Posted 05 January 2023 - 10:00
Posted 05 January 2023 - 10:00
News
‘We have to choose who potentially lives or dies’: emergency staff speak out
Nurses in emergency departments reveal agonising decisions they must make about who to admit first among patients in overcrowded waiting rooms
Nurses in emergency departments reveal agonising decisions they must make about who to admit first among patients in overcrowded waiting rooms
Nurses working in emergency departments have told how they are choosing which patients potentially live or die as they are forced to prioritise the most urgent cases.
One senior nurse working at a busy London trust said she faces the constant burden of choosing who should be admitted next. Short on beds, trolleys, staff and time, she explained that every shift begins with at least 45 people already in the waiting room, with some having been there for up to 36 hours.
‘The stress of deciding is agony’
‘Some people have been admitted but are waiting on a plastic chair for a trolley space for a whole day,’ she told Nursing Standard.
‘These are patients with appendicitis, with a Crohn’s flare-up or older patients. There are patients with mental health problems in departments for days waiting for beds without registered mental health nurses to help us manage their needs.
‘The stress of deciding whether to treat a 90 year old or a chemotherapy patient is agony. You’re potentially making a life-or-death decision.’
She added that staff are ‘running round like headless chickens due to workloads’, while also facing regular violence and aggression from patients and visitors due to their frustrations.
‘We are spread so thin’
Another emergency nurse working at a London trust said the difference between this winter and last was ‘so drastic’.
She told Nursing Standard: ‘I honestly don’t see any light at the end of the tunnel. Patients on chairs, patients on trolleys, standing everywhere. We are spread so thin we can’t give the care they need and deserve.
‘We’ve been in winter pressure since August, and there’s no reprieve. There doesn’t seem to be any plan to make things better.’
RCN highlights ‘grossly unsafe conditions’
NHS England wrote to staff in October to update them on winter resilience plans, which included measures to set up 24/7 control centres to manage demand for, and capacity of, services.
Health service staff claim the strategy is making no difference, and RCN general secretary Pat Cullen called on the government to take urgent action as nurses are forced to treat patients in corridors in ‘grossly unsafe conditions’.
‘I know so many talented nurses that plan to leave this year’
But for many staff and their patients any action may be too little too late, with one nurse saying she already plans to leave the NHS in the next six months.
‘It is so sad to see,’ she added. ‘This is not the NHS I joined five years ago, and it is falling part. I know so many talented nurses that plan to leave this year, and I’ll be one of them.’
A spokesperson for the NHS in London said the health service is experiencing record demand due to an increase in flu and COVID admissions.
‘While we have prepared for winter like never before with more beds, extra 111 call handlers and by expanding the use of 24/7 control centres to manage demand across the capital for urgent and emergency care, we recognise the strain our staff are under dealing with this extra pressure.’
The Department of Health and Social Care has been approached for comment.
In other news