On hospital wards across the country, a fleet of exhausted and demoralized staff are doing everything they can to meet the needs of every patient.
But they are under increasing pressure and feel trapped in the middle of a logistical nightmare.
STV News was given access to Aberdeen Royal Infirmary’s orthopedic trauma ward, where the doctors briefed us on the issues they face.
In an honest assessment of the situation, nurse Silvia van Hoeflaken said: “Getting people in and not being able to move people has been the biggest problem for us.”
‘Stuck in the middle’
Silvia says that her team of nurses knows that patients are waiting longer than ever for a bed, but it is increasingly difficult to free them.
“It’s frustrating,” he said. “We have patients who come in through the front door who need to be operated on. They’re being looked after by a very strict system of occupational therapists, physical therapists, and when they’re ready to go, they can’t go anywhere. They are effectively trapped in the room.”
When asked how much easier her job would be if the discharge challenges were solved, Silvia admitted: “It would be 100% easier. Our nurses could spend more time with patients and give them the time they deserve.”
Why is this happening?
It’s a sentiment that resonates throughout the ward: all day long, staff have told us the reasons for the problems they face when trying to discharge patients.
They said some patients are overly anxious and reluctant to leave, while others require family assistance at home, which isn’t there, or has no way to get there.
But the reason that constantly came up is the challenges facing social care. Simply put, there are not enough professional places or people to care for patients in the community.
Sarah Barclay, the ward’s physiotherapist, said: “We’re trying to find the right care in the community for people. The best place is home first, but we can’t bring them home if we can’t give them the level of support and care they need.”
trapped in the halls
It means that patients like Betty Sadler, who has been in hospital for nearly three weeks with a broken hip, are often stuck on wards waiting for the next stage of their care.
Betty said: “It’s been great here, the nurses are so friendly, they can’t do enough for you.
“I’m much better, I can move with a frame, but I can’t wait to go home.”
‘We need help, not abuse’
Staff feel the pressure could be eased with more confidence in your medical judgment and help with transportation or aftercare.
Sarah Matheson has been a nurse for 20 years; She says it’s never been more difficult and her colleagues face pushback from patients and families.
“It’s more challenging than ever,” he said. “I feel caught in the middle of this. They talk to us like we’re trying to kick people out. Nurses never do that. I get it, a lot of people are just afraid of family members going home.”
Lead nurse Silvia also hopes people can trust her judgment more. “Families need to understand that if we feel patients are safe to go, then they are safe to go. We don’t hold anyone against their will, we want people to be safe.”
For two years, ARI has operated a discharge ward, a place where patients well enough to leave the hospital can wait in comfort, freeing up beds on wards. It was meant to be used only in winter, but now the demand is such that it is open all year round.
With only 12 beds, nurse Elanor Gray says it’s vital that people pick up family members immediately. “Families do what they can, each one has commitments, we only encourage you to do so as soon as you can come to pick up your relatives.
Elanor added: “We have the ambulance service, but that is also under a lot of pressure, so everyone is doing their bit.”