| 送交者: icemessenger[♂☆★★★SuperMod★★★☆♂] 于 2022-11-20 2:44 已读 1170 次 | icemessenger的个人频道 |
The NHS is failing the nurses who keep it afloat 在疫情期间不知疲倦地工作的护士比其他任何公共部门群体都更应该得到倾听，但他们需要的不仅仅是更高的薪酬。
The threatened pay strike obscures a wider refusal to value, reward and retain experienced staff. 6park.com
如果你站在罢工纠察线上，你要怎样去保护病人呢？我有点忧虑地问一位护士朋友。“太有意思了，”她沉吟道，“我们太重要了，以至于不能罢工；但又不够重要，无法得到适当的报酬。”随着英国进入一个充斥着不满情绪的冬天，在疫情期间不知疲倦地工作的护士比其他任何公共部门群体都更应该得到倾听。但他们需要的不仅仅是更高的薪酬。英国国家医疗服务体系(NHS)在各个层面都辜负了他们。 6park.com
How will you protect the patients if you’re on a picket line? I ask a nurse friend, somewhat anxiously. “It’s funny,” she muses. “We are too important to strike; but not important enough to be properly paid.” As Britain heads into a winter of discontent, nurses who worked tirelessly through the pandemic deserve a hearing more than any other public sector group. But it’s not only better pay they need. The NHS has failed them at every level. 6park.com
The Royal College of Nursing is demanding pay rises of 5 per cent above inflation, which the government can’t afford. But nor can the country afford inaction. Cancer backlogs have reached all-time highs. Poor health has become a brake on economic growth. 6park.com皇家护理学院(Royal College of Nursing)要求的加薪幅度相当于在通货膨胀的基础上加薪5%，这是政府无法承受的。但这个国家也承受不起无所作为。癌症积压病例已经达到了历史最高水平。健康状况不佳已成为经济增长的阻碍。 6park.com 6park.comThe NHS now feels like a vast sinking ship, with staff retiring early or jumping off in frustration, patients facing long waits, and leaders struggling to plug the holes. A vicious cycle of stress and feeling undervalued is leading GPs to become locums and nurses to turn to agency work. “We can’t see the cavalry coming over the hill,” a former RCN president, Dame Anne Marie Rafferty, tells me: “only a mountain of work.” 6park.comNHS现在感觉就像一艘正在沉没的巨轮，员工要么提前退休，要么沮丧地跳下船，病人面临漫长的等待，而管理者则在努力填补漏洞。压力和感觉被轻视的恶性循环导致全科医生成为替班医生，医院护士转为编外人士代理护士。皇家护理学院前主席安妮•玛丽•拉弗蒂女爵士(Dame Anne Marie Rafferty)告诉我：“我们看不到增援部队，只有堆积如山的工作。” 6park.com 6park.comThe immediate challenge is to head off the strikes — and with more than just warm words. But ministers must also think about the system they want to see after inflation abates. 6park.com眼前的挑战是阻止罢工，而且不能只是说一些暖人心的话。但大臣们也必须好好想想，通胀减弱后他们希望看到什么样的制度。 6park.com 6park.comThe government prioritised the lowest paid in the last deal. But it might be better to focus on those whose retention makes the greatest difference to whether patients live or die. Research shows these are the highly skilled, mid-ranking, experienced nurses — for whom agency nurses are not a substitute. 6park.com政府在上一份协议中优先考虑工资最低的员工。但是，更好的做法可能是把重点放在那些对病人的生死有最大影响的人身上。研究表明高技能、中级、有经验的护士正是这类人，代理护士是无法替代他们的。 6park.com 6park.comYet the NHS doesn’t properly value that experience, because staff are trapped in a clunky pay system called Agenda for Change. This covers more than a million full-time equivalents working in a huge range of jobs, and across regions where the cost of living can vary widely. Since 2004, it has simplified pay negotiations, and underpinned a national career structure. But paying people according to their “band” does not distinguish between a nurse who is taking blood pressure in outpatients, for example, and one dealing with life or death in intensive care. It does not, in fact, do what it was created to do: deliver equal pay for equal work. 6park.com然而，NHS并没有适当地重视这种经验，因为员工们被困在一个名为“变革议程”的笨重的薪酬体系中。该体系涵盖了100多万全职同类人员，他们从事的工作各种各样，所在地区的生活成本可能差异巨大。自2004年以来，这个议程简化了薪酬谈判，并支撑了一个全国性的职业结构。但是，根据人们的“级别”来支付工资并不能做到有所区分，比如，区分在门诊量血压的护士与在重症监护室处理生死攸关事务的护士。事实上，这个议程并没有实现它的初衷：实现同工同酬。 6park.com 6park.comThis is a classic example of how the NHS is often its own worst enemy. Good staff reach the top of their “band”, and can then only earn more by being promoted to a different job. But some great nurses want to keep doing what they do well. Instead of recognising and paying them for their experience, we hit them with higher national insurance and pension contributions once they start earning more than £35,000 a year. 6park.com这是一个典型的例子，说明NHS最大的敌人往往是它自己。优秀的员工会达到他们所在“级别”的顶端，然后只能通过晋升到另一个工作岗位来赚取更多的钱。但一些优秀的护士希望继续做他们擅长的工作。一旦他们的年收入开始超过3.5万英镑，我们就会让他们缴纳更高的国民保险和养老金，而不是认可他们的工作经验并据此支付薪酬。 