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Shock testimony of NHS nurse reveals harrowing reality of A&E today - from men dying in wheelchairs to women lying in soiled sheets READ MORE: Half the UK will end up in A&E soon, top doctor warns By ANONYMOUS Published: 20:31 EST, 23 January 2025 | Updated: 20:45 EST, 23 January 2025 e-mail View comments When I had last set eyes on the man who had been brought in with a suspected heart condition, he was wedged in a wheelchair into an alcove normally used to store hospital equipment. He was clearly seriously ill and should have been in a cubicle attached to a monitor – but then you could say the same for the dozens of others, crammed into the corridor outside my hospital’s frantically busy A&E department, the only physical space available left to us. I say ‘space’ – there wasn’t any.
Even the corridor was filled to capacity with patients on trolleys, in wheelchairs and waiting room chairs, along with their relatives and other ‘walking wounded’ patients, all trying to navigate their way to and from the vending machine at the far end. So crammed, that when the man in the wheelchair suffered a cardiac arrest, it was impossible for the crash team to get to him to resuscitate him. There was literally no room to reach him, less still to lie him on the floor and perform CPR, something which has become not uncommon, along with nurses straddling patients on trolleys performing CPR as everyone watches.
That man died right there in his chair as his frantic wife screamed for help. It was – and is – inhumane, but then I could use that word to describe a lot of what is unfolding in our emergency departments these days and in which corridor nursing, which should really only be used in exceptional circumstances, has become a daily reality without which A&E departments couldn’t function at all. This last week the sheer monstrous scale of the problem was laid bare in an eviscerating report from the Royal College of Nursing, which featured the testimony of more than 5,000 nurses and exposed the daily horrors unfolding in emergency departments up and down the land.
Your browser does not support iframes. They painted a picture of scenes which would once have been barely believable - men and women dying in chairs and on trolleys, mental health patients rampaging alongside frightened dementia sufferers and women waiting for antenatal care miscarrying in corridor alcoves – but which have become almost horrifyingly routine. In fact, treating patients in corridors has become so commonplace that a hospital recently advertised for nurses to take on 12-hour corridor care shifts.
It’s a picture I certainly recognise only too well after 25 years on the frontline of nursing in a busy Greater London hospital. Back when I was a trainee, there was never anybody in the corridor. In fact, there were times when there was barely anyone in the department itself.
Certainly, when the day shift handed over to the night shift at around 9pm, there would be, at the very maximum, a handful of patients left. At night, certainly during the week, it was not unusual for there to be close to empty. That feels like ten lifetimes ago now: fast forward to today, and it’s chaos, 24 hours a day, seven days a week.
To give you some idea of the pressure we are under, the hospital where I work has capacity for 60 patients in the emergency department; at one point recently there were 167 waiting to be treated. Half the population of England will end up in A&E every year by 2034 if the NHS does not 'go for broke' and shift more care from hospitals to the community, a top doctor warned recently. (file image) That’s nearly three times capacity, and the only option is to put them in the long draughty corridor outside the doors, at one end of which is the ambulance access door which is continually opening and closing to allow crews in and out, bringing in freezing winter air and debris with it.
That particular day had not started well. I’d arrived for my afternoon shift to find a mental health patient having a breakdown, surrounded by four security guards, just by the entrance to children’s A&E. The patient was in crisis; he was trying to strangle himself and had ripped a handrail off the wall which he was trying to use as a weapon, all the while cursing and swearing at top volume in the packed corridor to the obvious distress of everyone there.
Sadly, this again is not uncommon, but it’s still hard to see frightened children and elderly patients seeing things that should be unfolding behind a locked door. That was just the start of the corridor: looming ahead was a 100 foot long space packed with trolleys - some left by paramedics doing what they call a ‘dump and run’ – meaning they are so time pressed they have to leave a patient with their notes before running outside and getting back into their ambulance. The trolleys line each side of the corrider, with chairs wedged wherever there’s space.
Some people are on IV drips. Then there’s the walking wounded, relatives and people popping to the vending machine at the far end of the corridor, meaning navigating it is like wending your way through a bendy racetrack – not that you can race anywhere, as there’s no space and every time you move you’re stopped by a patient, a relative or another staff member asking for help. Help with checking a drug, moving a patient, taking a patient to the toilet .
.. the list goes on.
There’s a reason working on the corridor is known as ‘running the gauntlet’. Your browser does not support iframes. As bad as it is for us though, it’s far worse for the patients; all of us are doing our best, but a corridor isn’t a clinical space (it seems ludicrous having to write that sentence, but that is where we are).
