Insomnia makes Student Nurse think: "Why, a culture of cynicisim may not be a bad thing now you mention it!"

I have no problems with the NHS as an idea, nor of its aims. It was responsible for the 23 operations I had on my hands, feet and mouth. That was the reason I wanted to be either a Doctor, a Nurse or a Paramedic. But what bothers me is the way that in the past few years the focus of the NHS has shifted from providing care which is intended for the benefit of patients, but for the finance of the NHS. The trust deficits have run into millions. One wonders where all this money has gone. If a trust has over-spent by £20 million providing patient care then this is fully justified. However, the biggest bug student nurse has on the issue is why the shortfall was not a) noticed sooner or b) Planned for in budgeting. Did the trust leave at 5pm one Friday all ship shape and on return at 9am the following Monday suddenly think "Crikey, £30 million in the red!". When the idea of foundation hospitals was initiated, I personally considered the financial penalties for low performing trusts rather odd. Should it not be that those who are struggling be given the extra funding to put toward investment in services to improve the outcome and service for patients while the better performing trusts be given an increase in line with inflation to maintain the standards which they operate at, but be given reward by placing of regional units and first choice of a new facility to be developed (with the attendant increase in finance to meet such investment and expansion). By having the questioning of any changes which have changes which hide ulterior motives, clinicians are best place to have a say on these changes and to ensure that the safety and the service which we offer are for the greater good for both the trust and the patients.

But when this system begins to fail, there is a huge impact. I remember back when I was more involved as an ambulance attendant the old agency agreement which was held with the former county ambulance service. My regular mate was once activated as an emergency team and the ambulance pressed into service for the NHS. On arriving in A&E, he overheard a county Paramedic mention about "Cheap work while we are on overtime ban". It was very clear, the agency agreement intended for when county was swamped was being used as cover for industrial action. It was swiftly terminated. The forth-coming weeks was busy and the service swamped, and it resulted in a death of a patient. I have never forgotten that event.
Now though, this has grown to record levels. I am a third year and should be ecstatic over the prospect of finishing university, planning for a lifelong career, looking forward to my graduation day when my family can see me gain my "cap and gown", and take another step down life’s great road and plan for what the future holds for me and my girlfriend (also a student nurse, on the child pathway). Instead however, I fear that I will be left with no job and fail to gain employment as a Nurse, have studied for 3 years for nothing but my certificate to show or face having to leave my area to find a job and leave all which I hold very dear: Family, friends, my dear girlfriend, have the headache of finding a home for my historic vehicle, change the address for correspondence for an organisation which I am a committee officer/Editor for, and have to pay for accommodation for the initial weeks (with what money though as I am heavy on the overdraft as it is). I understand that some trusts have to find ways of balancing the books but this really is not a healthy culture to have with staff. I am doubtful that I will gain employment which I am passionate about. In all placements had a great rapport with staff and patients, shown a high level of knowledge of both medical and nursing knowledge/theory, passed essays and have done well with that. I admit, I referred on a research essay, this was when I was going through a rough time and knew I would not pass the essay becuase of the situation, but that is an exception (I got nearly 70% for assessment at the end of year one, and despite the horrendous second year got slightly lower at a range of 50%-60% for essays). I am now pulling out all the proverbial stops to increase on second year and build on the sucess which came at the end and re-build my confidence, but this is the one dark cloud on the horizon: Job freezes.

Unless all health and medical professions work together, there is ever chance that students who have the potential to be good novice nurses, junior doctors, physiotherapists, Occupational therapists or Radiographers in the upcomming 18 months will be left unemployed. Unless the full reason for change is ever explained (and I mean without political unspeak), I cant help but think that thinking cynically may lead to the true reasoning behind changes.