Trust defends use of extra beds in full wards

9 March 2010 | By Dave West

Royal Bournemouth Hospital & Christchurch Hospitals Foundation Trust has justified its policy of putting patients in wards which are already full, after Nursing Times received a complaint that the practice was unsafe.

Nurses at the Royal Bournemouth Hospital said additional beds were being put in bays and they were concerned it was increasingly affecting the safety and comfort of patients.

The nurse said it was also increasing workload – a common complaint of others responding to Nursing Times’ survey, which shows that Royal Bournemouth is far from alone in treating extra patients on wards.

The extra beds are used about once a month, more during winter, and on about eight wards of different types.

The areas used in the middle of wards do not have immediate water and suction access. The trust said it had recently installed curtains, though in the past screens were used.

Joe Smyth, the trust’s deputy director of operations, said: “It happens in unusual circumstances. If we get a surge of admissions and the hospital is already full we are faced with a choice of escalating patients into the ward or closing the front door.”

Mr Smyth said it was usually in the morning while waiting for discharges – usually a few hours. Sometimes they are used through the night, for up to about 10 hours.

“You have to balance risk, but we have qualified doctors and nurses making the decisions. We are reducing it to an absolute minimum.

“If nurses feel it is a problem they should raise it but I have to say we have fully risk assessed the beds.”

National Patient Safety Agency director of patient safety Suzette Woodward said in some cases using non clinical areas was acceptable. She said risk assessments should be carried out and, if there were problems, the trust should review bed and patient management.

Readers' comments (15)

Anonymous | 10-Mar-2010 8:34 am
As someone who trained in the 70's this practice was found to be unsafe then, so whats different now? Yet again we see the effects of cutbacks and the need to meet targets and it's the front line staff who have to manage!
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Anonymous | 10-Mar-2010 9:59 am
I was in B'mouth hospital recently and these escalation beds are in use 24/7. They often have no table or bedside cabinet and create an even tighter space for nursing staff to work in.
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Anonymous | 10-Mar-2010 5:41 pm
Please could somebody justify the argument that over full wards or non-clinical areas are safe for patients and, apart from all the problems this involves which are far too numerous to list here, what about prevention of cross-infection which is already a serious problem in hospitals. Has anybody involved in this highly dangerous practice, not only to patients, but also to staff and visitors, considered the traumatic psychological effects this can have on the most vulnerable members of society as well as their families and to the staff looking after them?
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Anonymous | 10-Mar-2010 5:47 pm
Targets is management jargon used for those working in manufacturing industries with production lines and not a dignified term for the care human beings who are patients in hospital! Patients are not objects or labels and should be central to all activities in hospital involving care and not this obsessive striving to meet targets imposed by management just to satisfy them!
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Anonymous | 10-Mar-2010 5:52 pm
I once had to barrier nurse a patient with typhoid in the corridor. The only barrier to protect others was a pair of flimsy screens where gowns hung on the outside. Also external to the screens, in the corridor, was a commode and a bedside locker with hand disinfectant, paper face masks, latex gloves and bonnets to cover the hair of staff and visitors. My colleague who called in the local press was severly reprimanded by management and feared for the future of her job.
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Anonymous | 11-Mar-2010 3:21 pm
Does it take a death or 2 for management and the government to realise that this is not safe practice! I get so annoyed when i hear of these things and i would defend any nurse that said to this practice.

As a nurse and law student it amazes me how trusts have got away with so much. Even the recent reports on mid staffs and basildon have not changed practice in some other trusts.

The government really must sit down and rethink targets and make them more realistic - they need to take on board that the infrastructure around many acute hospitals are growing, but the hospitals are getting no bigger and they do not have the budget to bring in more staff.

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Anonymous | 11-Mar-2010 7:09 pm
How dare they come out with such bare faced innacuracies. It is common practice and we all know it. Also to imply it is a clinical decision is disingenuous, many times clinicians in this type of scenario are overuled by officious managers, who then infer that they are obstructive. I live and work in the west country where bed numbers have been desimated over the last few years, always with the mantra that they are no longer required as people get care nearer home!! Utter tosh, its money pure and simple - good care is a side effect not the true aim! Year on year lack of capacity is a major problem - hence patients without bed spaces. The winter pressures are now a year long problem, but still we are fed the same old rubbish. I just wish some of our managers would stand up and say enough is enough...but that is a risky stance to take as they only want yes people in this arena.
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Anonymous | 11-Mar-2010 9:18 pm
I think this is outrageous and a sad sad representation of the NHS. There needs to be a public enquiry into this so we can find the full 'facts'
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Anonymous | 12-Mar-2010 12:09 pm
When beds/wards are closed, the staff that used to staff them are no longer there. When these beds/wards are re-opened 'temporarily' no new staff are employed, the existing staff are expected to stretch to cover. Already stretched staffing levels then become dangerous. As mentioned in a previous post, 'just-in-time' manufacturing processes do not work with a service dealing with vulnerable human beings - there needs to be some slack in the system so that it can cope with sudden surges in demand. This would surely be cheaper in the long run than being sued/fined when things go wrong.
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Anonymous | 12-Mar-2010 7:42 pm
one can write as many comments as one wishes and grumble amonst ourselves but will anyone that really matters, and who can make the necessary changes for the safety and benefits of the patients and the provision of a reasonable working environment which is necessary to enhance the quality of care, read them?
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Anonymous | 13-Mar-2010 9:34 am
i think this is unacceptable and the government needs to address the reality of the nhs and the fact that nurses are exhausted but carry on for the patient. theses working conditions are happening too often. Also i think that the communites need to use the services available effectively, i mean where access to care, fast track (ha), neighbourhood team, they are not being used because they are not confident in nursing in the community!
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Anonymous | 15-Mar-2010 0:05 am
What a squirmy response of that trust and complete lack of responsibility admitted. Find a way to stop coping and tolerating it cos this is the rules they're playing by spoken in black and white.
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Anonymous | 15-Mar-2010 6:34 pm
managers don't care, accountants don't care, chief execs don't care and most importantly politicians don't care.

It has to be said the NMC and RCN/Unison don't care either.

Nurses have no leadership.

The public do care and ultimately will apply pressure to whichever sorry shower of s*%t govt is in charge. It will take probably many years. The NHS is on the verge of being dismantled as the public currently know it. As the services they need deteriorate they will apply pressure...but as i said it will take many years.
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Anonymous | 16-Mar-2010 9:43 am
Unbfortunately the public are kept in the dark about the ever increasing surreptitious methods of privatisation within the NHS. The coffers of the NHS are almost bare, and yet the demands that are placed on it are huge. Maybe it is about time to lay a dying dog to rest! It is about time that the public stood up and took some responsibility for this as well as the same people who "love" the NHS are the same people who take it wholly for granted!
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Jacqueline Hickman | 17-Mar-2010 3:58 pm
How can this be categorised as a safe practice? Are infection control nurses involved in the risk assessments? Has the risk of MRSA, C. Diff, etc infections miraculously disappeared? As usual, these decisions are made by target-orientated non-clinical staff.
I was proud to work for the NHS when I started my nurse training; now my heart bleeds for the patients, staff and the NHS as a whole. I agree that it is time that the public take some responsibility and lobby their MPs.
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