2 January 2016

Agency Nurse Pay Cuts

My name is Amy and I'm an 'agency nurse'.

Even in my own mind that phrase has negative connotations. Of laziness. Of greed. Of low quality nursing care. 

These connotations, which even I struggle to get past, go through the minds of every nurse I work with.

But I'm a good nurse. I work hard. I have years of experience across a range of specialities. I truly care about my patients. I am keen to learn. I stay late whenever necessary to make sure my documentation is of the highest standards. I gladly give up my tea break to chat to mums who need a friendly ear. 

I didn't train to be a nurse to work for an agency. I'm not doing my masters in nursing to work as a temp. I trained and I continue to train to be part of the best health service in the world.
I'm not "an agency nurse" at heart. I'm an NHS nurse.

I left the NHS when my husband started working 9-5. He could no longer fit his work schedule around my ever changing unpredictable shift pattern

Agency nursing offered me what the NHS couldn't wouldn't: the ability to work one shift on the same day every week, a day when my husband is at home to take care of our 2 preschool aged children. Part time work while my children are very little. On a day that I can arrange childcare. Doesn't seem too much to ask of a 24/7 service does it? But the NHS (on the grounds of 'fairness') now require every shift worker to work a combination of days, nights, weekends and weekdays.

Childcare settings on the other hand are only available on the same days each week. A friend of mine has been on a waiting list for a "Friday" session for months at her child's nursery. There's little hope of finding one which will have the boys for a different day each week with often only a few weeks notice of the dates.

Without a local set of healthy, willing and available grandparents to call on, it's a tall order to source childcare for 12 hour shifts that change every week. I'm sure some people have found a way, but I couldn't.

So I left the NHS.

When I left I gave up my pension, the security of guaranteed work (and therefore income), chances of career progression, development opportunities and, crucially, my place in a team. Love or hate your colleagues at work, you should cherish them. I truly miss being part of a team, even just knowing who to steer clear of and who to ask a favour of when you're in a bind. It's exhausting trying to get to know brand new team every few shifts as well as learning where they keep the sats probes, how you get to theatres and how their paperwork works.

As well as missing knowing my way around, I miss the stability and security of a 'real' job. Just last week my shift was cancelled. It was a shift I booked in as extra to pay for Christmas presents. A few weeks earlier I was sick, I couldn't work and lost a quarter of my monthly income. We coped with that because the pay from agency work is was enough to make up for that instability. Was. 

This year a huge change is taking place for agency nurses like me. The increased wages which used to make up for the loss of guaranteed income, loss of sick pay, loss of pension, loss of training and development opportunities are being reduced.

Soon my wages will be the same as an NHS nurse. The same pay per hour but with none of the perks of being employed, like sick pay, or a contract.

We'll struggle to pay the bills. Something will have to give. Our quality of life will decrease. 

But paying us less will save the NHS millions. And that's wonderful.

I care about the NHS and want to save the NHS as much as anyone.
The problem is that cutting my wages isn't really solving the problem that the NHS don't have enough nurses. Reducing my pay isn't making it any easier for me to come back. Paying me less won't drive me back into the open arms of the NHS because the reasons I had to leave still stand. 

I'd love to come back, all I ask is that I can work around my family.

Simple, obvious, family friendly working conditions would bring me back.

Letting me work weekends while my kids are little so my husband can look after them. Or allowing me the same shifts each week so I can put them in a nursery or get a child minder. A nights only contract when they go to school so I can do the school runs and sleep while they're at school. Easy solutions for childcare issues, solutions that used to be commonplace when I was training to be a nurse.

So, bizarrely, although I'll be 30% worse off this year, I welcome the reduction in my pay... Or at least I will, as long as the NHS uses this opportunity to bring back real family friendly contracts for nurses. Like 'the good old days''.

I can only hope that the pay cuts will bring real, positive change to the NHS. That I'll find a job that allows me to work part-time while my boys are so little, but with all the many wonderful benefits of being back in the bosom of the NHS.

My concern is that, if the NHS doesn't take the next step and make these simple changes, then dedicated, highly trained agency nurses like me will be driven out of the profession altogether.


  1. Oh wow, I had no idea the NHS worked in such a way. Such a shame as they are forking out money for agency nurses, when a simple 'family friendly' approach would be better all round.

    1. Don't get me wrong, there's a lot more that needs to change, but I do think offering set shift contracts or would be a start to improving retention rates!

  2. This makes me so frustrated and sad, Amy. I really do not understand why we are not doing more to retain nurses. The new guidelines for nursing ratios are getting hospitals in to more hot water - there just aren't enough nurses to go around, it's not for want of trying - the government's policies are just completely bonkers xxx

    1. Hopefully this agency cap will kick start a few other ideas for filling the gaps. I do think lots of agency workers will stop doing it, which will indeed save the NHS money... but possibly at the risk of having dangerously understaffed wards. Fingers crossed!

  3. This is such a sad post really as I see them cutting pay but not making those changes. Other emergency services are often the same - in our experience anyway. It's really, really sad.

    On a positive - I love the new header!!

    PS, we need a play date! x

  4. Brilliant article love. I ve shared it on the page of the company I work for (Healthcare rec agency!) Some very relevant and poignant points! K x

  5. Im a agency nurse in the same position I will be leaving my nursing career. I cant cope with the stress or lack of flexibility. The current rates when paid petrol taxes courses drive two hours for shifts are leaving me in financial hardship. I was passionate about nursing I am deflated and currently earning more doing simple beauty treatments from my home. When will the government start praising nurses and paying them a wage that allows you too live. I have over ten years experience worked in Emergency departments. Its an insult I can earn more painting nails than saving lifes I will predict that more nurses will quit.