A nursing and beds crisis is gripping Oxford's John Radcliffe Hospital. As reported in two Oxford Mail exclusives, an emergency ward had to close for three days and some patients are dying before reaching the operating table as the situation reaches chronic levels. Today nurses tell PAUL HARRIS of the pressures they face...

Nurses face threats, abuse and extremely long hours as they battle to keep the emergency ward of the John Radcliffe Hospital afloat.

So far the flagship of Oxford's health service has not sunk - but nurses are bailing out at an alarming rate as the pressure mounts.

Nurses are the public face of the NHS. They are the first to meet patients and the ones who spend hours on the wards. But now they They feel exhausted and let down by a chronic shortage of staff and growing patient waiting lists.

Some nights the emergency ward is at bursting point, with patients spilling into corridors and stuck for hours in rooms awaiting treatment.

Sister Annie Nelhams said: "Sometimes as another ambulance drives up your heart sinks, and you think 'Where am I going to put this person?'."

Sister Judith Mansfield added: "We are very aware that patients in the corridor do not have any privacy. We cannot turn the lights out, and There are patients in quite a distressed state lying watching everything.

"For someone lying unwell in hospital it is not the ideal circumstance to be down in the A and E. We try and give the best care we can, but it is not the optimum. It is not satisfying. We are on a conveyer belt."

Even worse, there is only one casualty doctor on duty at night to see patients not referred by a GP.

Sister Shauna Bowen-Thomas said: "You take a lot of flak from the patients when they are waiting to see not a nurse, but a doctor.

"We get abuse a lot of the time. We know why people are upset but there is only one casualty doctor at night." Staff nurse Lucinda Darnton added: "There are less nurses spread over a wider area and it makes it difficult for patients waiting in the waiting rooms."

Sister Nelhams said nurses do get hurt by spiteful comments. "We are constantly apologising for things that are out of our control. People accuse us of being uncaring and it is very hurtful because we try our best.

"You explain (to relatives) there are other patients who have come in with a heart attack, and they almost accuse you of lying. We do appreciate why people feel angry and upset, but it makes us feel under more pressure if we are shouted at and abused."

There are eight nursing vacancies in the emergency ward, from a total of 140 unfilled nursing jobs within the hospital trust. Eighty of these have been vacant for three months.

Last month (MAY), an entire emergency ward had to close for three days due to the nursing shortage. Nurses said that at one point there were 35 patients lying on medical trolleys waiting for a bed.

Elsewhere, patients waiting for operations are dying before they reach the operating table, as the crisis reaches chronic levels.

Life-saving operations have been cancelled because of staff shortages on wards and surgeons often pack up early at 2.30pm because nurses are not available to assist them. The hospital hires agency nurses to fill the breach - but these nurses do not always stay long. They also have to ask regular nurses for simple advice because they do not know the system, which makes matters even worse.

At Accident and Emergency the crisis is acute. Sister Mansfield said: "You cannot just walk into this department and work to your best potential. The specialist knowledge to work in an A and E cannot be learnt overnight."

The nurses fear the proposed cuts to the Oxfordshire community hospitals could deepen the crisis. Those hospitals concentrate on rehabilitation and nurses fear waiting lists might get even longer.

What is the solution? Nurses want more staff and beds throughout the entire hospital. That way beds would be freed up quicker, patients would be seen with greater efficiency and there would be no log-jam in the emergency ward.

But money is tight and the NHS has a national nursing shortage and longer waiting lists, which the Government stills needs to address.

The John Radcliffe Hospital is trying to recruit nurses, but without success. Mike Fleming, the hospital director of personnel and administration, said nurses were quitting because the pressure is often 'intolerable'.

He said the hospital wants to 'sharpen up its recruitment process' to attract, and keep, high-calibre permanent staff. It won't be easy.

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