Patients are routinely being treated in areas of hospitals not designed for care, a survey by HSJ’s sister title Nursing Times has revealed.
Nurses are being asked to treat patients in store rooms, mop cupboards, wards that are already full and, in one case, a kitchen area.
There is no privacy, no oxygen and no call bell
In a Nursing Times survey responded to by more than 900 nurses, nearly two thirds said patients at their hospital were being treated in areas not designed for clinical care.
They highlighted threats to safety including patients having no access to call bells, water and suction facilities, missing emergency equipment, risk of infection and fire exits being blocked.
Patients’ privacy and dignity is often compromised and nurses say the situation makes it harder to provide good care.
Of those nurses who had seen the practice, nearly 60 per cent said it happened more than once a week. Two thirds said patients were left in the areas for more than 12 hours – for some the areas are used for days at a time.
A majority said it had happened at their trust for at least a year.
One nurse said patients had started describing an area normally used to store linen and equipment, where beds were being put, as an “overspill car park”.
One said: “There is little room around the three beds and it would be difficult to get a crash trolley into any of the beds. There is no privacy, no oxygen and no call bell.”
Just 3 per cent said nurses were asked whether they agreed with the area being used. Eighty-three per cent said they had raised it with senior nurses or managers but, of those, only 4 per cent said it had then been stopped.
They were commonly told that all other space was full, accident and emergency was under pressure, the move was authorised by senior managers, or the A&E waiting time target was at risk. They were told there was “a temporary capacity issue”, “the hospital does not close its doors” and “unfortunately the hospital is full”.
A small number said complaining had resulted in bullying, being accused of “not being a team player” or told the issue was “none of your business”.
One nurse said: “I carried out a risk assessment on my ward which showed this was a very dangerous and high risk practice, but it still continues as I am told there are just no other beds available and the instruction has come from the chief executive.”
Another commented: “I was advised to find a more appropriate patient for the extra bed, as the bed was needed, and if I couldn’t find a patient then they would.”
NHS South Central chief nurse Katherine Fenton told Nursing Times: “Directors of nursing should be visiting areas and forbidding this kind of practice. This type of practice is always unacceptable.
“You have to make sure that your processes through the hospital are lean and that you are getting patients out at the other end, as you are bringing the right ones in through the front door.
“If you haven’t got good senior management, and this is not just about nursing, you don’t get those fundamental processes sorted out.”
The Department of Health said: “It is for local healthcare commissioners and providers to assess the services needed locally to meet the demands of their population.
“However, every nurse must comply with the standards, performance and ethics outlined in the NMC code. In particular, any nurse who is concerned about any risk to their patients should report their concerns to their manager, in writing if necessary.”