The pandemic has made their role visible, but they continue to denounce the terrible working conditions that have been dragging for years. Low ratios, high interim rates, a contribution level lower than that of doctors… Nurses, supported by their patients, say enough is enough and remember that their work has a direct impact on population health. These are the testimonies of some of these professionals and their patients.
David Oliver. “As the pandemic improves, nobody remembers anything anymore & rdquor;
David Oliver, 57, has been working as a nurse all his life. First in a hospital; now in the primary care center (CAP) Montilivi, in Girona. The situation of his profession, he says, has gotten worse in recent decades. “Nursing has lost a lot. The Catalan health system has always been very short on staff & rdquor ;, he says. The few nurses there are for a aging population in the main demand of the group.
Oliver explains that the great decline of the profession, which already had structural problems, began 10 years ago, with the famous cuts that were never fully reversed. “The pandemic has made visible that there is a lack of nurses because they have gone abroad to work. And the people who leave the universities, instead of staying in Catalonia, have had to leave & rdquor ;, he adds.
Conditions outside are better. In Catalonia, according to this nurse, there few people with fixed place, many interim and there are still temporary contracts (“one week, one month…”). According to the Satse nursing union, Catalonia needs some 24,000 nurses. The ratio of nurses in the territory (same as in Spain) is five nurses per thousand inhabitants, while the European average is eight per thousand inhabitants. The ‘conseller’ of Health, Joseph Maria Argimon, has recently committed itself in Parliament to reduce temporary work in the Catalan health system up to 8%.
The covid-19 has done nothing but aggravate this situation because there is work that did not exist before the pandemic and that must continue to be done now, such as carrying out diagnostic tests or vaccination against the disease. “And in the meantime, we’re trying to catch up on chronic disease care and all that work that still needs to be done,” Oliver said. Catalonia has been able to maintain the new hiring of nurses that occurred due to the pandemic thanks to covid funds.
Like the rest of his healthcare colleagues, this nurse alludes to the long working hours in which it is necessary to attend to a huge volume of people and to whom it is not possible to dedicate all the necessary time. “People age and have various pathologies. The needs in the CAPs are higher than before & rdquor ;, she points out.
These conditions affect mood. “We are exhausted & rdquor ;, she insists. And, in addition, there is “social tension & rdquor; (patients who get angry at not being treated as they would like), “physical and psychological stress”. According to Oliver, the nurses had the “hope & rdquor; that their conditions improved after covid-19, which served to make their work visible, but this has not been the case. “Unfortunately, when the pandemic improves, nobody remembers anything. Negotiated agreements do not represent any improvement for nursing & rdquor ;, she concludes.
Marta Rubies: “We have lost 30% of our purchasing power”
the nurse of the Traumatology and Burns Hospital of Vall d’Hebron Marta Rubies focuses on the fact that the low ratios of nurses in both Catalonia and Spain directly affect the health of the population. “It is scientifically proven that the less qualified personnel attending the patients, the higher the mortality. The impact on the patient’s health and well-being is direct & rdquor ;, says Rubies, 54 years old.
Increase the number of nurses It is precisely the main claim of the Satse union. But to have those 24,000 nurses that Catalonia needs, it would be necessary for the 8,000 Catalan nurses who are abroad (especially in the United Kingdom) to return. “And, for this, the conditions should be attractive. We should be at the A1 trading level [están en el A2]. The return is not attractive at all & rdquor ;, admits Rubies.
This nurse describes the situation in her hospital to illustrate the conditions in which her profession finds itself. “In Vall d’Hebron, 70% of the nursing staff is temporary or interim. If we don’t even offer them stability in the workforce, how are they going to come back & rdquor ;, says Rubies.
Satse also claims for the profession that the bonuses for night work, dangerousness and hardship be recognized (paid, for example, by policemen or airplane pilots) in order to benefit from early retirement at 60 years of age. That nursing specialties be developed and that more public places be created in universities.
According to Rubies, about 50% of nurses think of leave the profession and 80% of them have suffered some type of aggression. “The covid has increased the tension,” he certifies as his partner Oliver.
Although he believes that science has come a long way in recent decades, working conditions have deteriorated. “Right now I have the same salary as in 2009. We have lost 30% of purchasing power& rdquor ;, he points. That is why, emotionally, they are “more labile, more vulnerable & rdquor ;.
Although he does feel citizen recognition of the “titanic effort & rdquor; done during the pandemic, Rubies believes that neither the State, nor the companies, nor the institutions recognize the work of nurses.
Now, in the hospital where she works, that “titanic effort & rdquor; It is focused on recovering all the activity that was delayed by covid-19. They find that there is “saturation & rdquor; in outpatient consultations. “There are people who wait up to three or four hours & rdquor ;, she warns. The challenge is to update some hospitals that are “collapsed & rdquor; for all that she left undone. “And it is difficult because there is a deficit of people & rdquor ;, says Rubies.
