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Under-fire Belfast hospital plans to boost nurse numbers


Around 40 extra nurses are to be appointed at Belfast’s Royal Victoria Hospital. It follows a staffing review sparked by patient safety concerns and reports of nurses crying due to the pressure they were under.

The review, by the Regulation and Quality Improvement Authority (RQIA), was ordered after a major incident at the hospital’s A&E department in January, which at one point saw more than 40 patients waiting on trolleys.

An investigation is also under way into five deaths, where delays in treatment may have been a contributory factor.

Of the extra staff, 15 nurses will join the trust’s accident and emergency department and 25 will go to its acute medical unit. Belfast Health and Social Care Trust, which runs the hospital, has also appointed a senior nurse as a dedicated clinical co-ordinator for the AMU.

The new posts were announced last week in an update on the situation at the hospital by Northern Ireland health minister Edwin Poots.

“Nurses will be able to provide some services which would traditionally be undertaken by middle grade doctors”

Edwin Poots

In a written statement, Mr Poots also said the trust was looking at ways to improve the flow of patients out of A&E and to and from the AMU, and ensuring they were properly tracked throughout their hospital stay.

Edwin Poots

Edwin Poots

He said the trust had already made other changes, including training two emergency department nurses to become advanced nurse practitioners.

“This will mean they will be able to provide some services in the emergency department which would traditionally be undertaken by middle grade doctors,” he said.

A wider review of emergency care in Belfast and across the region is also under way. It is being led by RQIA director of reviews and medical director Dr David Stewart.

The review team will feature leading nursing experts including Kathy Fodey, director of regulation and nursing at RQIA, former emergency department nurse and independent nurse advisor Mary Monnington, and Dr Elizabeth Myers, nurse consultant in emergency medicine.


Readers' comments (8)

  • So many Patients waiting on trolleys.
    Why ?
    Is it because there is not enough staff in A&E?
    Is it because of not enough porters?
    Is it because the flow to get on the wards is a problem?
    If the flow of discharges is a problem.
    Is there enough staff on the wards to take care of the rest of the patients and the patients for discharge?
    Is it because of transport problems out ?
    Is it that too many patients are staying too long in hospital as there is not enough care or placement in the community?

    On the ward I work on we have patients months on the ward, waiting for placement, no where to go to.
    We have problems with the privatised transport turning up late most of the time.
    We nurses now have to carry a phone on us so the site managers can call us at any time to find out if we have discharged our patients as yet. We nurses who carry this phone also have a full compliment of patients to take care of. The pressure on us to get the patients out is too much, we also are at breaking point. There is the safty aspect of our other patients, who they want us to take as second priority to the patients for discharge, so the hospital don't go over the waiting time in A&E. We do not have enough help on the wards to do all that is required in the required time in a safe efficient way.

    Problem with Patients waiting on trolleys need investigating properly no quick fix is good enough.

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  • sounds more like quantity than quality and safety!

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  • tinkerbell

    'It follows a staffing review sparked by patient safety concerns and reports of nurses crying due to the pressure they were under'

    OK if we're not going to take industrial action to resolve dangerously low staffing levels, let's at least all start crying, maybe that will work instead. Anything is better than nothing because patients lives are at stake.

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  • Tinkerbell,

    just imagine a mass cry-in, or better still a wail-in! if every NHS nurse participated at the same time it could be quite effective! At least they couldn't help noticing, esp. if you did it outside No. 10 with the PM and family in residence although Larry might get a little upset if you frighten his mice away! You just need to time it so as to cause maximum disruption!

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  • tinkerbell

    Anonymous | 25-Mar-2014 8:10 pm

    yes, yes, yes. I like it when a plan comes together. National nurses cry in day.

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  • tinkerbell | 25-Mar-2014 8:46 pm

    shall we start the movement? somebody has to start somewhere!

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  • He he! Love the idea of a cry-in - we might need to buy some onions ............. On a more serious note I speak as an ex A&E junior sister. On my way to work one day I found myself crying because I didn't want to work another 12hr shift with a 15min break, constant stress, a relentless stream of unwell patients who NEED to be in A&E, arguing with managers about which patients can justifiably breach the 4-hour target, giving what I felt was sub-standard care because we never had enough NURSES, PORTERS, DOCTORS, BEDS,SUPPORT from management. The list could go on and on. To just focus on moving patients out of A&E is a grave error. I felt desperately sorry when I handed over an A&E patient to the ward staff who I could see were struggling with a lot of the same issues. And on top of all this to hear NHS chiefs arguing that closing dozens of A&Es will result in better care (when the current A&Es already cannot cope) and that we don't need so many in-patient beds is enough to make me scream as well as cry. By the way wasn't the large number of patients attending this A&E in Belfast related in any way to the fact that other local A&Es had been closed?

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  • Anonymous | 28-Mar-2014 12:25 pm

    from Anonymous | 25-Mar-2014 8:10 pm

    "He he! Love the idea of a cry-in - we might need to buy some onions ............."

    I am bitterly disappointed in you - the tears would have to be genuine!

    I can't help much as I am not in the UK but could fill an ocean with my tears when I hear all these stories and what is happening in the NHS and our profession and how it is manipulated by these managers and everybody else whose main interests are business and not patient focused. How can we treat our patients in this way and offer them such poor levels of service?

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