I am an intensive care sister and I have worked in over 25 hospitals in London alone, my primary employer being a nursing agency. They decide where I work and I need to fall in.

Over the last five years, I have noticed a significant decline in the availability of work in London.

Most of the National Health Service (public) hospitals went on huge recruitment drives and employed nurses from India, the Philippines and of course, from South Africa.

The result is now a multi-cultured work environment with the usual inevitable squabbles about who earns what and who has access to working overtime and how much overtime can be allowed for one individual.

The advantages of working for an agency is that can work when you want to, the pay is great and weekly. Rates go up at midnight on a Friday, remaining in place on Saturday and return to normal rates on a Sunday midnight.

Also, the agency is obliged to give you leave pay, pro rata to what you have earned. You may go on selected training through your agency, and agencies are interlinked so they can check for work for you.

To top it all, nurses are required by law to update their basic life support certificates and manual handling (safe moving and handling of the patients for nurse and patient) every year and you can decline offers for a specific hospital without any negative consequences.

The disadvantages are that you spend your life being on call. There are always last minute cancellations. Most holidays and weekends are a nightmare for public transport as that is the time when repairs are usually carried out, making public transport a nightmare. Agency staff are also usually get assigned to the long term patients relegated to the side rooms and you seldom feel part of the permanent staff.

While with an agency, my usual working rhythm was between four and five nights a week earning me a salary of between £800 and £1000 per week depending on if a weekend was included or not. In South Africa, I would usually clear R500 a shift.

Living in London is certainly not cheap. I paid £90 per week for a room in someone’€™s house, then there is a weekly travel card for buses and underground which could amount to £22 per week and of course food which easily adds up to about £30 per week.

Recently I let go of my independence, high wages, taking leave as and when I liked and basically committed myself to one full time employer.

I opted for life in the country and chose Addenbrookes Hospital, the training hospital for Cambridge University.

I chose to take a break from intensive care nursing and now work in the casualty department. In six weeks, I could count on my one hand the number of lacerations that needed suturing as opposed to the suture room on a Friday night at Helen Joseph Hospital in Johannesburg, where the trauma unit would be popping at the seams with knife and gunshot wounds.

At Addenbrookes I have yet to see a major trauma case as a result of a high impact motor vehicle accident. Driving laws are incredibly strict here, speed limits are low.

I work 37 and a half hours per week and do not get paid for tea and lunch breaks. On night duty you can have a sleep during your break and most hospital departments have a couch or sleeper couch where you can stretch out.

This is in stark contrast to South Africa, where you have to try and make a bed on a cold floor somewhere, usually a storeroom or bathroom.

In South Africa, usually at public hospitals, the need for a break is rarely recognised and gets rationalised away ‘€˜because we are short staffed’€™. I find that personally abusive and dangerous for the patients who end up being nursed by exhausted staff.

My working week includes one weekend a month, unlike in SA where we work every second weekend. I am expected to do a minimum of 5 nights per month in the United Kingdom.

In UK hospitals, all wards and departments have a wide range of equipment to assist the nursing staff to move a patient effortlessly.

Personal training and development is another advantage gained.   I can attend any course that is relevant to the department I am working in and it is during work time. A study day counts for seven and half hours pay.

In South Africa you have to squeeze in a quick lecture in the unit between tasks.

My annual salary is £22 103. That is without the ‘€œunsocial’€ (after) hours allowance which per annum will probably add up to about £3000, considerably less than agency work in London but a large chunk better than a South African salary.

The greatest and most important thing is that in Britain I feel acknowledged as a professional by doctors and colleagues. My opinions and experience count for something.

Would I ever return to nursing in South Africa? I guess I would consider it if the system ever changed and stopped being so abusive.

It’€™s definitely not only about the low salaries. The sooner working conditions improve, I’€™m sure South Africa would find quite a few of their nurses returning.

I have worked with a number of fellow South Africans and many are desperately unhappy as they have left small children behind in the hope of earning money that can improve their quality of life and offer their children a better education.

Will I ever return? I love my country but as long as I feel abused and there is limited scope for professional development, I will remain in London.


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