Theatre nurses walk out over ‘final straw’ shift pattern changes

Nurses working in day surgery units at the central London trust walked out this morning (Thursday, 27 June) as part of a two-day strike over the trust’s decision to extend shift end times from 8pm to 9pm, a move their union, Unite, condemned as “dangerous”. Their second strike is scheduled for Tuesday, 2 June.

“It is absolutely not the job we signed up for”

Aara Essajee

Speaking from a picket line outside St Thomas’ Hospital today, staff nurse Aara Essajee told Nursing Times that the combination of weekend surgery lists, general increases in workload and the “final straw” of new shift patterns had left staff burned out and exhausted.

“Stretched to the limit is an understatement,” said Ms Essajee.

“It seems that our management think the best way to deal with waiting lists is to inundate nursing staff with more patients without any plan for increasing capacity and hiring more staff.

“There is a total lack of empathy for our workload and what is expected of us.

“There is a total disconnect with the understanding that stretched, overworked staff cannot give their best and are very prone to making mistakes.” 

Previously, shifts would run from 9am-7pm, then 10am-8pm shifts were introduced. Then, earlier this year, the trust rolled out 11am-9pm shifts.

Aara Essajee

Unite members told Nursing Times that staff at the trust overwhelmingly opposed these plans when they were first aired, but they went ahead anyway.

Ms Essajee said: “It may appear that it’s just an hour… but the people who work [here] chose to do so because it suited their lifestyle, their childcare arrangements and their caring arrangements.

“It is absolutely not the job we signed up for.

“When I started at the unit, we didn’t work weekends, and the finish time was 7pm. That was extended to 8pm, then weekends were introduced, much to the dismay of nursing staff. And now, the push from 8pm to 9pm is the final straw.”

She said the new patterns would be particularly disruptive for nurses who travel in from outside of London, and that a 9pm finish could mean even later in reality because nurses often end up working extra after their shift ends.

While the Unite strike is only about the 9pm finish, nurses on the picket line also raised other issues related to their workload.

These new evening shifts came after the introduction of rostered weekend shifts and optional participation in High Intensity Theatre (HIT) list shifts, where lower-risk surgery patients are operated on in quick succession.

HIT lists were introduced at Guy’s and St Thomas’ to help clear long surgery waiting lists, and similar measures – to be rolled out nationally – were included in the Labour Party’s general election manifesto.

Ms Essajee said that many nurses felt pressure to sign up to these optional shifts in order to make ends meet amid the cost-of-living crisis.

However, she said the later weekday finishes combined with weekend shifts was “just far, far too much for an already exhausted workforce to cope with”.

She claimed that patients were at “tremendous risk with the current situation” as “exhausted people can’t look after patients”.

Fellow theatre nurse Mary Adeleye said the HIT lists, the changes to shifts patterns and introduction of weekend work for day surgery nursing staff, all contributed to the frustrations which fuelled the current strike.

“[Day theatre units] used to be really appropriate for people who had children and who wanted a work life balance that other departments couldn’t afford to give them,” she said, adding that this was increasingly no longer the case.

Mary Adeleye outside St Thomas’ Hospital during the Unite strike

“A lot of staff raised issues about safety, that leaving at 9pm isn’t safe especially in winter for those who live in Kent or commute that kind of distance – it’s not fair and it is exhausting.”

Ms Adeleye said that, as well as longer shifts, the workload on the wards had been rising and the turnaround of patients was high.

“At a certain point, you don’t remember patients’ names, just what they came in for and that they have to get out by 8pm,” she continued.

“[The trust] pushes a lot in the name of productivity… we need to increase productivity [but] how much more productive do you want us to get?

“We do the HIT lists, we discharge 50 plus patients, we discharge our own patients… it’s just really not fair.”

NHS trusts have been under pressure by the incumbent Conservative Party-led government to increase productivity, with chancellor Jeremy Hunt having recently imposed strict efficiency targets on the entire public sector.

Ms Adeleye said regular working days were already feeling high in intensity, and that measures to meet these targets were going to lead to burnout: “I’m afraid for what theatre nursing will look like.

“We want patients to stay safe. How far will you go before it becomes unsafe? What has to happen before you realise maybe productivity isn’t everything?”

Unite’s dispute with Guy’s and St Thomas’ is expected to continue unless a new offer is tabled by the trust. If this does not happen, the nurses will strike again on Tuesday, 2 June.

Nurses at the St Thomas’ picket line were joined by some of the trust’s junior doctors, who walked out as part of the British Medical Association (BMA)’s ongoing dispute with the NHS and government over pay for the workforce.

Jeremy Corbyn, former Labour Party leader and now independent MP candidate for Islington North, attended the picket line in support of the striking nurses and doctors.

Former Labour leader Jeremy Corbyn at the Unite picket

“I’ve just been hearing about the change in rosters which is damaging to the living standards and conditions of these nurses, some of whom travel very long distances to get here,” Mr Corbyn said.

“They’re taking strike action to try and defend and improve their conditions. I support them.”

A spokesperson for Guy’s and St Thomas’ said: “We are disappointed that Unite are continuing with these strikes while constructive talks are ongoing. We would urge them to call off this action so we can continue making progress on improving the shift patterns for our highly valued and important theatre nurses.

“We are working closely with colleagues to plan for the impact of this strike, and any changes to patient care will be communicated directly to patients and via our usual public channels as appropriate.”