“For what we have to do, the sector is vastly underpaid, and for that we feel massively undervalued”: The truth of being a clinical support worker on a stroke ward

Here, a clinical support worker who works on a stroke ward shares their story of the true reality of working on a stroke ward in 2023, including their thoughts on the recruitment process, as well as funding and feeling undervalued.

It was never my intention to go into the care sector, and not something I ever thought I would consider myself doing. Though sometimes life throws a situation at us, suddenly we find ourselves on a path that takes us in a totally different direction to the one we were expecting.

This is where I found myself at the beginning of April 2022. To cut a long story short I needed a new full time job and my housemate, a student nurse who works part time as a Clinical Support Worker suggested I give it a try.

I applied, and within a week was offered an interview by the Stroke Unit at my first choice hospital. My interview took place via Teams on the morning of Tuesday April 12th, it lasted around 10 minutes before they thanked me for my time, and the interview was over.

I was none too hopeful, thinking that if I’d been successful they’d have wanted to talk to me longer, however, to my delight and surprise I received a phone call offering me a position as a Band 2 Clinical Support Worker on the ward later that day.

I already knew that even if successful it would take a wee while before I started, when I was called to be offered the job they told me to expect to start in July to August time.

As I needed a job in between time I had another interview that day for a temporary customer service role, this was the industry I was trying to leave, for so many different reasons, but I thought “It’s only going to be for around three months”

Within two weeks I had submitted all the documentation requested, it was now just a matter of waiting.

Unfortunately, the recruitment process is a complete shambles. I waited, and waited. I emailed the recruitment team on multiple occasions and received no replies. Trying to get through on the phone was just as bad.

Where I was working we only got 40 minutes for lunch, and I spent many lunchtimes on hold without getting to speak to anyone.

It was only in the September when I’d taken some holiday that I could spare the time to sit and wait for my call to be answered and finally speak to someone.

Only then did things start happening, though still I had to do a criminal records check, I finally had a start date, November 7th, seven months after being offered the job.

In an industry crying out for workers, the recruitment process is simply not good enough. I am not an isolated case, we have had three new clinical workers start since I have and each of their situations took six months from job offer to start date.

I had an idea of what to expect, though nothing can prepare you for the reality of what you face when you begin the actual job.

All of our patients have had strokes, and lot also have illnesses like Parkinson’s or Alzheimer’s to contend with as well.

My first week I worked 7am to 3pm as the charge nurse said he wanted to ease me in gently, normally the shifts are 7am to 7.30pm for days and 7pm to 7.30am on nights, though you don’t start nights until you have completed two full months in the job..

For me, starting at 7am means getting up at 5am and returning home usually around 8.30pm, it’s an incredibly tiring job doing 12.5 hour shifts made harder with commute time taken into account, sometimes three days in a row.

We do three 3 day weeks, and one 4 day week a month.

The first two weeks spent on the ward are called supernumerary, during this time you shadow another worker constantly, as they teach you the job.

As I mentioned, nothing can prepare you for the reality of actually doing the job itself. The sights, the smells, and dealing with patients who have lost significant cognitive function.

The buzzers going off constantly, there are 26 individual rooms on our ward, and there is very rarely any respite.

Towards the end of my third day of my second week I felt like a broken man. All I kept thinking was “Why am I here, What have I done?”. Over and over again.

I was convinced I couldn’t do it, that I’d made a massive mistake in thinking I could do this job. I’ve always been full of self doubt, and this was like nothing I’d ever experienced.

It was at this point that I found somewhere to be on my own, I needed some alone time, I was close to tears, and  actually shed one or two.

All week I’d felt like running away, hiding and crying. And this is exactly what I found myself doing.

One of the Band 6 nurses came to find me, her words of encouragement and kindness were extremely touching. She took me to her office and closed the door.

She sat me down and told me…

“Matthew, this is an incredibly tough job, though everyone I’ve spoken to tells me how well you’re doing, how quickly you’ve picked everything up. You’ve got this”

I had mentioned my concerns to someone and they’d had a chat with her about them.

She then added “Please tell me you’ll come back next week.”

I promised I would, and despite my fears and anxieties I kept my promise. I didn’t want to let her down after the kindness she had shown me.

I had even considered calling the customer service company to see if the full time position they had offered me was still an option, despite everything I despised about the industry, and the extremely poor pay.

Then suddenly, everything seemed to click. I no longer felt overwhelmed by the patient buzzers going off, I felt comfortable going to answer them on my own, going to get assistance if required, so many of our patients can only be cared for with two people.

A standard day starts at 7am, and between 7 to 7.30 we receive a handover, the night shift team provides an update on all the patients, making us aware of any issues, changes that have occurred overnight.

