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We’re nursing sickly hospital back to the best of health
The last year has been difficult for East Lancashire’s hospitals, with the Royal Blackburn and Burnley General being placed in ‘special measures’. Yet despite the criticisms, much excellent care is given by thousands of nurses, medics and support staff, who work hard over long hours. In a series of features, starting today with the Royal Blackburn Hospital, LAWRENCE DUNHILL meets some of these unsung heroes MATRON Lianne Robinson aims to play a crucial role in driving improvements, after being drafted into Blackburn’s much-maligned emergency department in October.
Last year’s wide-ranging inspection report, by NHS England chief Sir Bruce Keogh, said the energency ward had struggled to cope with surges in patients due to staff shortages.
And although it remains under severe pressure, Lianne said nine new nurses had been recruited, with increased efforts being made to divert patients with less serious problems to other services, leaving medics free to help those in serious need.
And the move appears to be paying dividends after the A&E department hit a key waiting time target earlier this month for the first time since last summer.
Lianne said: “I’ve been at the trust since 1999 and was approached because we needed some fresh eyes to see what the issues were.
“We’ve acknowledged that we probably haven’t had the right numbers of staff in the department and that it wasn’t big enough for the numbers of patients we were getting.
“But I think staff can see things are starting to change. Morale is improving. For example, we didn’t have a system for assessing patients’ risk of developing pressure ulcers, and that is now in place.
“I think the critcisms have been fair, but it’s also very easy to blame a department which is under pressure. We see 500 patients a day so there will always be mistakes because we’re human. The emergency department is notoriously busy and staff often work a whole shift without breaks.”
Another key area of the hospital is the medical assessment unit [MAU], which includes an ambulatory care service, where patients are sent from the emergency department as well as direct from GPs.
Getting things right in this area is crucial to avoiding unnecessary admissions, and therefore key to easing pressure on the rest of the hospital.
Senior medics on the unit, which is currently being expanded, see 80 patients per day, with about a third able to be discharged after any required tests or assessments have been carried out.
Kalie McFadden, an MAU healthcare assistant, said: “We can be extremely busy with very sick patients all requiring different types of care, so it can be difficult to prioritise sometimes. But we have a great team and we all support one another.
“The NHS does a fantastic job and I think people forget all the good, like how many lives we save a day and all the patients that go home treated.”
Lesley Gaw, matron for medicine for the last 15 years, said: “It’s a very busy unit and we’re turning the beds over a few times a day. But there are a lot of good people here and I think we are coping.
“A lot of the stuff that came out from the inspections we knew already, so it wasn’t a big surprise, like improving the nurse to patient ratios, but we can see that things are changing now.”
As well as about 100 new nurses being recruited, significant work has also been carried out to ‘join up’ different departments with specialist staff following patients through their stay in hospital.
Staff in the critical care outreach team, who track patients when they transfer to a ward from intensive care, were actually praised in the Keogh Report for providing a ‘rapid response’ when patients deteriorated.
Sister Janet Hoyle, who heads up this team, said: “We got a couple of positive mentions from Keogh and morale is very good here. The readmission rates for the unit used to be high but we’ve cut this right down. We call ourselves an intensive care unit without walls, because we follow the patients once they’ve been discharged from critical care.
Her colleague Stephanie Houlker, a critical care nurse, said: “We cover all the wards so we get to see all the departments across the hospital and I’d say all the nurses are working really hard to look after people.”
Dozens of specialists also operate across the wards, such as colorectal nurses Andrea Darbyshire and Tracey Hacking, providing a ‘consistent face’ for patients when they move between departments. Andrea said: “We never really discharge patients from our care and we get to know them inside out. Being a nurse has taken over my life and I really thrive off it.
“It has been a difficult year but we are getting regular communication and there is a feeling that things are changing. The people I work with are like a family.”
Tracey added: “Sometimes it is hard to hear negative stories and experiences because within the trust there are pockets of people working extremely hard. You want people to come and see all the good things that happen.”
A whole raft of support staff also play an important role behind the scenes, such as multi-disciplinary team co-ordinators Helen Bates and Ross Dawson.
They track every cancer patient at the hospital to make sure they are receiving the right care within the national waiting time targets, as well as bringing different medics together to arrange the correct treatments.
Helen said: “It’s never nice to hear negative reports but we are aware of just how hard people are working here.”
The nature of news means the unusual, and therefore negative cases, normally make the headlines, but there are clearly thousands of patients who receive excellent care at our hospitals, including Julie Shorrock, 55, from Sabden, who arrived at the emergency room suffering spasms in her throat and struggling to breathe.
She said as she was being discharged: “I was really impressed by the doctors and all the staff were lovely. I’d heard some bad things about the hospital on TV before coming in, but I’ve had a good experience and I felt very safe the whole time.”
The more people you meet at the Royal Blackburn, you realise the hospital is not in special measures because it has poor doctors and nurses, but because of staff shortages and systems and processes which became embedded over several years.