration.

A lack of self-confidence and experience meant I often would spend a lot of time worrying if I had done enoughRachael

When I first qualified and was looking after very sick patients and in my first experiences of patients dying, a lack of self-confidence and experience meant I often would spend a lot of time worrying if I had done enough or that more senior nurses might have been able to do things differently. The biggest challenge then was learning to accept that I am doing enough, and sadly part of the job involves looking after patients who may be too sick to recover.

Working in the height of the pandemic was tough. So much wasn’t known and still isn’t about the virus so the fear element was definitely a constant presence. The fear of catching the virus ourselves or passing it on to our loved ones. I was fortunate enough to work somewhere where we had sufficient PPE, but that was a lot to get used to, wearing all of that PPE for the best part of 12 hours wasn’t easy. It was very hot, there was little opportunity to rehydrate, the FFP3 masks would often leave sore marks. I developed contact dermatitis initially from the PPE. I lived alone and so found it hard to come home from a tough day and to not have that social contact as a release from work. Another tough aspect was the very sick patients whereby they weren’t responding to treatment. Nothing we were doing was improving their condition, and these were young people with no previous conditions. I think it caused a lot of staff across the NHS to burn out.

For my own mental health, I think it’s important to decompress after work. Sometimes it’s just watching some good old trashy reality tv. Reading a book. Crying if I need to if it was an emotional day. It’s definitely better for me to acknowledge how the day made me feel, process it and then I can move on. As a newly qualified nurse, I didn’t do this and ruminating over things is definitely not good for my mental health. It’s good to have a balance of friends that are nurses because they completely understand what it’s like, but also to have people outside of the profession who maybe aren’t quite as jaded as we can be!

I have definitely experienced working environments where the attitude is that crying is seen as a weakness or that it shows you can’t cope with the job. Rachael

Sadly, I don’t feel as though there is enough emotional support for nurses. I have definitely experienced working environments where the attitude is that crying is seen as a weakness or that it shows you can’t cope with the job. This sort of attitude is very detrimental, as though because you’re a nurse you shouldn’t have feelings when at times the situation can be highly emotional and we are human.

When it comes to the dynamic between members of staff, in general in A&E, I find there’s a good relationship with the doctors! It’s all about having mutual respect and trust. Most doctors are approachable, there’s not really the old fashioned  hierarchical attitude of doctors, they genuinely know the value and importance of the role of nurses. 

I have witnessed it in practice, but thankfully I think it is much less common than it was. Like anything in life, you’re going to come across people you don’t like, or like more than others. It’s about maintaining a good professional working relationship despite how you personally may feel about someone. 

I do weirdly love watching medical dramas! I think as a general rule though, the tv shows are highly unrealistic! In Grey’s Anatomy the doctors seem to do it all, nurses don’t seem to exist or if they do they are normally portrayed in a negative light or are being belittled by the doctors. I think most shows don’t show the real pressures we are under. They also tend to get the medical information drastically wrong! Which is hard to watch. I have read This Is Going To Hurt and it was very relatable, including the heart breaking bits and the reasons why he sadly chose it was best for him to leave the profession. I can’t speak for how well they have translated that to screen though!

I love that nursing is a job where I’m constantly learning, every day is a school day! I also find medicine super interesting which helps! I like that no two days are the same. It’s a very sociable job. It’s a privilege being able to care for people in their hour of need. It’s very rewarding when you give treatment and see dramatic improvement in the patient’s condition or you’ve been able to relieve their pain and discomfort. People have had such interesting lives and I love hearing from them what stories they have from along the way! On the flipside, one of the worst things is the verbal and physical abuse you get. People can forget that we are human and we are just doing our best in what are often less than ideal circumstances. Some people it seems they become a patient and feel as though they have a right to physically or verbally abuse healthcare staff. It can be a very thankless job. This went to an extreme with people attending protests calling NHS staff murderers saying the whole pandemic was a conspiracy we are all in on. So disheartening and insulting at a time that was really difficult for us all.

The work life balance is also hard to master. Nights really affect me and so having any plans in the days after finishing nights I find really difficult. I have always had a job where I’ve worked weekends but I still find it hard when my non-nursing friends have every weekend available and I have to have some serious planning to make sure I’m free on that date! I try to use requests wisely to ensure at least once a month I have a weekend off. Try and coordinate things like going for breakfast with work friends when we finish nights. I think it is also finding the right workplace that works for you! When you know you are somewhere where the same group of you is always on nights and weekends, that the rota is not done fairly, that can definitely impact on your work-life balance!

