A former accident and emergency nurse in the hospital at the centre of the Stafford care scandal has denied fiddling records of patient waiting times to fulfil management’s “draconian” demands to meet targets, accusing managers of falsifying documents, a tribunal heard.
Sharon Turner said management would only alter times by “a couple of minutes” but that the demands of senior staff to get 98% of patients in and out of A&E in the four-hour government target were sometimes impossible to achieve as capacity at Stafford General Hospital dwindled.
Earlier in the tribunal, the NMC heard that there was a “culture of bullying” among senior management at Stafford who “made a spectacle” of nurses for breaching waiting time limits and shouted at them.
The allegations came at a misconduct hearing into the standard of care provided by Turner and another nurse at the hospital at the centre of the Francis Report into care at the Mid-Staffordshire Trust, where hundreds of patients are said to have died unnecessarily.
Tracy White faces five charges of misconduct relating to patient care and falsifying waiting times, and Turner faces six, including falsifying waiting times, patient care and racist conduct, relating to their time in charge of the A&E department in 2007.
But Turner denied telling another nurse, Helene Donnelly, “my advice is to lie about the breach time”, when she rang through from the minor injuries section saying they had patients who were about to clock up four hours in A&E.
Last Monday Mrs Donnelly told the hearing that patient records were “routinely” doctored in the “chaotic” department, which lacked a permanent manager at the time, to hide breaches in waiting time limits.
Turner admitted the targets were a “bone of contention” among staff but that it was management who falsified waiting times on patient records as nurses were “too busy doing their jobs”.
James Townsend, representing the nurse, asked her: “Was there any general practice for nurses on the unit to fiddle the times by a small amount in order to prevent breaches?”
She replied: “Not nurses on the unit.”
He went on: “By anyone else?”
Mrs Turner replied: “Because you get the breaches (reports) through the following day I think we acknowledge that minutes were taken off - a couple of minutes here and there by managers.”
The following day the lower-level managers had to take breach reports up to senior management and explain if the limit had been broken.
She went on: “I think it was probably something subsequently done by management - I don’t think there were excessive times taken off.”
She said it was “just a couple of minutes, the time to walk down a corridor.”
“I think they just thought ‘what is the point in declaring a breach if it is only a couple of minutes?’”
Turner said the only time she altered records was when night staff got confused by a 24-hour clock.
“They used to get confused by the 24 hour clock and you would get breaches by thousands of minutes.
“Obviously that was not the case so I had to change that and sign to say we had changed that,” she said.
She also said that when the targets were introduced in 2004 under Labour, there was not a problem with waiting times at Stafford.
“There were no specific protocols but I think it was seen that a patient should be processed effectively through the department,” she said.
“We were only a smaller general hospital so the horror stories we were hearing about at other hospitals didn’t happen at Stafford.
“I don’t think there was a major capacity problem back then. People sometimes waited longer than you would have liked them to but I don’t think there was an instance that I thought they waited longer than what was acceptable.”
“Initially 98% seemed to be adequate. However, as demands on A&E grew and you no longer had the capacity and you were waiting for discharges before getting people in the front door so that 98% target gradually became harder to achieve.”
Turner added that as staff left the A&E department they were not replaced, making the targets tighter.
She also said management at the hospital would not accept the 98% target and actually wanted every patient to be dealt with during the four hour time limit, saying A&E staff were “held to account for any breach”.
Turner said sometimes this was impossible due to a patient’s condition but that managers did not listen to A&E staff when they tried to explain.
The nurse, who now works at the Royal Shrewsbury Hospitals Trust, also denied making racist comments, including likening an Asian junior doctor to a suicide bomber.
She denied referring to a doctor derogatorily as “him in the turban” and a female gynaecologist as “her in the yashmak”, saying she used to say “the doctor in the turban” to easily identify him.
She said she never used the word yashmak, but may have referred to the other doctor’s hijab.
White, who is expected to give evidence tomorrow, is accused of calling a seriously ill elderly patient a “naughty little monkey” and refusing to lift her from a wheelchair to a bed.
The patient died the following day.
White is also accused of saying “she can wait if you can do that to your baby” when a woman came into A&E suffering from bleeding after having an abortion.
White and Turner contest the charges. The hearing continues.