Truro, United Kingdom – When Lisa Jeffery was 21, she was rushed to the hospital, experiencing excruciating pain in her pelvis. She was suffering from an ectopic pregnancy – a condition where a fertilised egg implants outside the uterus – and required life-saving surgery. Although the procedure was swift, and she was able to leave the hospital a few days later, the warmth and compassion of the nurses who cared for her left a lasting mark. “It all stemmed from that,” she says. “From then on, I wanted to look after other people who were poorly.”
After a nursing career spanning three decades and five hospitals, Jeffery, 53, is now at a twilight time in her professional life. As a ward sister, she runs a gynaecology and urology unit with her team of nurses in Cornwall, the UK. She could, by all accounts, be winding down towards a quiet retirement.
But Jeffery is joining legions of other British nurses making history in a series of national walkouts. In December 2022, the Royal College of Nurses (RCN), the country’s largest nursing union, began staging a series of 48-hour strikes.
Nurses from more than 44 hospital trusts in the UK – which are part of the publicly owned National Health Service (NHS) – withdrew from their wards and took to the picket lines.
At the heart is a fight for fair pay – with the RCN asking the UK government for a 19 percent pay increase to keep pace with inflation and reflect the scale of work nurses take on every day. For Jeffery, this could be anything from a 37 to a 50-hour week of giving patients life-saving care.
Sometimes we bring patients ‘back to life’
“Nursing is not the profession it once was,” says Jeffery, on the picket line outside the Royal Cornwall Hospital one overcast January morning. Voices hoarse, banners high and drums pounding, she stands with a sea of 200 nurses, bundled up in the cold, calling for change. “I felt really guilty yesterday – I wasn’t sure if this was the right thing to do,” she says. This is Jeffery’s first strike and although she believes the time has come to make a stand, it is hard to squash the worry that patients will need her.
Jeffery, along with her fellow nurses, insists this is not only a debate about pay, but a stand against working conditions in a perennially underfunded sector. “We didn’t go into nursing to make money. We look after ill people, sometimes we bring them back to life, their souls in our hands. Yet we’re constantly run ragged and paid [a] pittance,” she says. Jeffery, who is slight, with long brown hair and a fringe that frames her face, lives with her teenage daughter, who she says she “would never allow” to go into nursing.
For Jeffery, work begins at dawn, in a pothole-riddled car park known among some staff as the “gravel pit”. In the winter, when the sky is slate-black and the wind howling – Cornwall is one of the UK’s wettest counties, exposed to the whims of the Atlantic Ocean – the seven-minute walk to the ward feels extra onerous. Jeffery pays 31 pounds ($38) a month to park there, as nurses at the hospital do not benefit from free parking, a point of contention among many nurses nationally.
From the moment Jeffery enters the ward, a carousel of daily tasks begins. Between patient observations, administering drugs, serving meals and washing incontinent patients – which, on a urology ward, is sometimes every hour – she “barely has a moment to sit down”. One half-hour unpaid lunch break punctuates the day, although this offers little respite. “We usually don’t have enough time to queue to buy hot food and we don’t have a staff room, so we sit in a cupboard and take our break,” Jeffery says.
When 5pm strikes and Jeffery can technically go home, she is reluctant to clock off. “I stay later because the staff are struggling – there’s just not enough staff to do it all,” she says. “Sometimes I stay until 6 or 7pm. This week I did around 50 odd hours but I would only get paid [for] 37 and a half.”
Wages don’t reflect skills
The average annual basic pay for nurses was increased to about 37,000 pounds ($44,866) in April 2022, after a decades-long struggle to increase wages in the sector. However, these salaries are calculated on a band system, with the most common grade for NHS nurses being Band 5, a pay grade where salaries range from 27,055 pounds ($32,806) to 32,934 pounds ($39,935).
“Our wages don’t reflect the skills that we have,” says Jeffery. “Our knowledge covers catheters, drains, fluid pumps, drugs and their side effects.” Plus, there’s a heavy weight of responsibility in the medical profession. “We have to be able to recognise an acutely unwell patient and act there and then,” she says. When feeling overworked, the threat of errors looms large. “If we do something wrong it’s the nurse who will lose their registration,” she adds.
Due to inflation, the salaries of NHS nurses have fallen in real terms by 8 percent since 2010. Before April 2022, this equated to a reduction of more than 3,000 pounds ($3,638) from a decade earlier.
At the rally, many of the nurses said their fingers had regularly hovered over the “apply” button on other job applications. “Some of our healthcare workers could be in the supermarket stocking shelves for the same pay, but they’ve got skills that are vital to the health service,” says Jeffery.
Striking is a last resort
Although the UK government has dismissed the RCN’s demand for a 19 percent raise as “unaffordable”, talks of a fast-tracked pay deal by April are on the horizon. But it is hard to ignore the cacophony of complaints from other sectors, with an eruption of recent strike action branded Britain’s new “winter of discontent” – an allusion to historic strike action in the 1970s.
