NHS: Night shift and a cold rage


A mental health worker

I’m a psychiatric nurse in a crisis/home treatment capacity in a South Yorkshire mental health trust.

Tonight I worked a night shift. I assessed three very different people in the local A&E department, three people who are all in their own ways victims of austerity.

The first was a young woman who, earlier that day, was subjected to a sexual assault by her partner. Despite experiencing such an awful ordeal, one of the woman’s principal anxieties was about money.

With the partner now gone, she realised it will take the DWP weeks to adjust her benefits and having no family living locally, she had no idea where she would find money for food and to pay her payday lender.

In a humane society the victim of such an assault would not have to contend with these worries. But where’s the humanity in Iain Duncan Smith’s benefits regime?

The second was a resident in a private care home that claims to specialise in accommodating people with mental health problems.

That afternoon the man had got drunk and become troublesome to staff and was sent to hospital in an ambulance, with a request for a mental state assessment.

By the time I spoke to him he had sobered up and calmed down. His behaviour was not the product of mental illness – he is unhappy living in the care home and wishes to live independently.

This is not an issue a crisis worker can address at two in the morning. All I could do was to suggest that he returns to the care home and asks to see his social worker to discuss his placement in the morning.

The care home staff initially refused to take this man back. The A&E sister had to argue with them over the telephone for almost an hour before they relented.

The home charges the local authority £1,200 a week to provide “specialist care” for this man.

Private care homes regularly dump residents they find difficult to manage onto local NHS hospitals and then try to walk away from their duty of care.

I don’t actually blame staff in these homes. They’re often paid the minimum wage and with minimal staffing levels.

I can understand why they seek to remove individuals who display challenging behaviours.

What makes my blood boil are the owners, who charge the NHS and local councils huge sums of money for services they clearly cannot deliver.

The final assessment was with a woman who had taken an overdose. On benefits and with two teenage sons, she cannot afford to buy her boys new shoes. In a moment of despair she saw suicide as the only way out.

She was tearful and contrite when I spoke to her, ashamed of her actions. Beyond showing compassion, there was little I could actually do for her. The NHS does not have a cure for poverty.

It was a fairly typical night for a mental health crisis team working in Cameron’s Britain. We see some people whose difficulties are due to mental illness but for the most part our client group are victims of an inflexible benefits system, of private providers that attempt to shirk their duties of care and of poverty.

Rain fills the sky as I leave the hospital to return to my base. The heavy grey clouds matched my mood.

Back at the office I revive my spirits with coffee and a cigarette. I “officially” gave up smoking six years ago but caffeine and nicotine are the only things keeping me going throughout a night shift.

Like many health professionals, the stresses of the job make me a lousy poster boy for healthy living.

Another typical night and typically I am angry. It’s a cold rage that I feel, but a rage of empowerment which steels my determination to fight for socialism and to win the day when the stories I heard tonight become distant memories of a cruel and defeated past.