Student nurses still motivated as NHS pay cap hits retention

July 12, 2017

Student nurses still motivated as NHS pay cap hits retention
If you remember my article explaining the odd relationship between compensation and performance, then you’ll know that according to Herzberg’s two-factor theory, we aren’t motivated by salary alone. Rather, salary serves as a ‘Hygiene Factor’, protecting against dissatisfaction, and stopping us from giving up.

So when the UK government recently confirmed that they have no plans to end the 1% NHS pay cap for public sector workers, it’s understandable that many people’s worries about the NHS intensified. And it’s even a little ironic that it’s the ‘hygiene’ elements that the NHS seems to struggle with.

Evidence suggests that the continued pay freeze is impacting employee retention within the NHS. Badly. But our next generation of student nurses seem determined to prove that money isn’t everything.

Pay freeze hits NHS retention – more nurses now leaving than joining

The Nursing & Midwifery Council (NMC) regulates the UK’s nursing industry. Any practicing nurse must register with the NMC, making the NMC register a great way to measure nursing staff retention across the country.

According to the NMC’s 2017 report, the number of UK nurses cancelling their registration now exceeds the number of UK nurses signing up. Yes, there are more nurses leaving, than there are nurses joining. And this has been happening now for three years running – starting around the time George Osbourne announced a further four years of pay caps for NHS staff.

This growing gap between nurses joining and leaving potentially spells out just how real Herzberg’s theory is. It seems to confirm that a blatant disregard for people’s salary could lead to mutiny. But while fewer nurses might be joining the profession, our next generation seems ready for the fight.

Numbers of UK registrants joining and leaving the NMCThis extract is reproduced and reprinted with permission with thanks to the Nursing and Midwifery Council, The NMC Register, July 2017

Most new nurses aren’t in it for the money

Abigail Crowley is in her final year of mental health nursing at Sheffield Hallam University. She began her studies in 2015 – the same year George Osborne announced that public sector pay caps were to continue for another four years.

“I knew when I decided to become a mental health nurse that my future salary was unlikely to have the brightest outlook” she says, “but I didn’t make my choice because of money. Like most of my colleagues, I joined this profession so that I could make a difference to people’s lives.”

Crowley explains that while some of her colleagues are now reconsidering their career options, most are simply feeling even more driven than ever to get out there and prove that you can’t put a price on another person’s health.

If the government won’t take care of the people, we will

According to Crowley, there is a very strong spirit right now in the student nursing community, which is best explained with a simple mantra: If the government won’t take care of the people, then the people will take care of the people.

“We know the NHS is in a bit of a bad way right now” she admits, “but this just makes me even more eager to finish my studies, and go fix it. I know what it feels like to be a patient, and it makes all the difference when you have somebody looking after you who genuinely cares. I want to be that kind of person – I want to show my patients that their health and wellbeing comes before my ambition for a big fat pay packet.”

However, for some student nurses, there is a growing feeling that their passion to help people is being taken for granted. Take Bradley Watts, for example.

The NHS needs to stop taking nurses for granted

“I’m currently on placement in Chesterfield’s Accident and Emergency Department, and I earn the equivalent of £2 per hour” says Watts, who will become a fully qualified nurse by early 2018. “Thanks to further pay caps, by the time I qualify, I’ll still only be earning similar to what I’d be earning in a supermarket.”

Like Crowley, Watts also joined the nursing profession because he wanted to help people. But he also feels a certain level of resentment, and believes that nursing salaries need to reflect the levels of risk and responsibility their job roles carry.

“I am responsible for people’s lives” he explains. “If a supermarket employee makes a mistake, what’s the worst that could happen? They have to replace some stock. If I make a mistake, I could have a person’s death on my conscience for the rest of my life.”

The money might be awful, but at least the job’s not boring

“I knew the NHS was severely understaffed when I started my studies in March 2015” says Watts. “So I knew exactly what I was in for – and I knew it wouldn’t be easy.”

Watts says that working in a busy, understaffed A&E department certainly has its fair share of challenges. But at least it isn’t boring.

“The sheer volume of patients we’re treating makes it really difficult to deliver the level of care we’d like to” he tells me. “And it’s a thankless career – patients verbally abuse us, spit at us, and sometimes even attack us. But none of this has dampened my motivation to do a great job – at least I can go to work every day, or night, knowing that not a single shift is going to be the same as the last!”

According to Herzberg, it is challenge that motivates us

That last comment from Watts brings us right back to Herzberg’s theory of motivation. Herzberg argues that while factors like a good salary protect against dissatisfaction, it is factors like a challenging workload that actually provide the satisfaction itself.

A list of motivators, according to Herzberg’s two-factor theory, include:

  • Responsibility
  • Achievement & recognition
  • The work itself
  • Advancement
  • Growth

So while a nursing career may not currently be the most ‘hygienic’, I am starting to see why our next generation of nurses have such passion in their hearts, and such fire in their bellies. And ultimately, isn’t that the kind of person we want looking after us when we get sick?

What HR and employers can learn from the NHS pay caps

The NHS itself may have its hands tied in terms of government funding – although I’d hope this is a situation that can be resolved, and quickly, before our new generation of nurses lose the fire that’s driving them forwards. But that’s a conversation for another day. For now, I think it’s important to look at what the NHS pay caps can teach employers and HR professionals in the private sector, about how we can deliver a better working environment for our employees.

  1. If you want to motivate your employees, then give their jobs a real purpose
  2. You need to recognise the risks and responsibilities each person in your company carries
  3. Failure to pay a decent wage could lead to eventual mutiny

Are you doing enough to make sure your people are motivated, appreciated, and fairly compensated?

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