Between 7.30 to 8 am we try to wash at least two patients before starting the breakfast round at 8 am. We have to check the dietary requirements of each patient as we go.

Some patients can only have soft chew diets, some patients have diabetes, and we have to make sure they’re not receiving sugar, or sugary items even if they request it and we have to be aware of the patients that are Nil By Mouth.

After breakfast we continue washing until all 26 patients are done, then it’s constant care rounding of them all, whilst responding to patient buzzers in between up until lunchtime.

After lunch it’s back to routine, care rounding, answering buzzers up until tea time, and again, care rounding answering buzzers up until 7.30 pm when the night shift take over.

We also have to find the time to stock up the patient boxes that are kept within their rooms, so that everything we need is on hand.

Bagging and tying up the dirty laundry ready for it to be collected.

Though there is so much more to the role than the above.

We have to look for, and be aware of any changes in the patient’s condition and report these to the nurses so they can check if the patient requires any further medical attention than they are already receiving, and they in turn report this to the doctors where required.

We have to be excellent listeners, not just so we can let the nurses and doctors know what the patient themselves have described regarding any changes or new symptoms they are feeling and experiencing, though also because they are scared and anxious, often severely depressed over the sudden unexpected life changing effects of the stroke they have suffered.

At times we are like mental health advisors as we try to reassure patients helping them with their anxieties and depression, sometimes we sit and listen and talk to them whenever we get a chance even if they have not buzzed.

We also do this with the patient’s family members.

Since I started we have had 18 patients pass away on our ward, when I started writing a week ago the number was 16.

Six of these happened between Christmas Eve and New Years Eve.

For some patients when they arrive on the ward we already know that we are providing end of life care, unfortunately this is just part of the job.

These patients are with us for weeks or months and in most part are rarely conscious during this time.

For these patients we provide care as we would a patient who is conscious and we are helping in preparation for discharge to home or care home, though we also have to provide additional care.

Such as wetting a sponge and keeping moisture in their mouth to prevent it drying out as this would cause them significant discomfort.

It was to provide this type of care that I found a patient who had passed away.

I had been to her room less than an hour before to place a sponge in her mouth and she was still with us.

I was answering a patient buzzer in the room next to hers and decided to go to her room whilst the patient I had been to see was using the toilet.

As I went to place the sponge in her mouth I noticed she was no longer breathing. She was a Do Not Resuscitate patient so I did not pull the emergency alarm.

I opened the window, and closed the curtain across it, as I left the room I pulled down the blind on the window in the door as I closed it behind me.

I went to find a nurse and we returned where the nurse agreed with me that the patient had passed away and the doctors were called to confirm the time of death.

We open the window of a patient as a kind of ritual, it’s something I was taught when dealing with my first deceased patient, it’s to allow their soul to leave the room. It’s something we always do.

As the family would hope and expect, a deceased patient is treated with incredible care, dignity and respect.

During the process of preparing them to be taken to the mortuary we talk to them throughout, explaining what we are doing and why.

The family was called and asked to come to the hospital, we don’t break the news over the phone.

When they arrived it was staff lunches and as all other members of staff not on lunch were with other patients, I was the only member of staff available to speak to them.

They wanted to know straight away why they were called, if it was the news they were sadly expecting.

I took them to the day room and closed the door, and confirmed what they were expecting to hear.

I then went to find a nurse and doctor to come and speak to them for further information.

I was slightly worried that I should have not have been the one to break the news to them, though a nurse confirmed I had done the right thing, rather than leave them waiting for someone else to come and speak to them as we didn’t know how long this would have taken, and they shouldn’t be left waiting.

Thankfully there are lot of positive outcomes, one patient arrived and at first she couldn’t speak and communicate with us. By the time she was discharged home I couldn’t walk past her room without her shouting my name to call in for a chat. I say chat, it was more of a listen, the improvement she made was incredible and she would talk as long as I would sit there.

She was a very funny and interesting lady, so I was happy to sit and listen to her.

The night before one patient was discharged I went to see her, I wasn’t working the next day and she would be in a care home by the time I returned.

When she had first arrived she kept saying how she wished she had never been found and that she had been allowed to die, and that every night she went to sleep hoping she wouldn’t wake up in the morning.

She thanked me for my kindness as I had spent many hours in her room listening to her, talking to her and she was now glad she still had some years left ahead of her, that she would get to see her daughters more and see her grandchildren grow up and not put them through grieving whilst they were so young.

For what we have to do, the sector is vastly underpaid, and for that we feel massively undervalued.

There is so much more to this job than most would possibly imagine, it can affect both our mental and physical health.

For a lot of us dealing with certain situations can set off triggers for anxiety, and PTSS, and there isn’t anyone that works on the ward that doesn’t suffer with a bad back due to the physical aspects of the job.