Emergency department nurses show ‘exceptional resilience’ despite overcrowding

CQC inspectors praise staff for compassion in managing delays for mental health patients

The ‘exceptional’ resilience and compassion of nurses working in an overcrowded emergency department has been praised by the health watchdog.

Care Quality Commission (CQC) inspectors carried out an unannounced inspection of urgent and emergency services at Blackpool Victoria Hospital in January.

Inspectors found significant delays in most areas of the service, and a poor layout that leads to overcrowding and patients being treated in corridors. 

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They also found delays of more than 17 hours in transferring patients awaiting a mental health bed, while reviews were undertaken by a mental health provider separate to the trust.

Difficult circumstances

But CQC chief inspector of hospitals Edward Baker also praised nurses’ efforts.

‘Although nurses lacked formal training in the management of mental health conditions, they demonstrated exceptional resilience and compassion when faced with patients who were clearly deteriorating,’ he said.

‘This included a nurse who remained kind and compassionate despite a patient screaming in their face after being in the department for 17 hours.’

Inspectors found nurses did not have appropriate training to be able to care for patients who presented with acute mental health needs.

Lack of formal mental health training

Staff said they frequently saw younger patients who had overdosed intentionally or who were at risk of suicide.

One senior nurse said: ‘We don’t have the training or knowledge to be able to deal with this. It can be frightening not to be able to help someone.’

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Inspectors also highlighted staff who went ‘above and beyond’, such as a nurse who stayed after the end of their shift to reassure a patient awaiting test results.

Requires improvement

During a previous trust-wide inspection in November 2017, the department was rated ‘requires improvement’, with safety rated ‘inadequate’. The latest inspection report is unrated, and the trust’s overall rating is unchanged.

The CQC said the department must improve standards of care, including triage and time to assessment for mental health patients.

Blackpool Teaching Hospitals NHS Foundation Trust interim chief executive Kevin McGee said the trust was experiencing high demand at the time of the inspection and had already acted to improve waiting times and overcrowding.

‘It is clear the report exposes areas of genuine concern that we recognise need to be improved, and many of these are being addressed as a priority by the trust.’

Related 

Read the CQC report

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