There’s no piped oxygen, only the odd plug point and no call bells, less still observation machines, heart monitors, defibrillators, and computers to access health records. It means most corridor shifts, as we call them, are a battle in locating and keeping hold of equipment: if you turn your back for five minutes, it’s gone. This has a real and desperate impact on patient safety.
It’s not unusual for patients to require oxygen, but when you’re on a corridor the only way you can receive it is via a cylinder - and cylinders run out. Such is the frantic rush for equipment that patients have been given half empty cylinders by accident, or their oxygen has run out with no-one noticing, which happened to one patient that day. On that occasion, I spotted in the nick of time that the man, who was in his early 50s and had been brought in suffering chest pain, looked very unwell and confused.
I was able to get him another cylinder, but one more hour or so and it could have been a very different story. That same day, another man needed an ECG (or electrocardiogram) to monitor his heart rate - but that requires access to a plug point, other equipment and space – all things I didn’t have access to. I had to leave him wedged between two trolleys with an oxygen probe on his finger which would at least monitor his pulse until I could navigate him to a plug point.
By the time I got him hooked up to an ECG, it showed he had an irregular heartbeat which needed immediate treatment – but there was no capacity to take him in to a cubicle. He was whisked to a ward, as a ‘plus one’, meaning an extra bed had been created for him between two others, which doesn’t sound too bad on paper until you confront the reality, which is that the bed has been squeezed between two others so that patients are effectively lying three abreast in a giant king size. Joanna Ormesher tweeted this photograph of the main corridor at Royal Blackburn Hospital in Lancashire recently, saying: 'Patients left out in cold corridors to be gawped at like exhibits in a zoo.
No patient dignity and poor patient care. Shameful at best' At least, unlike A&E, the wards are single sex, although this doesn’t change the fact that no-one should be receiving treatment without the privacy of a curtain which can’t always fit around a bed that’s not meant to be there. I later learned that his condition had improved, but it was yet another near miss.
Another abiding memory of that day is seeing a patient being treated [ITAL] in [ITAL] the entrance doors: one half of his body in the corridor, the other half in the car park, because the paramedics couldn’t get any further in. This man was really poorly – I later learned he had sepsis, but even from where I was standing I could see his face was purple from lack of oxygen. All the doctors could do was give him initial treatment - taking bloods, stripping down his top half to put on the ECG pads, until a bed in the resuscitation room (which of course was full) became free.
All the while people tried to squeeze past to go in and out. The weather was appalling, cold blasts of air made the doors rattle. None of this is hygienic, or safe – you can’t dispense proper patient care in Bedlam, however good you are.
It’s not uncommon for patients undergoing chemotherapy and who are immunocompromised, meaning they are really susceptible to picking up infections, to be sat near a toilet or even someone we later discover has Covid. Meanwhile I’m an experienced nurse, but even I routinely lose track of who I am treating: patients are constantly being moved, so the person in the third bed on the left of the corridor can become the person in the second bed by the time you have completed a task and looked up. Your browser does not support iframes.
Add in the fact that, however vigilant we are, it’s difficult to get access to computer records to check a patient’s history means that medication can be delayed or worse, wrongly dispensed. I consider myself resilient and confident, but the reality now is that we are stretched in so many different directions it’s impossible not to make mistakes. So far – as far as I know – this has not proved fatal, but it only feels like a matter of time.
Certainly, it’s little wonder that nurses dread corridor shifts knowing as we do that the person making the mistake could easily be them. All this is terrible enough, but the thing I struggle with most is the lack of dignity. Many of those who come through the doors to the emergency department are frightened and anxious, emotions which are compounded by the humiliation of undergoing not only medical procedures like ECGs in full public view but their most intimate acts, too.
It’s not uncommon for patients to soil themselves, and trying to change sheets and clothes in a packed corridor while preserving some form of decorum is almost impossible. Often there is no room for a screen, and even if there is it isn’t big enough to provide proper privacy. Read More EXCLUSIVE The horrifying truth about A&E waits Recently, a patient’s catheter overflowed because it had not been emptied.
She was left lying in wet clothes and sheets for four hours. It’s no consolation that it’s the same everywhere. A friend’s son was instructed to go to an A&E at his nearest hospital in the Midlands after dialling 111 with a suspected concussion playing rugby.
When he got there, he was directed to sit in what turned out to be a set of old weighing scales. He sat there all night amid nightmarish scenes, and felt so unsafe that he contemplated ordering a taxi to go home. Think about what that says: if an 18-year-old, 6ft rugby player is frightened, how do the old, the frail, the vulnerable feel? It’s appalling.
In fact, I couldn’t sum it up better than the man who had been waiting on a trolley for 12 hours during my most recent shift. He had been stoic all day, but as I left he shouted that the place was ‘a living hell’. I can’t disagree with him.
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