Hospitals are so overstretched and understaffed that patients end up being cared for in clinically ‘unsuitable’ settings where staff may not have the right skills. More than one in four hospital nurses (27%) have seen patients being cared for in areas not set up for this purpose, according to a poll by the RCN of more than 20,000 nurses and midwives. A nurse on an adult ward in Scotland said patients and their relatives complained when an extra bed was squeezed into a four-bed bay, leaving the fifth bed with “no buzzer, no curtains, not even two metres”. The resulting situation was “completely unsuitable for rounds, nursing procedures, Covid precautions and additional stress on staff”, they added. An A&E nurse in Northern Ireland said how she had seen “patients waiting longer than the safe recommended time for triage, patients being triaged and being treated in corridors [and] patients waiting more than 12 hours for admission, without additional staff treating them as ward patients’. Children with mental health problems end up in pediatric wards, which are designed to treat physical rather than psychiatric conditions, due to a widespread shortage of beds in specialist mental health units for under-18s. The Guardian revealed last week that an 18-year-old woman in the midst of a mental health crisis was recently forced to wait for eight-and-a-half days at St Helier Hospital in Sutton, south-west London, because the NHS could not find her a bed in a psychiatric unit. Pat Cullen, general secretary and chief executive of the RCN, warned that the NHS is now so overstretched that patients being treated in the wrong place risk becoming the “new normal”. People stuck there may have to wait longer to be evaluated and treated, he added. “It is scandalous that nursing staff have to treat patients in corridors, waiting rooms and even in the back of ambulances outside hospital entrances. This must be avoided from becoming a ‘new normal’. “When care is not delivered in the right setting, it means that, despite nursing staff doing everything possible to provide the best care, there may be delays in assessment and treatment, or patients may not be treated in ward where staff will have specialist skills for their condition. That ultimately puts patients at risk,” Cullen said. He accused the government in Westminster and administrations in Edinburgh, Cardiff and Belfast of creating the situation by doing too little to tackle the “nursing workforce crisis”. More than 25,000 nurses have left the profession in the last year and the NHS in England alone has vacancies for nearly 40,000 nurses, figures show. Subscribe to First Edition, our free daily newsletter – every morning at 7am. BST The RCN asked 20,325 nurses and midwives working in different care centers in the four home countries in March. Respondents said they had also encountered adults who had to stay longer than necessary in mental health facilities because community-based treatment services were not available to allow them to be discharged. Nurses reported seeing mostly elderly people unable to leave acute hospitals, despite being medically fit to leave, because of a lack of social care to keep them safe after release. Almost two in three of the 1,954 A&E nurses surveyed (63%) had seen patients being cared for in inappropriate places. Hospital bosses and A&E staff are concerned that the prevalence in recent years of “corridor care” – patients being stuck in chairs or trolleys, sometimes without proper supervision – is increasing the risk of harm or even death. Almost a quarter (23%) of inpatient mental health staff had seen patients being left in the wrong care setting, as were 17% of them in elderly wards, 18% in community mental health teams, 14% in general practices doctor and 12% who work in a nursing home. Almost half (46%) of hospital nurses said that time pressure means patients don’t always get the care they should. Nurses surveyed identified staffing shortages as a major source of stress and potentially lower quality care. Some said they were “not able to care for patients as well as we would have liked” and were left feeling “incredibly frustrated and embarrassed”. Miriam Deakin, interim deputy chief executive of hospital group NHS Providers, said: “It is always worrying when care is not as good as it should be and we know the current pressures facing trusts, including staff and skills shortages and very high levels of demand exacerbated by rising levels of Covid, can affect care.’ A spokesman for the Department of Health and Social Care said: “We are growing the NHS workforce and aim to meet our manifesto commitment of 50,000 nurses, with nurse numbers over 29,000 higher in April 2022 than in September 2019 when we committed . ”
