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Nine out of 10 nurses witness dying patients stranded in hospital

21 February 2018

A new survey by Nursing Standard and Marie Curie has found that nine out of 10 UK nurses have seen dying patients stranded in hospital as a result of delays in funding. These funds would have otherwise allowed them to be cared for at home or in the community.

Launched today, the survey of more than 600 nurses highlights how end of life care is being compromised by pressures on the NHS. The report found that six out of 10 nurses say seeing patients dying while stuck in hospital is a common occurrence, and more than half think that the number has increased since last year.

Nurses were also worried about the impact of this year’s winter pressures on end of life care. Almost eight out of 10 feel it has had a negative effect on the quality of care they are able to provide to dying patients, and 43 per cent think the impact has been worse than last year.

A surgical ward staff nurse said:

“Patients wait on trolleys in A&E for hours, even days due to bed shortages, only to be transferred to a ward with staff shortages. It is difficult to provide a high level of care when you are trying to focus on so many things at once. It should be a privilege to nurse a person in their final days of life. Sometimes we might be the only people they have.”

Many also raised concerns that patients are dying alone in hospitals and in the community because there are too few staff to spend time with them. Others had seen patients die in emergency departments while waiting for transfers to wards or hospices.

A nurse responding to the survey commented:

“I have unfortunately experienced patients without families dying alone in rooms due to staff shortages. I am often unable to attend to families right away following the death of a loved one due to needing to administer medications.”

Additionally, the survey  found that:

  • Almost two thirds of nurses say they do not have sufficient time to provide high quality care for patients who are dying, a similar proportion to those who answered the survey last year.
  • Staffing levels and time constraints were the main barriers identified to providing high quality care, followed by a lack of care provision in the community, including care homes, peoples’ homes and hospices.

In response to the findings, Anne Cleary, Deputy Director of Nursing for Marie Curie, said:

“The results illustrate the unsustainable pressure being placed on nurses while they shoulder the huge responsibility of caring for people at the end of their lives. Nurses go to work each day because they want to provide high quality care. Not being able to meet those standards, can then put real pressure on how they feel about their job, not to mention the unnecessary pain and distress it causes for patients and their loved ones.”

“Nurses have told us that they are caring for more and more people who are dying in hospital when they do not need to be there. Now, more than ever, we need to support them by investing in community care so that people can get the nursing they need at the end of their lives outside of hospitals, in a place of their choosing.”

Eleanor Sherwen, the RCN’s professional lead for end of life and palliative care, said:

“The results of the survey are disappointing but not surprising. We only have one chance to get end of life care right. How people die remains in the memories of their loved ones for a long time. Nurses are doing their best in incredibly challenging circumstances but there is a lack of time.”

“We need training and education for nurses, action on nursing recruitment and retention, particularly in district nursing workforce, and a social care workforce who can support district nurses. Health and social services need to work together.”

Also commenting in response to the survey, Carole Walford, Chief Clinical Officer at Hospice UK said:

“It is of great concern that the number of dying people stranded in hospital is higher than last year.”

“Nurses continue to face huge barriers as they try to provide quality care to people in hospital during their final days. This causes considerable distress to patients and their families and is also highly stressful for nurses themselves.”

“As this survey shows the winter pressures on the NHS this year have again impacted on end of life care in hospitals. However, the survey raises other ongoing issues such as the need for better integrated working between the NHS and community-based services.”

“Many hospices are already reaching out to hospitals to work together in partnerships to improve end of life care in acute settings through training and education. Hospices are also working to improve and expand services such as rapid discharge schemes and also support carers, so that more people are able to die in a place of their choosing.”

To see the full survey results visit Nursing Standard 

See more articles in Research

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