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Paramedics 'doing jobs of nurses' because of staff shortages

Paramedics are waiting with patients in hospital corridors outside A&E departments because there are not enough nursing staff and beds to cope, a top ambulance service boss has said.

Steve Wheaton, Assistant Chief Ambulance Officer at West Midlands Ambulance Service, says if the problem carries on 999 calls “will go unanswered”.

“Our paramedics are ending up doing nurses’ jobs, while our response times are going down the pan,” he said.

“Somebody is going to have a serious ‘off’ in the street, and we aren’t going to be there.”

He said the problem was the equivalent of having eight ambulance crews “sitting around doing nothing but nursing patients in hospital corridors”.

The issue “is not unprecedented” and has been getting “progressively worse” for the last few years, according to Mr Wheaton.

He also believes “this is a national problem” gripping hospitals and ambulance trusts across the UK.

In one case this week, he said the trust’s paramedics stayed with a patient for six hours at a hospital in Dudley, West Midlands, while elsewhere 23 out of 26 ambulances were queued up at a Warwickshire hospital waiting to hand over patients to nurses.

Earlier this month there was “no cover across Coventry and Warwickshire for 15 minutes” because crews were waiting to hand over.

In another case an ambulance crew covering Staffordshire was sent to attend a 999 call over an hour-and-a-half’s drive away.

The ambulance service must achieve a turnaround, where the patient is handed over to the hospital’s A&E staff, within 30 minutes to hit national standards.

Mr Wheaton also said the trust had been meeting its response targets to get to 75% of calls within eight minutes and had “the best performing call-answering of any ambulance trust, nationally”.

But he said this was only due in part to a decision not to scrap 80 older ambulances and to hire 60 extra paramedics.

The trust has also been paying increased overtime to its crews, who are handling up to 47,000 turnarounds a month.

However, despite this Mr Wheaton said the trust was now on course to miss its response target for the first time in 18 months.

“It’s not about meeting government targets, we just want to avoid a case like we had recently where I had an old lady with a fractured finger waiting over an hour because I had ambulances sat outside a hospital, waiting with patients,” he said.

Solving the problem would mean “parallel” investment in acute hospitals and bigger A&E departments, a wider range of out-of-hours provision, and funding for social care.

“Eventually you could invest less in the ambulance services and A&E departments, but not until you’ve sorted out the problems now,” said Mr Wheaton.

His comments come on the day the Queen Elizabeth Hospital Birmingham announced it was reopening two wards at its old neighbouring hospital site to meet what the health trust’s boss called “unprecedented demand across the region”.

Dame Julie Moore, Chief Executive of the University Hospitals Birmingham Trust, said: “The region has seen a 10% increase in A&E attendances in the first quarter of the year”, with the Birmingham Hospital bearing the brunt of that increase.

A Department of Health spokesman said: “Staffing levels should always be sufficient to ensure patients are safe.

“There are now more clinical staff in the NHS than in 2010, including around 5,500 more doctors, 1,300 more midwives and more than 900 more health visitors.

Sign our Speak Out Safely petition to support a transparent and open NHS. We are calling on the government to implement recommendations from the Francis report that will increase protection for staff who raise concerns about patient care.

“Ultimately hospitals are best-placed to decide how many nurses are needed to care for patients.”

Readers' comments (23)

  • This issues relating to ambulance handovers and turn around delays are not new, they have been in existance for about fourteen years.

    Individual acute trusts and ambulance trusts have come up with novel ways of managing delays in offloading patients; some of these involve the use of designated RNs to supervise patients waiting to entre EDs, even the deployment of inflatable 'major incident'.
    tents to temporarily house patients waiting to access ED with non critical patients supervised by ambulance technicians.

    The overiding solution to the delays lies not with the ED but rather with the hospital and its ability to facilitate patient discharges and have capacity and manpower to accommodate - almost always the cause of ED overload.

    Mike Paynter
    Somerset

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  • Susan Markham

    Sigh....

    Just join the queue because soon enough you'll be having to resuscitate the RNs who are supposed to be relieving you....

