As the news focuses again on the dangers of going into hospital and the pressure I wonder if we are missing something fundamental.
I know from my own experience how quickly things can go wrong when the bed pressures take precedence over safety. Some years ago I worked a night shift on a ward with seven empty beds.
Within 15 minutes of starting work we had four patients arrive, three at the same time. The admissions ward refused to hold off on the next three patients who arrived in short succession. At 2am we were still completing assessments, trying desperately to get through the work.
Then the cardiac arrest buzzer went off. One of the new patients had arrested and by the time we confirmed she was not for resuscitation, CPR was well under way and the team had been called. No-one remembered the transfer nurse handing the DNR over and the admitting nurse had not had a chance to look in the patient’s notes.
The patient didn’t survive, she died alone and she didn’t get the end of life her family had been promised.
We wrote an incident report but like many nurses we finished a shift feeling we had worked really hard but let our patients down.
I seems to me that just as the Beveridge Report could not have anticipated the effect of modern pharmaceuticals and medical advances on longevity, neither have we really got to grips with the demand that an ageing population is putting on our health care system.
There is endless talk about the need to provide more care in the community but while there is a shift in that direction, these developments are not keeping pace with demand.
Without adequate community services is it surprising that pressure on beds and pressure on staff is increasing and mistakes happen?
Currently we have hospitals with too few beds and community services that are not sufficiently developed to provide acute care at home. Between the two is a huge gap that no one wants to take responsibility for.
The people who suffer most are the old and vulnerable who end up in a system that is not designed to meet their needs being cared for by people who care but simply don’t have time. That is not good for anyone.