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Nurses' warnings about Mid Staffs were ignored

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Warnings made by nurses about chronic staff shortages in emergency care at Mid Staffordshire NHS Foundation Trust were ignored, Nursing Times can reveal.

Desperate shortages of staff and the resulting poor standards of care at the trust’s Stafford Hospital were no secret to the nurses who worked there. But those who spoke out were quite simply ignored.

Elizabeth Clare joined Mid Staffordshire NHS Foundation Trust in 2002 as a newly-qualified nurse, working a series of rotations before moving to the A&E department as a band 6 emergency care practitioner.

Ms Clare, who has now left the trust, said she was relieved that the Healthcare Commission’s report has now put on record her concerns.

She confirmed, for instance, there was no proper triage in the A&E department at any time of day or night, and that it was left entirely up to the receptionists to process patients for treatment.

Although a rule was introduced that receptionists must find a nurse if small children with serious injuries were brought in, or if a patient presented with chest pains, that did not always happen, Ms Clare said.

There was no allotted room to physically assess patients, and staff shortages were such that sometimes a nurse could quite simply not be found, she said.

The trust did introduce an incident reporting system for staff complaints, but the forms were time-consuming and complex, and staff saw no improvement despite their complaints.

‘I filled them in countless times, to report staffing shortages or broken equipment,’ said Ms Clare. ‘There was a box you could tick to say you wanted feedback, but I never heard anything.

‘The form was very detailed and, as we were so short-staffed, the time spent filling in forms was time away from patient care. People said they’d fill it in after their shift, but they were so busy that they were too shattered when they went off duty,’ she added.

Patricia Marquis, RCN West Midlands regional director, confirmed that nurses working at the trust, and the RCN locally, had raised concerns about the situation at Mid Staffordshire, both formally and informally.

She said the incident reporting forms submitted by staff appeared to ‘fall into a black hole’. ‘Incident forms is always something we would encourage staff to use, but generally speaking, when someone says: “I have filled in 25 forms and nothing has happened”, it can become very demoralising,’ she said.

‘Staff shortages, already acute, became worse as unhappy staff left, and the trust’s local reputation among nurses meant it became even more difficult to recruit,’ Ms Marquis added.

Ms Clare eventually submitted a formal complaint about nursing practices in A&E, and an internal investigation took place, but she said that ultimately her actions made little difference.

‘As a whistleblower I felt completely unsupported and thought I might as well have kept my mouth shut,’ she said. ‘I put my neck on the line and as a result staff morale was still at an absolute low, and patient care hadn’t improved at all.’

A spokesperson for the trust said: ‘We can confirm there were issues raised by staff in A&E around the conduct of colleagues, an investigation was undertaken and appropriate actions were taken.

‘We are unable to disclose specific details as these are confidential to the employees concerned,’ the spokesperson added.

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Readers' comments (3)

  • Mmmmmm...........I dont know what to say and think........All I can see is disappointments for nurses and staff. Its really hard to complaint when the other line is busy and not listening.......I think the big issue here is not having a bad system or poor quality care for the pts. but the real concerns is we dont know how to listen with each other.......until we
    learn how to do that, our situation will remain the same and never we will reach our goals! We are like a wheel keep on rolling but no direction at all coz we dont even aware or understand the thing we are doing.......... A waste of time is the most time wasted!!!!!

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  • I have been in the same situation in previous posts. Unfortunately the ones who suffer most are the nurses who have desperately been trying to deliver a decent service, usually without much support or encouragement from senior managers. This frustration if not addressed can develop into cynicism, or a withdrawing from close caring in the future.

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  • Having trained at Stafford, and witnessing the appalling care there at the end of 2005, i can say it is the problems are down to mismanagement, incompetence, and demoralisation at ground level. Too many targets, too many corners cut... by the time youve cut all the corners... theres nothing left. Stafford is by far one of the worst hospitals i have experience in 15 years in the health service, but the problems there are by no means exclusive.
    I hope that Stafford will make some very thorough and rigourous changes, including better systems of work, better staffing levels and better staff education and support services, and that other trusts will follow suit, but more importantly, i hope that the management who allowed the substandard services there will be held to account for the '400 deaths' they caused or contributed to, like a nurse or a doctor would if they were negligent.
    Patients and Satff alike need to feel that something positive has come from this, and that it will bring a lasting change for the better

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