    Perhaps we can get a few "well trained" "domestic servants" who are capable in "blood-letting" and "servitude" to help out the NHS?


    This has really gone beyond the pale....


    And yet....


    You know - how ever many steps I think Nursing (with a capital "N") has allowed itself to fall....

    ....some "anal-wipe" manages to take it three steps below what I thought was possible....

    Nursing is no longer a "Calling" - nor is it a "Profession".....

    What is it called when you sell your body, mind and soul for a pittance of a discretionary fee?

    Lady of The Lamp?
    Lady of the Night?


    ....you decide...

    Me? It's actually too close to call and I've been doing it fo decades....

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  • Susan Markham

    Answer:-

    Prostitution.

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  • This comment has been deleted

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  • Comment deleted due to breaching site terms and conditions http://www.nursingtimes.net/terms-and-conditions/

  • It's all much of the same really, the numbers game and resources and you can't really improve the situation with endless enquiries, punishing staff, and new fancy initiatives!

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  • Susan Markham

    Here we go...

    This is me BTW.... (and I don't apologise)

    ALL Nurses (trained and untrained) in the UK are treated as disposable entities - such as a condom - which, once it has done its primary function, can be flushed down a toilet and then forgotten.

    A box of chocolates, a Thank You card, maybe even some free pairs of stockings is what we get......

    Well EXCUSE ME..... I JUST LOOKED AFTER YOUR 2-YEAR OLD CHILD FOR THE LAST 32 HOURS (DOING 12 REVERSE SHIFTS) WHILE I WAS REVERSE-BARRIER NURSING HIM AND I HELPED SAVE HIS LIFE....

    In the meantime - my husband got bored with my eccentric work hours and dumped me for an Inguana reptile called Betty Trump....

    And you send me a box of chocs and a “Thank-Yew” note?

    I must admit that was 30 years ago - I’ve gotten over it now! :-)

    So thank you - all you people out there who call me a “Dedicated” Nurse....

    Keep your box of chocolates, and your “Thank You” cards, and especially your free pairs of stockings....

    What we really want is a decent “flocking” pay rise....

    Something slightly more than we might earn by being “Ladies of The Lamp” - rather than “Ladies under the Red Lamp”.....




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  • Steve Wheaton

    I have great admiration for the ambulance crews I've worked with over the years. But really........

    "He said the problem was the equivalent of having eight ambulance crews “sitting around doing nothing but nursing patients in hospital corridors”.

    Given that we don't have time to 'sit around' and the corridor is not actually a suitable location to find a nurse at work, perhaps you'll understand our problem. We've had problems with being unable to do OUR job properly for years!!

    Nursing staff are usually inappropriately used by all hospital services and AHPs. We become substitute Physios, Phlebotomists, OTs, ECG Technicians, etc. when the services of these individuals become unavailable after 5pm, weekends, holidays and numerous meetings. It isn't the fault of the nurses. It is the fault of management and poor allocation of work between all health workers. If everyone else would do their job, we could do ours. Maybe then we just might have a chance to sit down too, Mr Wheaton.

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  • Susan Markham

    Anonymous | 22-Mar-2013 2:09 pm

    Even not knowing you - I'll give you a big hug for that one...

    Well fugging said! :-)

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  • michael stone

    Earlier this month there was “no cover across Coventry and Warwickshire for 15 minutes” because crews were waiting to hand over.

    __________________

    That is my locality, so I take this personally !

    But I'm guessing the following is the reason he is raising the issue:

    'However, despite this Mr Wheaton said the trust was now on course to miss its response target for the first time in 18 months.'

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  • ...in the middle of the night, when there's a lack of beds + no more nurses to look after patients, wake up the CEOs and the senior management team and say that A&E will be close to all new admissions, as people are literally dying to get in, and we need their hands to help out with everyone else at work. If paramedics start helping out in A&E too, they'll think everythings fine and dandy and that the paramedics can't bring in any more new patients.

