‘There’s no dignity in this’, say extended A&E staff

“I ain’t got no oxygen,” screams emergency department nurse Lisa Blackwell.

She calls for more supplies as three ambulances are about to arrive at Chesterfield Hospital in Derbyshire.

The new state-of-the-art A&E unit opened less than two years ago but is already at breaking point.

During several days of filming, BBC News observed that 22 cells in key bays were filled, and beds were overflowing in corridors.

“There is no dignity in it,” says senior matron Stacy Russon.

An elderly woman has fallen on slippery ice outside and has a large wound on her forehead. Blood is dripping from his cheeks. His son tries to gently wipe it off with a tissue, just then a nurse comes in with a blood pressure stand.

His trolley is lined up in a row of five chambers outside, while the patient lying on the bed in front is vomiting into a sick bowl.

Nationally, flu numbers are finally falling. It is hoped that the number of patients will also fall – but the extreme cold is causing problems.

“Cold and snow are not a good combination for older people,” says Dr. Dan Crook, clinical co-chief in the emergency department.

A woman’s leg was crushed after her car slipped on ice and she got stuck in a garage door.

Ann says, “Some local schoolchildren heard me screaming and eventually enough of them gathered and pushed my car and saved me. They were amazing.”

Patients are also suffering from hypothermia.

Michael Elton, 83, is in the resuscitation bay. When he arrived his temperature had dropped to 30.6C (87F).

He was found by his neighbor, who decided it would take too long to wait for an ambulance and took him inside.

As soon as the blood is taken, it works quickly to apply a warming blanket to try to bring its temperature back to the normal range of around 37C (99F). He is confused and weak.

Dan Crook’s emergency pager beeps to signal another action and he runs to the ambulance arrival bay.

James Oakes is elderly, hypothermic and confused. Paramedics fear sepsis.

“He’s a farmer,” says Dan. “He has been under treatment for some time but now he is seriously ill. We need to raise his temperature and oxygen levels rapidly.”

A patient like James should also be seen in the resuscitation bay but it is full.

Instead he was assessed and stabilized in the ambulance area. It is only when he is finally wheeled into a room that the nurse has time to take off his dirty wellington boots.

“How long will I be here?” he asks. His animals need fodder. “I’ve never been to a hospital before and I don’t want to stay here long.”

Managing the flow through the hospital – that is, freeing up beds for those who are ready to go – is a significant and challenging task.

Dr Hal Miller, medical consultant and chief executive of Chesterfield Royal, says 80 of the 540 beds are occupied by patients who are fit to leave but cannot do so because of home or social care issues.

Some of these patients have been admitted, even though there is nothing fundamentally wrong – they simply have no other safe place to return to.

“It makes it very difficult because it means we don’t have the capacity to take care of the people who need care the most,” says Dr. Miller, “but when 2:00 hits, we can take care of these people.” Let’s care – it’s the right thing to do.”

The message from the Chesterfield staff is that they are coping, they are fair, and they are providing safe care.

But they are clear that it is nowhere near where it should be and, through no fault of their own, the standard is falling below the level they were trained to provide.