The treatment of patients in inappropriate areas such as corridors and waiting rooms is increasingly common and compromises patient safety and dignity, emergency nurses have told the Royal College of Nursing.
Over five hundred specialist A&E nurses in the RCN’s Emergency Care Association shared their experiences of overcrowded hospitals ahead of the College’s annual Congress, which begins today (Monday) in Brighton.
The full conference will discuss the impact of ‘corridor care’ and the “moral injury and distress for nursing staff, knowing that they are providing suboptimal care to patients.”
In her keynote address tomorrow, Pat Cullen will say “health and care systems around the UK are sailing dangerously close to the wind.”
The survey of emergency care nurses reveals more than eight in 10 say treatment in non-designated clinical areas, including store rooms, has increased since the beginning of last year.
Over nine in 10 raised concerns that patients may be receiving unsafe care and patient dignity, privacy and confidentiality is compromised. More than six in 10 added that the situation leads to fears of being struck off the nursing register or a court case as a result of patient harm.
Two thirds have faced increased violence or aggression from frustrated patients and relatives, while a third said they did not feel comfortable to raise concerns about the impact of providing care in inappropriate settings.
Free-text responses saw nursing staff describe feeling ‘broken’ and ‘suicidal’; corridor treatment being ‘degrading’ for patients; and nurses leaving the NHS as a consequence, including after a death in the corridor.
Corridor care has become more common due to increased demand on hospitals because of a lack of GP appointments. Hospitals are also unable to discharge patients because of a lack of community care provision. Bed capacity runs at dangerous levels and patients in emergency departments cannot be moved to wards. As a result, emergency care staff provide care in inappropriate settings to cope with high numbers of patients.
RCN General Secretary and Chief Executive, Pat Cullen, said:
“This bleak picture comes from right across the NHS. Patients backed-up through emergency departments is a stark sign of a health and care system grinding to a halt. A corridor is no place to die and no place to work either.
“When ministers fail to grip this situation, they allow patients to pay a high price and nursing staff to work in fear, professionally compromised. Governments must urgently plan and invest to reverse this new trend.
“Our members have told us they’re so concerned about patient safety being compromised that they are fearing court cases against them. While any decision around a court case would take into context the particular pressures that a nurse is working within, these fears are evidence of just how unsafe conditions have become. It’s shocking that many nurses don’t feel comfortable about raising concerns, despite everything we’ve learnt from the Francis report a decade ago.”
Ends
Notes to editors
The RCN conducted an online survey of members of the RCN’s Emergency Care Association (ECA) exploring respondents’ experiences of corridor care. The ECA represents RCN members working in emergency care. The full survey results are here.
Free text comments in the survey include:
- “I am broken. I had to book into my own department as I was suicidal”.
- “I left full time work within the NHS as a direct result of a patient under my care dying whilst in the corridor waiting to get into A&E”
- “I am often overwhelmed and tearful as I cannot provide safe and effective care.”
- “This is so discriminatory and degrading towards our patients. But there appears to be little solution. I would not like to need to receive emergency care in the UK at this time.”
- “I have handed my notice in and am working the last 8 weeks in the Emergency Department. After 11 years dedicated to a career in emergency medicine I am burnt out, mentally exhausted and scared for the future of the NHS.”
- “My levels of stress and anxiety are now unsustainable. I'm looking to leave the NHS due to the decline in my mental health. I honestly dread going into work.”
- “For the first time in my life I am currently suffering extreme anxiety resulting in a period of sickness absence.”
- “I am concerned about my colleagues’ mental health and stress levels.”
- “It distresses me that I’m unable to provide the care patients deserve.”
- “Patients are definitely receiving poor care. And some not at all, because they walk out after 10 hours of waiting.”
- “It just makes you feel embarrassed by this, and you just feel awful for the patients. So undignified.”
Ahead of the debate, an emergency care nurse, said: “Caring for patients in corridors is destroying staff morale. When you walk into the department and see 15-20 people in the queue, day in day out - you lose any hope it’s going to be a good shift.
“We care for patients the best we can, but something happens every day. I’ve dealt with almost every situation I can imagine in the queue. We’ve had to fit call bells and crash buzzers after people have had cardiac arrests in a corridor. Patients who are incontinent need pads changing but there’s no space or privacy to change them. Patients and their relatives can sometimes be physically or verbally aggressive towards us because they are rightly scared and horrified about the setting they are being treated in – some are then arrested or removed by security. There are delays to medication. The list goes on.
“Having to care for patients in this way makes you feel you are a terrible nurse. Sadly I have become desensitised to it as I’ve been dealing with it for so long. But unless something is done we will continue to lose brilliant nurses who are getting to breaking point.”
For more information, contact the RCN press office at 020 7647 3633 or email mediateamhq@rcn.org.uk
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.