Looking to the future, sadly I think there’s quite a blame culture in my experience of the NHS. It can often feel like if a complaint were to be made, you’d be thrown under the bus and the complainant believed over the nurse every time. I think overhauling this culture would go a long way in ensuring nurses feel supported and protected.

Being a nurse is challenging, educational, emotional and rewarding. It takes empathy, personable skills, and adaptability. No amount of training can prepare you for that first year where you are a newly qualified nurse and suddenly you’re in the numbers!

Rachael

It feels completely different to being a student nurse. I definitely didn’t realise how much the nurse I was working with would be doing when I thought I was running the show as a student! It is no longer a little list of jobs you can do, you are responsible for all of the patients in your care! It is quite a leap. Even getting used to finding your voice enough with the doctors and learning to delegate work to others in the team took some getting used to for me! As a student I had very little interaction with the doctors and suddenly they valued my clinical judgement!

I personally feel that self-awareness is very important in being a nurse too. You have to acknowledge the limits of your skills and knowledge and recognise if you have made a mistake and constantly reflect and learn lessons on how you can improve your practice. Nursing is such a diverse career that I think there isn’t a single profile you can give for what makes a good nurse.

People think of nursing and just see a nurse on a ward helping a patient to go to the toilet, but it’s so much more than that! The career options are vast. Rachael

There’s such satisfaction from knowing that I’m helping others and can make a difference in someone’s life. Nursing opens up so many possibilities! People think of nursing and just see a nurse on a ward helping a patient to go to the toilet, but it’s so much more than that! The career options are vast. You can take it abroad. You can go back to university, go into teaching, continually learn and develop with training and courses. You can specialise. There’s so much to offer in finding your niche!

I do think A&E for me isn’t long term. It’s a place with quite a high turnover of staff. At some point I may consider doing a masters and going into advanced practice. I may venture to Australia and work there for a bit. I don’t have any solid plans to leave yet but the possibilities are endless!

Something to take away for Innational Nurses Day: Be nice to your nurses! Recognise that they do an amazing job, probably so much more than you realise unless you know a nurse personally!

Dan’s Story

I am a Ward Charge Nurse on a General Medical Ward. (Effectively a Deputy Ward Manager). 

Working during the pandemic was mentally, emotionally and physically draining. I have seen things that I will never forget throughout my whole career.

Would I change my career path? Nope. You will never know what job satisfaction is until you’re a qualified nurse.Dan

The biggest challenge that comes with nursing is being able to completely switch off mentally as soon as you get home from work. In my opinion there is hardly any accessible emotional support for nurses. The work-life balance can also be hard. I try to make sure I socialise with friends at least once a month, and also workout or swim at least twice a week, which helps me switch off mentally and forget about work just for that half an hour in the pool. Being a nurse means everything to me, it’s part of who I am. However, it’s the most mentally, emotionally and physically draining part of my life that can take a lot from me at times. Would I change my career path? Nope. You will never know what job satisfaction is until you’re a qualified nurse. Make sure you can handle pressure and that being a nurse is truly for you because it isn’t easy. I think about making the jump to a different area within my field often but it’s not as easy as just going and doing it.

Something I would take away from International Nurses Day 2022 is to remember what being a nurse means to me, especially on the days when I feel like giving it all up. Being a nurse takes pride, compassion, care, emotion, empathy and excellent interpersonal skills. Nurses are warriors. 

Dan

The most rewarding thing about being a nurse is the job satisfaction and feeling like you have made a good impact on someone’s situation, the worst thing about being a nurse is feeling undervalued and underappreciated. I doubt that nurses will ever feel valued and protected until the government actually take responsibility and make the profession of nursing feel like it is a valued part of society. Many nurses often feel like their nursing pin is hanging by a thread, so to speak.

Alice’s Story 

I studied children’s nursing at University of Birmingham for 3 years after finishing my A-Levels. When I was looking at what A-Levels to take, nursing felt like a good option for me because I’ve always enjoyed working with people, especially children. The career interested me and I had a heart for caring for people so it just felt right. I qualified as a nurse in July 2020 in the middle of the pandemic! But I’d worked in Paediatric Intensive Care as a student nurse prior to this.

