When Jeremy Hunt recently attacked the Royal College of Nursing (to be called, henceforth, Cecilia), by calling “ridiculous” its perceived threat to recommend nurses strike over plans for a seven-day NHS, he sent a warning shot over Cecilia’s bow. This worked, for Cecilia, wetting her knickers, soon sent out clarification of her position, her spokesman explaining: “There’s a big difference between industrial action and strike action. Nurses are never going to do anything to damage patient care and the RCN’s own rules would not allow that. What we want to do is sit down with the Government to work on how to take this forward in the interests of better patient care”. Cecilia is reprieved, no chopping block for now.

Some words to Cecilia: Of course, the issue of ‘unsocial’ hours payments for nurses is being considered by the government, but there are far more dangerous plans under the government’s microscope, one of which is the issue of split shifts. Nursing colleagues in Australia have battled against this ‘market friendly’ imposition for years, as headlined: ‘State Government proposals for nurses to work split shifts are an attempt to pass on cost savings being forced on hospitals, the nurses union says'(www.theage.com.au/victoria, 2011).

This report quoted ‘State secretary of the Australian Nursing Federation, Lisa Fitzpatrick, (describing) as unbelievable a government proposal for nurses to work split shifts from 7-9.30am, then midday-3.30pm, as part of enterprise bargaining negotiations. Fitzpatrick hit the proverbial nail: ‘All of the shift reduction initiatives the government is proposing are about reducing the nursing pay budget … If you pay less nurses for less hours then hospitals can make the savings the government is forcing them to make because of the decreased budgets they are receiving this year‘. Sounds uncanilly like  UK 2015.

Dear cecilia, before you curtsy to those who will ordain such a system on British nursing, please consider the full extent of it. The government’s plans mirror those found in restaurants – cooks and waiting staff often work only during mealtime rush periods, which means they might work the lunch shift, clock out for a few hours, then return for the dinner shift. A nursing split shift might mean being on duty from 7am-10am, then 2pm-7pm.

This is not the worst case scenario, as gaps between ‘shifts’ might only be two hours. In California, nurses with more than one hour between shifts receive a split shift premium of an extra hour’s pay. Union contracts also sometimes mandate special benefits for split shift workers, such as a minimum or maximum amount of time between shifts. There will be no such ‘benefits’ in the UK, for such as Cecilia will merely curtsy to the lord on whose table they wish to sit.

But a double commute will reduce personal time, and be expensive, especially if you live far from work. Tough luck on any partner or children.

Computer programmes for split shifts in nursing are already used throughout industry: ‘The Split-25 Excel spreadsheet creates schedules where each employee can be assigned to 1 or 2 categories … 1 or 2 locations … and 1 or 2 times (10:30 AM – 1:30 PM and 4:00 PM – 8:00 PM) each day for up to a month. Shift assignments are made from drop-down menus of qualified employees. The spreadsheet can … also keep track of your payroll budget based on employee wages and scheduled hours’.

Factoring in agency nurses is not a problem: ‘One option for scheduling a difficult-to-fill shift is to “split” the shift so that it is worked by more than one provider. For example, if no single provider is available to work the entire shift, the first half could be worked by one available provider and the second half by a different provider. Split shifts in EPSKED are shifts that are normally worked by only one provider, but are instead being split between two or even three providers’ (www.rsoftr.com).

The salient point here is cost reduction. These systems can find the cheapest mix of staff.

Hours of work may not be known in advance. Nurses await a text message.

Another facet of the torture to come is that these split shifts may be ‘floating split shifts’, which mean that a nurse starts their shift in one unit and then at some point during the shift is moved to a different unit. If you are late at the next unit, you get a bollocking. No time, then, for a full report to the next nurse, thus, patients’ continuity of care is likely to suffer. This system is quite common in America, and will be introduced under the Americanisation of British Nursing Plan being fine-tuned by the corporation-serving UK government. (These ‘reforms’ will also include doctors and care assistants).

Some nurses, rather like Boxer of ‘Animal Farm’, will embrace such change, internalising government rhetoric into their belief system: “I’m a flexible, modern nurse, fit to meet the demands of a changing society” – to paraphrase Wordsworth, people think what they must, then call it by another name. Some nurses will leave, the strain on their social and family life being intollerable. The army of foreign nurses will just get on with it, and jump through whatever hoop is put before them, as long as they can continue sending money home.

Cecilia, meanwhile, will continue to chant: ‘What we want to do is sit down with the Government to work on how to take this forward in the interests of better patient care’, whilst quoting selected studies which the government does not care a rat’s ass about, for they will commission studies showing right to be on their side.

Oh my dear Cecilia, they so dislike you that you are not even told of their plans. Do you honestly think they give another rat’s ass if you sit down with them or not? You are like a little girl in a school yard who is not part of the gang.

Cecilia will not do anything to damage patient care?

Leave that to the government, as long as Cecilia can negotiate the best terms of nurse ‘flexibility’, thus damaging patient care!

Must not strike like naughty Australian and American nurses!

Will Cecilia recommend that ‘enterprising’ nurses work in McDonalds between their split shift? “Get those fries down you, I’m due to give an injection in 10 minutes”!

Oh Cecilia, have you ever considered that nursing exists within a starkly political world, in which the only defense of nursing is a robustly political one?
lenin nightingale 2015