Antonio Valdivia: “My nurse changed my negative focus towards my illness & rdquor;
Antonio is 31 years old and in 2007, at the age of 16, he was diagnosed with Crohn’s disease, a chronic inflammatory condition of the digestive tract that causes abdominal pain, diarrhea, weight loss and fatigue, among other symptoms. Antonio began with these problems when he was only 11 years old, but the diagnosis, as often happens, was slow in coming. In addition, four years ago he was diagnosed with spondyloarthritis, a disease that causes inflammation of the joints, in his case especially in the back and that is related to the other ailment, since both are caused by a failure in the immune system.
Antonio is feeling better now but a few years ago his illness was for him so incapacitating and frustrating that “I only saw the negative part & rdquor ;. “He had a fatigue from which you do not recover no matter how much you sleep or rest, it almost does not allow you to get out of bed. She had severe abdominal pain and constant diarrhea. The psychological part affects you a lot because I had to live next to a bathroom and had tried several treatments that had not worked at all & rdquor ;, she explains.
Three years ago he began having a “more frequent” relationship with Carmen, who is the nursing professional of the specialized unit of inflammatory bowel disease at the Virgen de las Nieves hospital in Granada. She “changed her perspective & rdquor ;, explained to her that it would take her several months to recover and regain her quality of life and in the end Antonio” has agreed with her & rdquor ;. “For the chronically ill, the complex patients, who we see that treatments don’t always work or that the therapeutic options run out and you do not assimilate it, the work of the nurses is fundamental, they act as psychologists, they solve our doubts, they reassure us and Carmen helped me to change the focus, seeing the pathology in another way & rdquor ;, he points out .
Antony has passed hours and hours in the day hospital and he has established a much more intense relationship with Carmen than the one he maintains with the doctors. “She asked me about my studies, about my work, about my family, I have had conversations with her that give much more than the five minutes of the consultation, has become someone from the family and close environment & rdquor ;. In fact, Antonio now goes to the hospital less often because he gives himself the necessary injections, but he has in mind to visit her any day now. In addition, the telephone contact continues to be constant because Antonio sometimes has doubts about the injection or its effects and Carmen continues to be the reference healthcare professional.
In addition to Carmen, Antonio has been to the emergency room several times and has been hospitalized and has always received “good treatment & rdquor; of nursing professionals. “I have everything to thank for them and I have not found almost anything negative, they are essential & rdquor ;, he relates from the knowledge that also gives him being the health area technician of ACCU (Crohn’s Confederation and Ulcerative Colitis).
Patricia Ayuso. “The nurses have treated me as if I were their daughter”
Patricia Ayuso’s assessment of the work of nurses cannot be higher. “I have been treated as if she were his daughter”, explains about the affection, attention and dedication he has received from the nursing professionals who work in the hematology unit of Hospital La Pazwhere they treat their son Mario Habis, who was diagnosed with hemophilia when he was six months old.
Ayuso has thousands of stories to tell, such as when she was told that Mario suffered from severe hemophilia A: “I collapsed and the first two people who attended me when I cried It was two nurses, Feli and Carmen, who reassured me, gave me kisses, held me… Now they are retired but I don’t forget them & rdquor ;, he says.
Also his son, who is now 10 years old, has a unbeatable impression of nursing professionals. And that since he was 9 months old, the treatment of his disease requires constant punctures to receive prophylaxis, which for a child is not easy. But “a good nurse is the one who can make a child cope better or worse with his illness, because even if they make him suffer with the pricks, they always have a smile and do the unspeakable so that the child does not suffer & rdquor ;, Patricia assures.
Mario has gone through several phases in his illness. Until he was a year and a half old he had to go every other day to receive prophylaxis in the hospital. From that age on, she was fitted with a Porh-a-cath, which is a device that provides permanent venous access, but her parents had to go to the hospital every day for two months to learn how to use it. “The bond with the nurses then went further because I was a nerd in all of this, I had never seen a needle in my life& rdquor ;, says the mother. In addition, the child did not want to go, already fed up with so much pressure from the professionals and from his parents in the learning process, but the nurses “took the necessary time to convince him, entertain him, whatever was necessary & rdquor ;.
“Your role is essentialfor me they are at the same level as any doctor & rdquor ;, says Patricia emphatically, because for her family the work of these health professionals It is as important as that of the doctorsrehabilitators, psychologists, all those who make up the specialized unit.
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When Mario was 7 years old, the Port-a-cath device was removed and Patricia and her husband had to relearn how to stick him but in his veins. “I still remember the day I found the vein and the three nurses who were there gave a shout of joy and a party was set up & rdquor ;. And, in the current phase, Mario punctures himself.
All the teachings on how to prick yourself, how to disinfect the material and surfaces, how to avoid any possible source of infection that can be very serious for a hemophiliac, have been learned by this family from the hands of Alfonso, Sara, Araceli and Carmina. “The time has come when Mario does not want to be served more than them& rdquor ;, maintains Patricia.