On 23 June every year, the United Nations celebrate International Public Service Day. This internationally recognised day is designed to highlight the value and virtue of public service to communities and development, as well as recognise the work of public servants and encourage young people to pursue careers in the public sector.
Iona Strang, a qualified nurse in the UK, shared her views on working in the nursing profession, working throughout a pandemic and whether her gender impacts her ability to do her job successfully.
When did you decide to study a nursing degree and what were your motivations for doing so?
Well, I would probably go back quite a few years, probably to college time. I originally wanted to be a paramedic, purely because I liked the uniform and I thought it was cool! And then I broke my leg and I spent time in hospital. Also, my Auntie Helen spent a lot of time in hospital before she passed away and I saw the incredible care she received, and I thought the nurses were just absolutely amazing. They gave us a real opportunity to spend the last few months together and the care she received was quite outstanding really. So, I said to myself, “if I can make someone else feel like that, when they need help, when they're feeling their lowest and most vulnerable, I think it would be quite fulfilling”.
So, that's why I initially went into nursing. During my time at university, I discovered I really liked the knowledge base behind nursing and the practical side of it as well. I like that there is always something going on, it's never boring. The day and night shifts are very different and things with a patient can change quite dramatically. It is never a dull day!
Do you think your personality type has made you a better nurse?
I think so! Both of my parents were teachers, and I knew that absolutely was not something I wanted to do. I wasn't completely put off by the idea, but I knew that it was a difficult profession – it is hard work and very stressful. However, saying that, nursing can be very stressful. But patients and staff have often told me that I am always smiling at work, even with my mask on!
This is an interesting question because my teachers and friends have previously said that I am quite a caring person. I was always caught between friendships because I wanted everyone to be happy and well. So, I think you're probably right. Nursing was probably quite a natural thing for me to go into.
What was it like working through a pandemic?
Wow what a question! Let's start at the beginning of a pandemic. So, I was in my final year of university, in the last few months of my course and enjoying my time with my friends. We were kind of on what we call on the homestretch, working on our dissertations, final assignments and also doing practical work.
And then the pandemic hit.
There was a lot of confusion. I remember being in a lesson around November time last year and, ironically, we were studying a module on what would happen in an emergency, and Coronavirus was mentioned. We all thought – “oh it's fine it'll never get to us!”. Our lecturer explained that if there was a terrorist attack, or a major train explosion, or something that resulted in more than 100 casualties, we students would have to go into the hospital and help. They explained “you would not be paid to do that. It's your duty and you're obliged to go into the hospital and help, the same as the lectures that are still in practice”. And yet, we never thought that would happen.
When the pandemic hit, we weren’t sure whether to go home or stay at university. There was no real guidance. Then all the rules and regulations came in that changed everything. First and second years were told to go home and us third years stay on.
At this stage we were working for free. I went in for my first shift, and there were no patients on the ward. So, then I went to the ward next door and there was no one there either. The patients had been literally been cleared out ready for the COVID patients.
For about a month, I turned up to my shift not knowing which ward I was going to be working on, not knowing how bad it was going to be, or which nurses I would be working with. I would often arrive at work and be told that I would be on a ward on the complete opposite side of the hospital. In fact, I ended up working on the respiratory wards full time for the last two months of my placement. The whole experience was a massive, massive learning curve.
It was really difficult, emotionally and physically. It was the peak of summer and the windows didn't open because we were eight floors up. There was no aircon due to the risk of COVID spreading. So, it was HOT and you're in full PPE. You’ve got other staff moaning or crying from the stress, and then you've got the patients that are confused because their family cannot be there in hospital with them. People were calling the hospital every five minutes to ask how their loved ones were doing. This was particularly difficult because it was so tough to get anything done in between calls.
I held countless hands when patients’ families couldn't come in and witnessed life or death decisions being made without family being present. We had multiple occasions where we had to ring up the daughter or son of a patient and tell them that everything we’ve tried so far is not working. To avoid further suffering, they would agree over the phone for us to take their relative off of the oxygen that was supporting their life. Within 20 minutes this poor person would die. It was often just me and one or two others in a room with the patient until they drew their last breath. And then we move on – we had to get back to work. It was a horrible time, not allowing visitors into the hospital due to the government guidance.
