Patients treated on corridors and waiting hours for treatment - RCN
Published: 13 May 2012
Patients are being placed on hospital trolleys for hours on end and treated in corridors not appropriate for care, the Royal College of Nursing warned today (May 13), as it published results from a new ICM Research survey revealing the current state of the NHS frontline.
A survey of more than 1200 nurses and healthcare assistants working in acute settings raises questions about capacity in some hospitals. More than a fifth of nurses (21 percent) said that patients receiving care on corridors or areas not designated for patient care happened at least once a day, with four percent saying it happened hourly.
In emergency settings, the situation is even worse, with more than half of emergency department nurses (51 percent) reporting that patients receiving care on corridors or areas not designated for patient care happened daily. Nearly a fifth (18 percent) said they saw this happening hourly. Overall, nearly four in five nurses (79 percent) said patient safety was being compromised by patients being kept in those areas.
The RCN is today calling for NHS organisations to halt the closure of hospital beds until they can clearly demonstrate that alternative, tried and tested, patient services in the community are up and running. In the last decade (2001-2011) in England, the average daily availability of general and acute hospital beds fell by 22 percent, with Trusts often cutting beds for financial reasons, despite soaring demand and an aging population. In the same period A&E attendances have increased by 60 percent and the number of emergency admissions grew by 56 percent.
RCN Chief Executive & General Secretary, Dr Peter Carter, said:
“This survey paints a worrying picture of what is happening in our hospitals. Two years ago we warned that the need to make £20 billion in efficiency savings in England alone would risk sending the NHS back to the days of treating patients in corridors or areas not designed for care. Sadly, it looks like those days have now returned.
“We know that there is huge demand in A&Es and that it is growing at a substantial rate. However, this sort of situation is not only unacceptable from a patient experience and safety point of view, but causes great distress to families, carers and nursing staff.”
Other key findings from the survey revealed serious concerns about the length of time patients are being forced to wait, the setting up of temporary wards, and how patients are treated, including:
• Nearly two in five nurses (39 percent) working in emergency departments see patients kept in ambulances or held in a queue outside of a department because of a lack of trolleys and beds on a daily basis. A total of 16 percent said this happens hourly;
• Almost half of nurses (48 percent) said they have encountered patients being cared for or being asked to await care on trolleys for long periods in the last six months, with an overall average wait on trolleys of six hours and 23 minutes;
• Of those, almost five percent said patients had been forced to wait more than 24 hours;
• More than 40 percent of respondents (41 percent) said they witness patients moved to wards not suited to the patient’s condition on a daily basis;
• A third of nurses (33 percent) witness patients being moved every day for non-clinical reasons, ie to meet targets.
In addition to addressing bed closures, NHS organisations should develop a much greater understanding of pressure points in the system and better manage the changes in demand across the system. They must also provide safe staffing levels across all sectors. In November, the RCN identified that 56,000 NHS posts across the UK have been lost, or are set to go, with many posts remaining unfilled across all parts of the health service.
One respondent who works on an emergency surgical admission unit, said:
“My shifts have been so awful I seriously consider how I can carry on nursing. I’m 37 with 14 years nursing experience and have never known things so bad. Two of the day staff who had been on duty since 7 am stayed on the ward til 23.00 to help safely staff (the) ward as the normal night shift staff is two staff nurses, one HCA (healthcare assistant) and this was not safe. No help was available from anywhere else to increase staffing. I feel so demoralised and stressed and exhausted.”
Dr Carter added:
“Treating patients on corridors or areas not designed for care is a high risk strategy, which can have a serious impact on patient care. Patients need to be able to interact with staff, to be able to reach call bells and to know they are visible. They also need regular monitoring and easy access to equipment if their condition deteriorates. Finally, patients need to have their privacy and dignity protected. It is extremely disappointing that in this day and age patients cannot rely on receiving this care.”
Today’s survey also highlights the huge stress frontline workers are currently under. A third of respondents (33 percent) felt intolerable pressure was being placed on staff, with a total of 86 percent saying the current level of pressure was either not very manageable or not manageable at all.
Notes for Editors
1. ICM Research interviewed a random sample of 1246 members of the RCN online between 30th March and 19th April 2012.Respondents came from the following countries:
Scotland: 125
Northern Ireland: 37
Wales: 75
England: 1009
2. For further information, please contact the RCN Media Office on 020 7647 3633, press.office@rcn.org.uk or visit http://www.rcn.org.uk/newsevents/media
3. The Royal College of Nursing has developed eight principles of nursing practice, which detail what everyone can expect from nursing practice, whether colleagues, patients, family and carers. They are as follows:
Principle A
Nurses and nursing staff treat everyone in their care with dignity and humanity – they understand their individual needs, show compassion and sensitivity, and provide care in a way that respects all people equally.
Principle B
Nurses and nursing staff take responsibility for the care they provide and answer for their own judgments and actions – they carry out these actions in a way that is agreed with their patients, and the families and carers of their patients, and in a way that meets the requirements of their professional bodies and the law.
Principle C
Nurses and nursing staff manage risk, are vigilant about risk, and help to keep everyone safe in the places they receive health care.
Principle D
Nurses and nursing staff provide and promote care that puts people at the centre, involves patients, service users, their families and their carers in decisions and helps them make informed choices about their treatment and care.
Principle E
Nurses and nursing staff are at the heart of the communication process: they assess, record and report on treatment and care, handle information sensitively and confidentially, deal with complaints effectively, and are conscientious in reporting the things they are concerned about.
Principle F
Nurses and nursing staff have up-to-date knowledge and skills, and use these with intelligence, insight and understanding in line with the needs of each individual in their care.
Principle G
Nurses and nursing staff work closely with their own team and with other professionals, making sure patients’ care and treatment is co-ordinated, is of a high standard and has the best possible outcome.
Principle H
Nurses and nursing staff lead by example, develop themselves and other staff, and influence the way care is given in a manner that is open and responds to individual needs.
4. The Royal College of Nursing (RCN) is the voice of nursing across the UK and is the largest professional union of nursing staff in the world. The RCN promotes the interest of nurses and patients on a wide range of issues and helps shape healthcare policy by working closely with the UK Government and other national and international institutions, trade unions, professional bodies and voluntary organisations.