NHS strikes: Burnley nurse reveals mental health toll of working in 'unbearable' and 'impossible' conditions in A&E at Royal Blackburn Teaching Hospital

A Burnley nurse has revealed the mental health toll of working in “unbearable” and “impossible” conditions in A&E at Royal Blackburn Teaching Hospital.
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The department dealt with a total of 18,800 patients in December, equating to around 600 a day, according to NHS England data. Around 68% were seen in four hours or less - falling below the NHS target of 95%.

The nurse, who wishes to remain anonymous, said people requiring hospital admission can be left waiting in one of at least 10 designated corridor spaces for more than 12 hours for a ward bed.

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“The A&E in Blackburn is overwhelming. It’s really bad and extremely busy.

Exterior of Royal Blackburn Teaching Hospital.Exterior of Royal Blackburn Teaching Hospital.
Exterior of Royal Blackburn Teaching Hospital.

"We can’t cope with the number of patients coming in; we’ve no beds in the hospital. A&E is not built to be used as a ward but people are staying there too long. Probably five or six years ago, if you stayed over four hours, it was a big deal.

“Staff are dealing with three times the amount of people we are meant to deal with. Sometimes a nurse will end up with at least 10 sick patients to look after. That's impossible when you have medication to give, observations to do, and you need to get people to a ward. You can’t get everything done.”

East Lancashire Hospitals Trust is calling on the public’s support as it deals with “record-breaking” pressures on its urgent and emergency care centre, reflecting the national picture.

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More than 1,000 East Lancashire patients needing emergency care last month waited more than 12 hours to be admitted to the hospital after the decision was made.

Royal Blackburn Teaching Hospital. Photo: Kelvin StuttardRoyal Blackburn Teaching Hospital. Photo: Kelvin Stuttard
Royal Blackburn Teaching Hospital. Photo: Kelvin Stuttard

Some 94% of hospital beds were occupied, as of January 1st. And an average of 42 people per day who no longer needed treatment or observation were stuck in the hospital in the week ending January 8th.

“It’s a hard job but the pressures on the NHS at the minute make it unbearable. The way it is has just made it impossible. The whole system needs to be reformed: it is not fit for purpose. I think the whole thing is at breaking point.”

Within A&E, vulnerable people stuck on trolleys in corridors can be sitting for hours “in their wee and poo”, as the space offers no privacy for personal care duties like toileting.

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The nurse said: “We do clean them up but we’ve got to wait for a private cubicle to be free and also it’s difficult to find the time when we’re already rushed off our feet.

Royal Blackburn Teaching Hospital. Photo: Kelvin StuttardRoyal Blackburn Teaching Hospital. Photo: Kelvin Stuttard
Royal Blackburn Teaching Hospital. Photo: Kelvin Stuttard

“There’s no dignity in the corridor. People are walking past, it’s a busy environment, and patients are shouting.”

The Trust’s heavy reliance on agency workers also puts pressure on permanent staff as it offers a “lucky dip” of skills. And agency staff who are unfamiliar with the paperwork or the environment can slow the team down, the medic said.

“Staff work extremely hard: I’ve never worked harder in my life. It is quite mentally challenging to see patients in corridors, knowing we can’t do everything for everybody. Nurses have been telling me that they can’t stay any longer.

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“People are leaving and going into agency work. I can’t blame them. Why would you put yourself through that, especially on the front line? It’s shocking.

“I’m still debating leaving. With the way it is at the minute, it’s very emotional and difficult. I’d feel bad about leaving but I don’t know if it’s worth risking my mental health for it.”

The nurse does not blame the department or the staff and said she and her colleagues are highly dedicated to their jobs, despite working under high pressure. She believes the NHS is in “crisis” due to chronic underfunding, a lack of GP appointments, and mismanagement of money.

She also believes conditions at Blackburn A&E will eventually improve once winter pressures begin to ease but said they must not be allowed to become so difficult again.

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She said: “I think things are going to start privatising because we can’t carry on [this way]. The NHS is not going to survive. People should be scared and angry.

“I’d be worried if I needed to go to the A&E, seeing what it’s like. I don’t know what kind of care I’d get.

“But that’s nothing to do with the doctors and nurses - they’re all brilliant.”

Sharon Gilligan, Chief Operating Officer at East Lancashire Hospitals Trust, said: “Everyone at East Lancashire Hospitals is working every day to treat patients as quickly and safely as possible and save lives.

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“The support of local people is appreciated as we manage huge and record-breaking pressures on our urgent and emergency care centres and a rise in the number of patients needing treatment through our outpatient services.

“This has been made even more challenging through an increase in the number of patients with flu and COVID, an increase in patient acuity which means they are spending longer in hospital, and we are continuing to ensure that we are supporting colleagues at North West Ambulance Service to hand patients over as quickly as possible, as that is the right thing for patients and our communities, although undoubtedly puts extra pressure on the Trust. This has all created a challenging working environment for colleagues.

"It's a situation that is being seen by hospitals across the country, not just in East Lancashire, and we are among the best-performing trusts in the North West for seeing patients in the Emergency Department within four hours and discharging patients as soon as they are well enough to go home.

“Despite the additional pressures, our teams have done a fantastic job and I would like to thank them all for the work they are doing.”