I’m an A&E nurse – and in my hospital right now, we can’t give patients the dignified care they need | Susie

4 hours ago 2

A&E nurses thrive in a crisis. That’s why my colleagues and I came into the profession – to do the best for our patients in their moment of need, even in the most chaotic of circumstances. But the pressure is currently overwhelming. This winter, a bad but by no means unprecedented flu season has put immense strain on already struggling hospitals around the UK. Some patients are waiting days to be seen, with trusts using every inch of space to look after patients in corridors, physio rooms and even store cupboards, often without access to vital lifesaving equipment such as oxygen.

In the London hospital I work in, patients brought in on trolleys are often left for hours in an indoor ambulance bay with an automatic sliding door that opens on to the elements. While they wait for a bed, some are attended to in our viewing room for dead bodies. It’s the only private place left. Everyone knows that “care” is taking place in completely unsuitable parts of a hospital, yet there is no transparent data made available on how many patients are affected, how long their treatment lasts in these inappropriate places and the extent of the harm being done. Wes Streeting and NHS leaders should commit to publishing this data immediately.

This is not just a winter issue. Last summer, many hospitals like mine were declaring Opel 4 status; that means being under severe pressure, with the system at risk of breaking down entirely and hospitals unable to meet all care needs. This was the period when A&E departments were meant to get a reprieve. I remember chatting with other exhausted staff and asking our hospital leadership, “How can we prevent this becoming a terrible winter?” We never got an answer.

My New Year’s Eve shift was a good example of just how bad things have become. The hospital I work in is a major trauma centre and receives some of the most severely injured and unwell patients in the capital to its resuscitation room, with capacity for only eight people. A patient in that state deserves privacy and the care of a nurse. Instead, we were forced to almost double our capacity, stacking six of the sickest patients in a room with only one nurse. Rolled-out whiteboard screens provided a meagre barrier between each patient, and families were forced to hold the most intimate and heartbreaking conversations about the care of their loved ones with patients being resuscitated less than a metre away. It was almost impossible to deliver dignified care.

The joy of nursing is the ability to do the seemingly impossible by saving somebody’s life while also caring for them; holding a hand, counselling somebody through an extremely difficult time. Devastating staffing shortages and too few beds mean these moments are slipping away. The incredible pressure has led some nurses to become blunt and task-focused, stretched thin and unable to deliver safe and timely care. They have been robbed of the intimate moments that make nursing so special. The vast majority of the time we are providing treatment, but I wouldn’t call it care.

It is us, not government ministers, who have to deal with the repercussions of this inadequacy. They don’t have to comfort someone with dementia who has soiled themselves in a corridor, nor be on the receiving end of patients’ frustration that can escalate into aggressive physical behaviour. I’ve been spat at and even threatened with an acid attack. Multiple staff members on my ward have been physically assaulted.

We know that we need more physical space, including beds. We know that we need to move patients out of A&E and into the community. We know that we need more capacity for our mental health patients, but our hands are tied because we haven’t been given the resources. The challenges of the job are made all the more difficult because of poor pay. A registered nurse can earn as little as £29,970 a year, while those at the beginning of their careers face debts of about £61,000 from their training.

Training should be free – as it was when I trained. Wages also have to improve. The 5.5% pay award from the government last year did very little to make up for the 25% cut that nurses have suffered in real terms since 2010. There are currently more than 31,000 nursing vacancies in England alone – how can we expect to fill them when the practice is so poorly remunerated? I have moved a long way out of London and commute into the city to do my shifts in a block now, because I simply can’t afford to rent a home on a nurse’s salary.

All of this leads to a strange contradiction: I love my job, but I think about leaving every day. I love my colleagues, I love the characters I meet and I love being able to give the best care. But the poor pay and moral injury that results from not being able to give patients what I know they deserve is eating away at my personal and professional pride. I know I’m not alone.