Doing a 12-hour shift in full PPE is DIFFICULT! You can’t just go and grab a drink and it is hard, but we would really do anything to care for the children. I think working through the pandemic has made me more resilient. Alice

As 3rd year students, we were asked to come and help out during Covid and got paid for doing so. In children’s nursing, it wasn’t quite the same as it was in the adult world, but it was still hard.  A lot of our nurses went to help out in the adult ITUs and I know that was hard for a lot of them to experience. It was and still is tough due to short staffing and lack of resources. Doing a 12-hour shift in full PPE is DIFFICULT! You can’t just go and grab a drink and it is hard, but we would really do anything to care for the children. I think working through the pandemic has made me more resilient. 

Now, I’m a band 5 staff nurse in PICU (Paediatric Intensive Care).  It involves looking after very poorly babies and children and their families. We look after children on a 1:1 basis, which basically means there is one nurse to each child. We look after lots of ventilated children on lots of different medicines and work alongside the multi-disciplinary team to give the best care that we can.

For me personally, the biggest challenge is when you can’t do anything else for someone. You’ve tried everything and there’s nothing more you can do and it truly can be heart-breaking. It’s also challenging when you don’t feel appreciated for all the hard work you put in, whether that’s from other hospital staff or families. 

It’s easier to switch off at home because you can’t physically take your work home with you! It doesn’t stop you thinking about certain things but you have to put it past you, it’s 24/7 care for a reason. Alice

I tend to talk to people about my day, especially if it’s been a difficult one and then try to move on. There are always things that stick with you but you learn how to deal with it. In our unit, we also have a psychologist you can go to if you feel like you need that support. It’s easier to switch off at home because you can’t physically take your work home with you! It doesn’t stop you thinking about certain things but you have to put it past you, it’s 24/7 care for a reason. I don’t think there’s as much support as there should be.  As I said, our unit has a psychologist but that’s not a usual occurrence. I find that most of my friends who are nurses talk to each other. It’s sometimes hard to talk to your friends and family who aren’t nurses because as much as they try to understand, they sometimes just don’t get it. You never know the emotions that nurses feel until you witness what they do every day. There are obviously other services around but they’re not easily accessible or they cost a lot. 

You’ve definitely got to love it and it’s not for the faint-hearted (you need a strong stomach!). You’re dealing with life and death everyday so you have to be prepared for that. Obviously, you have to be caring and have a heart for looking after people. No amount of training can ever prepare you for your first resuscitation or death and the reactions of the parents. It’s not something normal to witness and it affects you more than you think it would. 

At first, I found the work/life balance hard too but I’ve definitely got better at it. With the hours we work, we tend to do 3-4 shifts a week when you’re on full time hours. On my days off I try to utilise them the best way I can, to have a rest but to also see my friends and go and do things. Night shifts are a little different because of sleeping in the day, you feel like you never see anybody, but after a day shift I sometimes go and see my friends and spend time with them. The NHS also offers flexible working and my unit is really accommodating- having that definitely helps with work/life balance. 

For me, the most rewarding thing about nursing is definitely the moments with the families. Giving a new mum the chance to have her first cuddle with her baby because they were too poorly before is one of the best feelings. It’s also so rewarding seeing the patients get better and go off to the wards and then home. The majority of families hugely appreciate the care their children receive and to hear that from them is rewarding because you know you have done a good job and it makes you feel accomplished. 

Being a nurse means being there for a child and their family through their hardest, darkest times. Caring for them and doing your best to ensure they receive the care that they need and deserve. It really is the most rewarding job ever.

Alice

Don’t get me wrong, the hours are long and it’s not an easy career but you take so much out of it. You can literally change or save someone’s life and not everyone can say they do that as their day job! I love working on PICU and couldn’t imagine being anywhere else. Maybe one day,  when I’m older,  I might think about community or GP nursing, but for now I’m happy where I am. 

This International Nurses Day, I’d love to see more support for nurses and for people to recognise that these past couple of years have been especially tough. Throughout the pandemic, we felt really valued but that has definitely reduced. I have to also be *that* person and say a pay rise would be nice. Nurses work such long hours and there are some that struggle to make ends meet. Celebrate your friends and family members that are nurses because you never know what they’re going through!

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