“Can that guy sit, do we think?” asks Dr Raj Pow, senior marketing consultant within the emergency division at Warwick Hospital.
He is speaking a couple of 90-year-old affected person who was delivered to house after fainting, the place he was discovered chilly and confused.
Now he’s steady. Can this open the mattress?
“If we can get him to sit, he can go to one of the chairs and that will free up his bed,” says Dr. Pau.
These are the conversations medical doctors and nurses are having in hospitals throughout the nation as a extreme flu season places the NHS beneath stress.
More than a dozen hospitals have declared severe incidents — a few of that are thought-about among the many finest within the nation.
Earlier this week, the BBC visited Warwick Hospital. It is run by the South Warwickshire Trust, which is among the high rated within the nation and prides itself on the graceful working of its 4 hospitals.
But this week the case load has been very excessive.
Warwick Hospital has 375 beds and at one time anticipated demand was about 100 greater than that. For the primary time, it needed to be declared a severe incident – the best alert stage within the NHS.
The BBC was current when hospital directors made the decision. Declaring a severe incident is a warning to the native well being system that the scenario is worsening. Often, this frees up hospitals to redeploy medical doctors and create new short-term ward house.
Over a interval of two days, the BBC noticed medical doctors and nurses doing simply that: discovering stop-gap options to deal with sufferers in no matter protected setting may very well be arrange.
With emergency departments overcrowded, sick individuals need to be handled within the very chairs they’re sitting on.
Others needed to wait in ambulances parked exterior emergency items for hours earlier than being taken inside.
One such affected person is Percy, who’s 80 years previous and is affected by liver failure. He got here to the hospital as a result of he was feeling unwell and had misplaced weight in current weeks.
Dr Arun Jayakumar, senior registrar of the ward, is among the medical doctors despatched to look at sufferers like Percy.
Going into the ambulance, he had a short session along with her. He tells Percy that every part is being finished to get him to the hospital.
Percy smiled softly, resigned to attend.
The paramedic who introduced him to the hospital has additionally resigned: he has seen too many circumstances like Percy's this season.
He activates the heating at the back of the ambulance and sits down once more whereas Dr. Jayakumar will get out and closes the doorways.
Doctors, nurses and consultants within the emergency division talk about easy methods to make room for the brand new arrivals.
Hospital beds are at an absolute premium. So many sufferers have arrived {that a} room has been arrange close to the ambulance entrance for these deemed “fit to sit”.
Every chair is occupied.
“It's not ideal,” says one physician. “But it's safe.”
Porters have to maneuver beds by means of this open house, between sufferers being handled in chairs and nurses kneeling on the ground to take away tubes. The drip stand is moved backwards and forwards to create space.
We see a nurse wheeling a affected person, nonetheless on a drip, to the bathroom in a wheelchair.
She leaves the chair within the hall and helps the affected person. A porter comes and goes to remove the empty wheelchair.
The nurse rapidly walks out. “That's my wheelchair,” she cries.
We flip it again to her and she or he begins laughing. “You can't take your eyes off them, even for a moment, or there will be another patient in there,” she says – solely half joking.
Elsewhere, Percy is rushed to the emergency division by ambulance after a three-hour wait.
“It's getting worse,” he says, closing his eyes nervously – however will probably be one other 12 hours earlier than Percy is admitted to the ward.
When we lastly see him transfer, he’s contorted in ache on his mattress and clutching the sick bowl.
Dr. Pow's first activity throughout his go to is to verify the rooms to see who he can take away from the mattress.
There is a whole ready room proper exterior his door and 4 ambulances parked exterior.
In the final room he enters, a girl is crying. Dr. Pow will get the most recent info on his situation from a nurse and orders some morphine.
“You're in the right place,” he tells the affected person. “We will take away your pain.”
Dr. Pau tells us: “The people who come in now are sicker than before. And here we are, trying to get them out quickly.”
He then visits a person who was admitted with a coronary heart assault two days in the past however is now not receiving energetic remedy. Can he be moved safely, Dr. Paw wonders.
“These are decisions we are being forced to make,” he instructed the BBC.
“I'm considering moving a heart attack patient to the waiting room so I can take his room.”
Another affected person Dr. Pau had noticed the day prior to this was nonetheless ready for a mattress within the ward, even after greater than 24 hours.
“This is nonsense. This shouldn't be happening,” says Dr. Pau. “People should not be spending 27, 28 hours in the emergency department.”
At one level throughout our time within the hospital we had been taken to a financial institution of screens displaying statistics.
It revealed that sufferers within the emergency division had been ready for a mattress for nearly 30 hours and there have been six ambulances queued exterior. One was there for 4 hours.
“It's the worst I've ever seen,” says one physician.
The South Warwickshire Trust has withdrawn its declaration of Tuesday's severe incident – nevertheless, employees instructed the BBC they’re nonetheless going through the identical stage of stress.
With inputs from BBC
