Dani Garavelli: Our biggest emergency case

Under the SNP, the number of nurses is at its lowest level since 2006

IT WAS my misfortune last week to spend a day in the ninth circle of hell, aka the A&E department of a crumbling Glasgow hospital. Referred there so my son could get a chest X-ray, I witnessed a level of chaos so overwhelming, it was all I could do not to tiptoe out, muttering an apology for having taken up a few square inches of space.

Every room was occupied, trolleys laden with elderly patients lined the narrow corridor, and cries rent the air.

Outside one cubicle, two police officers stood guard over a prisoner; in another, nurses tried to pacify a woman who was trying to discharge herself. Elsewhere, a confused, elderly lady complained loudly that she had been waiting for five hours (she hadn’t); all to a backing track of a man effing and blinding in agony.

In this hospital, there was no shortage of compassion; the doctors and nurses were run off their feet, but were as solicitous as circumstances allowed. They brought my son a chair when they saw him propped up against the wall and I heard them offer to fetch a sandwich for one old woman. They handled complaints with patience and abuse with forbearance and – though my son’s X-ray was probably the least of her problems – I had no sense that the doctor was rushing through her conversation with us so she could get on with more pressing cases.

Yet, with all the upheaval, the shuffling around of beds, the incessant griping and the sheer volume of patients, it was difficult to see how anyone could do much more than firefight. And, though we were treated with nothing but courtesy, my son and I felt more like refugees in a war-zone than patients in a western healthcare facility.

I have to be fair here and admit the unit we were in is one which has been earmarked for closure; the spanking new hospital opposite (which doesn’t have an A&E) is spacious, clean and efficient. Just the same, having heard countless tales about declining standards, it was interesting to experience first-hand what some patients (and medical staff) have to contend with, especially in the light of a series of studies highlighting the extent of the problems.

Last week, a report by the Quality Care Commission said a fifth of hospitals in England were breaking the law by failing to ensure elderly patients were properly fed and treated with dignity. Meanwhile, a survey by researchers at King’s College, London, found 75 per cent of nurses felt they didn’t have time to talk to patients and 40 per cent said at least one patient under their care had suffered a serious fall in the past month.

So who is responsible for this state of affairs? Over the past few years there has been a growing tendency to point the finger at the nurses themselves. Harking back to an era when Sister held sway over a spotless ward, critics claim nurses today lack dedication, refusing to work while on their breaks and passing jobs they feel are beneath them to auxiliaries. As the profession becomes more academic, student nurses are spending too much time in the classroom and not enough interacting with patients, and many are more interested in chatting about their love lives than tending the sick.

There will be some truth in all these allegations, doubtless. The lazy and the inept exist in every profession, but it seems to me, placing all the blame on nurses – most of whom work hard for little financial reward – is unlikely to get us to the root of the problem.

The real issue, surely, is one of resources; the rise in life expectancy means hospitals are overloaded with elderly patients, many doubly incontinent and too frail to feed themselves; and yet – particularly at a time of public sector cuts – there aren’t enough nurses or healthcare assistants to provide the one-to-one attention that would guarantee their dignity.

The situation is exacerbated – as I witnessed so graphically – by the changing attitudes of the general public. Once deferential to the point of self-effacement, patients are now a much bolshier lot, which can be a good thing, when it comes to standing up for your rights, but means nurses are frequently targets of abuse.

It would be surprising if morale weren’t at rock bottom. And sure enough a study published last month found Scottish nurses were at breaking point due to unmanageable workloads and fears over job security. Four hundred and eighty-six nursing and midwifery posts were lost between March and June, with a further 500 expected to go before March 2012. Under the SNP, which promised to protect healthcare, and has so much spare cash it gave us free prescriptions, the number of nurses is at its lowest level since 2006.

How nurses motivate themselves day in, day out, when the role they play is being devalued in this way is beyond me. And yet, my experience last week tells me many of them do. As we finally left the hospital, the reception area was busier than ever. And yet the nurses (and auxiliaries) still managed to smile and say goodbye, even as they ushered the next patient into the room we had just vacated.