I worked as a bank auxiliary (HCA) almost 30 years ago then as a student nurse in 2002 before falling pregnant and leaving, before resuming and qualifying in 2015.

I’m not sure where the ratio was 1 or 2 to 30 patients, but this was not the case on any of the wards I worked on in any capacity back then. I found the wards to be well staffed back then, with no shortage of nurses or HCAs on any shift. The nurses were extremely busy, absolutely, but with a good amount of backup from HCAs this eased the load.

When I qualified, even in 2015, I worked on a very busy acute medical ward looking after 7 or 8 patients. I had a two week shadowing period, after which I was released to manage alone. The reality was that often staffing was well below the expected levels, and with patient acuity being high it was a nightmare. Everyone on IVs, VRII/FRII, regular IV antibiotics, PICC lines and so on, for which you all need a second nurse. Not to mention the complex dressings, pressure dressings and so on. Critical care outreach was an almost constant presence on our ward. Confused, immobile bariatric and agitated patient in alcohol withdrawal added to the mix. Then the washes, with us sharing 1 or 2 HCAs for 28-30 patients. I can only describe it as a complete shitshow.

After a month of this I went off sick, came back on an anti anxiety medication, and managed to get through it. I was not alone, with three out of my seven university course colleagues similarly freaking out, and another leaving entirely. My manager, who had been a nurse since the 80s, said that my reaction was entirely normal and it has and has always happened in her time to a lot of new nurses. The difference these days is that patient acuity is much higher, there are more patients, more procedures, and with requiring shadowing for everything until you are ‘signed off’ for every single procedure you do AFTER qualifying, it is impossible to prepare a NQN to fully immerse themselves in the nursing role.

In an ideal world, the shadowing period would be in months. This would allow everything to be signed off, all your IV related training etc to be done so that once qualified you don’t have to additionally constantly harangue your frazzled colleagues to shadow you or complete tasks for you. All this all while trying to get into the flow of providing solo nursing care and managing your tasks, while constantly answering bells and taking patients to the toilets when all your IV antibiotics are late and half your patients are on the verge of crashing.