To Strike - Or Not to Strike? That is the Question ...

There was a fascinating discussion on the Nursing Times twitter feed today which I eagerly took part in.  It was centered around the debate as to whether nurses in the United Kingdom should consider strike action over the on-going pay dispute.

For those non-nurses among us - simply put, nursing and midwifery pay in the UK has effectively been frozen for the last 5 years or so, and the small increases when they have come have been so below inflation that they effectively equal a pay cut.  To add to the anger among my colleagues - it doesn't help reading about MP's voting and awarding themselves pay rises of considerably more.  Or (closer to home) perhaps some senior NHS managers receiving also larger pay rises.  A further note of discomfort for many colleagues is that our regulator - the NMC - is consulting to raise our yearly registration fee from £100 to £120 which is mainly use to hold Fitness to Practice panels often resulting in nurses being struck off over doubts over their capability.

Nurses are angry.  That is common knowledge.  But is striking the best way?  I responded a strong "NO"!  I've suffered too.  I had to take out a loan to renew my NMC registration this year.  My hero - Nursing Times Editor Chief Jenni Middleton commented this to me;

It made me take a step back and think.  Am I disgracing my profession and colleagues by such a standpoint?  Should I be marching with placards out in the street?  Are the government really cackling in glee at such a "naive" view as mine?  But here's my issue.

The Code of Professional Conduct - which defines myself and all colleagues as a nurse or midwife says this;

"The people in your care must be able to trust you with their health and well being. To justify that trust, you must make the care of people your first concern".

In it's closing statement to the "Mid-Staffordshire Public Inquiry" chaired by Sir Robert Francis, the Department of Health submitted this key statement:

"The patient should be at the center of all that the NHS does".

So before I personally consider strike action - no matter how angry I or colleagues may be - the patient must be considered!  Now a couple of unions have proposed variations on a complete strike.  What about emergency cover only (such as firemen often do)?  But here's the rub.  What constitutes "emergency" cover for the patients under my care?  Let me walk a few moments in my patient's shoes.

• What about the young person admitted to Surgical Daycare for the insertion of a Hickman line?  He has just been diagnosed with leukemia and needs to commence chemotherapy.  I guess the insertion could be cancelled - but the longer his chemotherapy is delayed, the longer the potential for spread.  I would argue that procedure constitutes an emergency for that family.
• What about the young person who has an outpatient appointment with a cardiologist - she's been having "funny palpitations" but as yet undiagnosed.  Without an OPD nurse, that appointment could be cancelled.  But the fears and worries for that family that their beloved daughter has a heart problem needing heart surgery would constitute an emergency in their case.
• What about the disabled child with learning disabilities who has been waiting months for an appointment to be fitted for a wheelchair?  They have been getting sore and uncomfortable and have outgrown their current chair.  Without that nurse-led appointment they may have to wait months more.  To that child and family - it's an emergency.

I am aware this very personal view may be seen as a "betrayal" in my colleagues eyes.  I will understand if some unions vote - and indeed go on strike to protest the unacceptable pay decisions imposed upon us as a profession.  But at present - I just cannot see myself personally and professionally accepting going out on strike.  The trust of the patients and their families just mean too much to me.  I have read the complete "Francis Report" and I think the actions of a few have brought the nursing profession into disrepute.

This doesn't concern me - it challenges me!  It is up to us - and me - to re-gain that trust and that respect from the public.  Patient by patient.  Family by family.  And I fear that strike action would further damage the profession I so love.