    Seems that before any of these people on megabucks get out of bed, they'll want porters, cleaners, domestics and maybe security to chip in too with life support skills to help nurses, hcas and junior medcs, as we're all working on the cheap 8-)

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  • everything should be running smoothly and seamlessly in the health and other services in a modern western civilisation. what has happened to people's organisation skills? it now appears they are rapidly becoming non-existent!

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  • A&E units with skeleton crews, many experienced staff voting with there feet, and whats this - CQUINS indicator all patients brought into A&E by ambulance have to be triaged with a full set of observations within 15 minutes of arriving irrespective of presentation. And you won't get any more staff when the world turns up at 11.00am.

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  • NurseInEastMids

    Well.. Said boss failed to mention the times that Community Nurses do the jobs a paramedic should be doing, due to shortages of paramedics??? Having just recently had to ring 999 due to a patient bleeding profusely from a burst haematoma, (over a weekend) sustained the previous evening after having fallen in her living room (paramedics attended and got her up in the chair but due to her having bilateral leg bandages did not see the haematoma) it took two of use numerous bandages and packages of gauze to control the bleeding while waiting for the paramedics... two hours later and a patient not looking incredibly well I rang 999 back and was told that they were dealing with life threatening calls and ambulance would arrive when one was available..... So we waited... Eventually we were had to leave the patient with her son.... after just over 4 hours an ambulance arrived and took our poorly patient to A&E the patient is still in hospital two weeks later and had a blood transfusion after admission... I did mention when on the phone that the patient was lethargic, sweaty and grey in colour... I guess I should have used the magic words CHEST PAIN!
    (Rant Over)

    I think all I'm really trying to say here is everyone is short staffed and feeling under pressure EVERYONE is sick of it and pointing fingers is clearly not helping...

    I wish I had the answer I don’t and perhaps that makes my comment here irrelevant other than it being a way for me to off load a very annoying experience (one of many)

    P.S. Patient was genuinely housebound (before anyone asks) and I would of taken her in my own car if it was possible.

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  • NurseInEastMids | 22-Mar-2013 10:37 pm


    this story is a total disgrace as is the response given you by 999. Although you shouldn't have to do this, I hope you said you were a nurse which usually puts things in perspective as far as urgency is concerned.

    your story should go to the national press. there is too little about the shortfalls of the other healthcare services as the problems with 999 requires emergency treatment before lives are lost.

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  • Anonymous | 22-Mar-2013 2:09 pm

    Totally agree. Since when was a nurse's job "sitttting around doing nothing" or "nursing patients in hospital corridors"? That isn't our job! And that's the trouble. People have to understand that the failures in the system should not become the problem of nurses.

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  • Anonymous | 23-Mar-2013 8:29 am

    well said. resourcing is a management problem and if they are non-clinicians it is their role to find out from the professionals their resourcing needs. you cannot be expected to provide the same services in a corridor as in a well equipped clinical area.

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  • from Anonymous | 23-Mar-2013 8:47 am

    Anonymous | 23-Mar-2013 8:29 am

    furthermore, one of the problems is that nurses have learned to compromise and improvise over the years which are skills they have developed and become extremely good at but this must not be taken for granted at the expense of providing them with the resources they need to deliver good quality care.

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  • Susan..... You are an inspiration. Thank you for making me smile.

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  • tinkerbell

    it could be worse
    try not to worry about it
    you've only yourself to blame

    probably the 3 most worthless expressions

    and also 'we're all in this together'.


    and the expression 'in real terms'

    and 'it's very difficult'

    and 'we were left with a huge deficit by the previous government'

    How long can one government blame a previous government? 2 years, 3, 10?

    George Osbourne is 'doubling his efforts', please don't george, it can only get worse if that's the sort of help you've got on offer.

    and 'the nhs is safe in our hands'.

    Any other useless expressions that might help save this situation?

    strike anyone?

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  • Susan Markham

    redpaddys12 | 22-Mar-2013 1:13 pm


    What?

    No smart reply?


    Obviously not a nurse then!

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