The whole experience was a massive learning curve and I'm grateful that I was there actually. But it was nice to come home. Thankfully I was surrounded by my friends as well and they were really supportive. I am now qualified and working on the surgical gastroenterology award which I really enjoy.
Do you think society values nurses enough?
I think they do now. But it's sad that you need something like this to happen in order for society to recognise the hard work we do.
It is interesting that the public were getting on board with the ‘clap for the NHS’ initiative. I think that was more helpful for the public than for the nurses, doctors and NHS staff. However, it was really nice to gain recognition for our work throughout the pandemic. I think it was nice for my parents and neighbours to all come together and feel like they were helping the cause.
Do you think nurses get paid enough?
Before I qualified, during the last few months of my last placement, the hospital decided that it was unfair that students were working for free. As a result, for the last month, we were placed on a band three salary. Now, as a fully qualified nurse, I am on a band five salary. It was tough not earning a lot whilst working for the first few months, so I was extremely happy to qualify.
When the government issued their plans to increase nurses’ salaries by 1%, the majority of the nurses at my hospital thought it was a bit of a joke. We all joked about how it would add up to around £3.50 a week – enough for a meal deal!
In addition, I also think that if we're talking about public service workers, there should have been a pay rise cross the board – i.e., for paramedics, midwives, and the police. Don't get me wrong, nurses were incredibly hit by the pandemic, and we worked very, very hard, but it wasn't just us. The supermarket workers and other key workers hit by the pandemic deserve recognition.
What do you think are the main barriers, if there are any, for women accessing healthcare in the UK?
That is a very good question, and an issue perhaps more experienced in GP practices than hospitals. However, I do think that potentially women’s pain may be more easily dismissed by doctors. For example, conditions like IBS are really hard to diagnose, and the majority of IBS patients are women. Endometriosis is another condition that women wait years and years to get diagnosed. It is often dismissed as ‘normal’ pain or ‘just a period’. So, I think there is definitely a wider issue here.
However, I do remember a time where we had a transgender woman in her 70’s come into our ward. At this point, she'd had surgery to transition from male to female. Now, when we get new patients, we treat them as individuals, not just another bed number. So, this woman was put into a female bay, given that she was now a woman. However, right from the outset, there was a lot of speculation about what bay she should be put in. In fact, many of the other female patients, other elderly women who were perhaps not so progressive as I think our generation are, did not agree with this. So, I think there was stigma and judgement from other patients, definitely. In the end, we allocated her to her own room, which she was really grateful for. Despite the wider societal issues around stereotyping and transphobia, I do think the hospital handled this situation really well.
Do you think that being a woman makes you a better nurse?
I have a really interesting story about a female doctor at the hospital I work at. This woman is a top consultant and surgeon. She is roughly 30 years old which makes that an incredible achievement.
There was one day that she went to attend to a male patient. This patient had previously made a few comments to me about how I was too young to be working as a nurse, among other comments. When the consultant arrived, he refused to believe that she was his doctor. He asked to speak to the doctor who carried out his surgery. She confirmed that she was the one that conducted the surgery. He still did not believe her.
I think this highlights a big problem in terms of women not being taken seriously in vocations such as
medicine. This man was fairly old and was not particularly progressive in his thinking, which leads me to believe it is definitely a generation problem.
But in terms of gender – whether the fact that I am a woman – affects my ability to be a good nurse, I do not think this is true.
Some of the best nurses I know are men. I understand the stereotype that women are caring, and some patients definitely prefer having a female nurse. This is why we always have to ask whether patients they would rather have a female nurse. So, I think male nurses definitely have to be more careful.
But I truly believe it doesn't matter what gender you are, all that matters is that you are caring, compassionate and you communicate well. If you have all those things and you are good at your job, and you make good informed decisions based on your unique patient, then your gender should not matter.
Some of the best nurses I know are men and I feel like they're a real inspiration to other nurses and aspiring nurses. A large percentage of male nurses are also from ethnic minority backgrounds. In their cultures, nursing is not a gendered profession. A lot of them weren't born here, but they do an amazing job for us in the NHS and we would be incredibly stuck without them.