6park.com 6park.comPay and pay structures must be improved. But so must the way the NHS treats nurses. A year ago, an RCN survey of its members found almost six in 10 were considering or planning to leave their post. The main reasons were feeling undervalued and pressured. I have spoken to nurses who have nowhere to get changed, nowhere to sit quietly and shed a tear — and who have to pay to use the hospital car park. The NHS is full of HR people parroting “values”, but riddled with bullying and harassment. 6park.com薪酬和薪酬结构必须得到改善。但NHS对待护士的方式也必须改进。一年前，皇家护理学院对其成员进行的一项调查发现，近六成人正考虑或计划离职。主要原因是感觉被轻视和压力太大。我曾与一些护士交谈过，他们没有地方可以换衣服，没有地方可以静静地坐着流泪，使用医院的停车场还要交钱。NHS里满是只会机械地重复“价值”的人力资源人员，却充斥着欺凌和骚扰。 6park.com 6park.comTen years ago, when I wrote an independent review into junior nursing and care staff for the government, I concluded that the now commonplace 12-hour shifts seemed bad for both nurses and patients. I was told, including by the RCN, that nurses liked the arrangement, because they had more days off to look after their kids. Resigned to the status quo, no one was willing to step back and ask what was actually the right thing to do. 6park.com十年前，当我为政府写了一篇关于初级护理人员的独立评论时，我得出的结论是，现在普遍实行的12小时轮班制似乎对护士和病人都不好。包括皇家护理学院在内的人告诉我，护士们喜欢这样的安排，因为他们有更多的休息日来照顾孩子。大家安于现状，没有人愿意后退一步，问问什么才是真正正确的事情。 6park.com 6park.comIn health and care, studies show that the most dedicated staff are the ones who suffer most acutely from guilt and stress when they feel they cannot give good care. Professor James Buchan, a visiting fellow at the Health Foundation, says that the English NHS “stands out” from some other countries in its lack of stringency in safe staffing. Recent strikes in Australia, he says, were driven by a similar combination of fury over low pay and an urgent need to improve nurse to patient ratios. This is an important part of the RCN’s case. As it says, “nursing is not a heroic deed . . . [but] a safety critical profession”. 6park.com在健康和护理领域，研究表明，最敬业的工作人员在感到自己无法提供良好的护理时，会感受到最深重的内疚和压力。健康基金会的访问学者詹姆斯•巴肯(James Buchan)教授说，与其他国家相比，英国的NHS在人员足量性方面缺乏严格要求，这一点“很突出”。他说，最近在澳大利亚发生的罢工，也是由对低工资的愤怒和迫切需要提高护士与病人的比例所引起的。这是皇家护理学院所提出主张的一个重要部分。正如它所说，“护理不是一种英雄行为……（而是）一个安全攸关的职业”。 6park.com 6park.comOne person in government knows all this: chancellor Jeremy Hunt. As health secretary, he fought for safety in the NHS. He also proposed building affordable homes for nurses on spare public-sector land — long commutes and high rents are problems for the profession. The Treasury stopped him. Now as chancellor, he should return to the issue. 6park.com政府中有一个人知道这一切：财政大臣杰里米•亨特(Jeremy Hunt)。在担任卫生大臣时，他为NHS的安全而奋斗。他还曾提议在公共部门闲置的土地上为护士建造负担得起的住房——通勤时间长和租金高是护士这个职业的问题。当时，财政部阻止了他。现在，作为财政大臣的亨特应该回到这个问题上来。 6park.com 6park.comWhy can’t we build homes for nurses? Why don’t we let nurses park their cars at work for free, and build proper canteens? Why can’t we reassure NHS staff that there is a better future? And why isn’t anyone in charge? The NHS is increasingly a mess of committees, recommendations and targets that run into the hundreds. That is not leadership — and it accentuates the feeling of insecurity among its staff. 6park.com为什么我们不能为护士建房子？为什么我们不让护士免费把车停在上班的地方，并建造像样的食堂呢？为什么我们不能让NHS工作人员相信，未来会更好？为什么没人负责？NHS越来越多地被各种委员会、建议和数以百计的目标搞得一团糟。这不是领导力——而且它加剧了员工的不安全感。 6park.com 6park.comIt is a sign of how strongly nurses take their responsibilities that fewer than half of the hospital trusts in England have voted to strike. There will now be a row over the RCN ballot’s structure. But the bigger picture is that the government needs to set nursing on a stable path. There are logical reasons to stand firm on the existing 4.5 per cent pay offer: the value of pensions, comparisons with teachers and the private sector. But cold numbers don’t capture the anguish of people who worked tirelessly through the pandemic, many of whom now say they will stop doing the overtime on which the NHS has relied. They need hope. 6park.com在英格兰，只有不到一半的医院信托机构投票支持罢工，这表明了护士们是多么恪尽职守。现在将会有一场关于皇家护理学院投票结构的争论。但更大的前景是政府需要让护理工作走上一条稳定的道路。坚持目前4.5%的加薪幅度是有合理理由的：养老金的价值、与教师和私营部门加薪幅度的比较。但冷冰冰的数字并不能反映出那些在疫情期间不知疲倦地工作的人们的痛苦，他们中的许多人现在表示他们将停止加班——而NHS的运行就仰仗于此。他们需要希望。 6park.com
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