These are Britain’s biggest health strikes, with nurses, junior doctors, ambulance workers, paramedics and physiotherapists joining the wave of teachers, post office workers, and train and bus drivers who began turning to strike action in December 2022 as a last resort.
As everyday costs – a tank of petrol, a gallon of milk, a bus fare – climb, workers are calling for higher salaries to keep their heads above water.
Jeffery, a single mother to a 17-year-old daughter, is one of those feeling the pinch. “I’ve obviously got my mortgage and bills. My house is run on oil and that’s 350 pounds [$424] for half a tank, I can rarely afford a full one.” One tank lasts three months in the winter, although she is careful to conserve oil by using the heating less.
However, there are work-related costs to factor in too. “I’ve got to find 120 pounds [$146] today for my nurse’s retention fee,” she says, referencing an annual administrative fee to stay in the profession.
“If it wasn’t for child support, then I would be scraping my overdraft every single month. As it is, I never have enough to put into savings or to make basic repairs to my house,” she says. Jeffery points out the plumbing and decorating she does herself and the dishwasher that sits broken in her kitchen. Jeffery’s house is modest but homely, filled with memorabilia of her daughter’s dance recitals – from ballet portraits to trophies and medals.
Despite being tempted to quit, her motivation for staying in nursing is to put her daughter through dance college. Currently, she performs ballet, tap, lyrical and musical theatre, and Jeffery says she would love to add singing lessons to the roster, but she cannot afford to. Recently, Jeffery picked up extra shifts to fund travel for her daughter to an overseas dance competition in New York. But for many nurses, these shifts are a “bugbear” – as they are paid on a basic rather than an overtime rate. “These shifts count as a second job which you get taxed on,” Jeffery explains.
‘A little more respect’
It took working on the front lines of the coronavirus pandemic to put the sacrifices Jeferry had made for her career into sharp focus. While working in a COVID ward, she made the decision to send her daughter to live with her father in a different county for three months. “It was horrible, I had no idea how bad it would be or if I’d see her again.”
At the January strike, a glass window at Royal Cornwall Hospital still bears a picture of a rainbow – a colourful national symbol of appreciation for the NHS born out of the pandemic.
From the picket lines a stone’s throw away, Nicky Key, a deputy ward sister, says, “All we’re asking for is a little bit of respect. During COVID, people would bang on pots and pans at eight o’clock every night, which was nice. But now it’s time to show us a little more respect, so we can have a standard of living that is acceptable.”
For many nurses, it is their first time protesting – yet spirits are defiant as they cheer at cars which honk in solidarity as they drive by.
“We see how corrupt the government is – there’s so much money for them but we’re not getting it reflected in our wages,” Jeffery says. “Look at what Boris [Johnson] spent on decorating his living room,” she adds, referring to a 200,000 pounds ($242,516) refurbishment to the Downing Street flat when the former prime minister was in power.
“Boris came down to this hospital and said he would put money into making a women’s and children’s building. That probably won’t ever happen,” she says. Local reports suggest plans for the building are delayed, due to rising construction costs, and may not be completed until 2027.
A spokesperson from Royal Cornwall Hosptial said, “We want to see a resolution as soon as possible to any industrial action, but ultimately pay is a matter for the government and the trade unions.”
Patient care is in her bones
Nurses choosing to strike insist that the temporary disruption – currently paused due to RCN negotiations with the government – is to secure the future of the NHS and that this is vital for a health service on its knees. “If I was at the beginning of my career, I would think about leaving,” says Jeffery.
But the question remains – who would plug the gaps in such a critical vocation. “I have days where I just want to jack it all in,” she says. Once, almost two decades ago she did – leaving nursing for a short stint as a community worker instead.
But looking after patients is in her bones. “I missed the teamwork and being in the hospital – that smell, the atmosphere, everything about it. As soon as I walked back into the hospital I felt at home,” she says.
Eight quick questions for Lisa
- What does going on strike mean for you? It means having a say so my colleagues and I can put our point across.
- What is the one thing you wish people understood about why you are striking? That it’s not just about money. It’s about working conditions and everything else.
- If your strike demands were met, what would it change for you? Lots. I would be able to make repairs on my house and go on holiday without having to work extra.
- What do you think of the way strikers are portrayed in the media? They put too much onus on the wage increase, which is a shame rather than looking at the reasons why we’re striking.
- Do you think the general public supports your strike? A huge amount, which is really lovely.
- What advice would you give to people striking elsewhere or considering striking? Think about it seriously as you don’t get paid for it. We got 50 pounds ($61) a day back from the RCN, but it’s not that much.
- When it comes to striking, who inspires you and why? I have admiration for anyone that stands up for what they believe in.
- Do you have a favourite chant, song or banner? We sang one over and over – “Two, four, six, eight, come on Rishi negotiate.”