Heartbroken A&E nurses are "seeing the same patients in agony for two or three days".
Nurses have said they feel helpless and patients are scared to ask for help on short-staffed wards, as they spoke to the ECHO on a picket outside Whiston Hospital this week. John Taylor, 58, has worked as a nurse in A&E for nearly 35 years, he told the ECHO: "It's heartbreaking for staff because we're seeing the same patients in agony for two or three days."
John said things have got "a little bit worse incrementally" each year and in the last year he's seen a "massive difference" as patients get stuck in emergency departments, or waiting outside them, because there's no capacity in social care for people in hospital beds to be discharged.
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Hospitals across the country have seen queues of ambulances with paramedics waiting to handover patients to A&E. The ECHO understands there were 14 ambulances waiting outside Whiston Hospital on one day in December, the second busiest month for calls to the North West Ambulance Service.
John said: "Staff are doing their best. You know, they're getting their bloods done, they're getting their ECGs. We're trying to keep them as safe as possible, but it's no way to run a civilised society. It's not a functioning emergency service."
St Helens and Knowsley NHS Trust claimed the maximum number of patients on a corridor is 30. It said this is a rare occurrence usually only happening during periods of extreme pressure on emergency services, like between Christmas and New Year. The corridors are staffed, and the Trust said patient care is of the same standard as in a cubicle with appropriate pain relief throughout.
The Trust has invested in extra nurses to deal with increased demand and to maintain safe staffing levels. It has also increased bed occupancy levels to improve the flow of patients through the hospitals, purchasing 30 care home beds to allow patients to be safely discharged while waiting for social care packages to be arranged.
John said it's not the fault of the Trust or patients that so many people who shouldn't still be in A&E are stuck there. With so many patients waiting on trolleys, chairs and corridors, John tries to keep his head down. He said: "Every time I go to do a job, I walk past patients who are on trolleys, who don't want to be on trolleys.
"They're mostly elderly, mostly frail, with frail families with them - partners who have sat in a chair for 36 hours waiting to help them, they don't want to leave them. I do my best, as does everybody. I've worked as a nurse for 40 years, and I do my best, but it's getting harder and harder to do your best, and the best just isn't good enough."
There's a similar situation in the hospital's gastroenterology department, where patients are "scared" to ask for help because they know nurses don't have the time to give the care they want to give, according to newly qualified nurse Katie.
The 21-year-old said: "Every patient has different needs. You could have someone in one bedroom with cancer - palliative, end of life, literally wants you for a chat. Then in the other room, you've got a patient detoxing, confused, agitated.
"You've got to balance which one needs you, but then you go to one room and they're like, 'I've been waiting for this for ages', and you're like, 'Oh, I'm awfully sorry, I haven't had the time, but I will get to you', and then you go to someone else and they're like, 'You said you'd do this for me'. You're just constantly apologising your whole shift for not being able to be there for them. It's hard."
Her ward colleague and former coursemate Isy, 23, said patients are aware of these pressures. She told the ECHO: "People will be in pain for three hours and just won't want to press the buzzer to get us because they know how busy we are, so it's sacrificing their care."
Katie added: "Half of them are scared to press the call button, and if they do, they're like, 'Aw I'm sorry, I know how busy you are', and it's like, this is what I'm here for - if you need something, you can ask me."
St Helens and Knowsley Teaching Hospitals NHS Trust, which runs Whiston Hospital and St Helens Hospital, had the longest waiting times of any hospital trust in Merseyside in December. According to NHS target figures, in December just 53% of people attending the A&E were admitted, transferred or discharged within four hours of arrival. The NHS target is 95%.
A Trust spokesperson said: "As with all other hospitals across the country, we have experienced unprecedented demand for our emergency care services. Our staff are responding to this increased pressure with exceptional professionalism and are working incredibly hard throughout the hospital to manage demand.
"Whilst acknowledging that the circumstances are challenging and not what we would wish for our patients or staff, the standard of care is maintained across the entire department and patients are provided with the appropriate pain relief. We appreciate how difficult the current situation is and would like to thank the public for their continued support and kindness."
Nurses have walked out on four strike days since December as part of a dispute over a 5% pay rise offered to NHS staff on Agenda for Change contracts. This includes ambulance workers, who are striking again on Monday and Tuesday. Both groups of NHS workers feel the dispute is as much - if not more - about patient safety and working conditions.
The Royal College of Nursing (RCN) and unions representing ambulance workers - Unite and GMB - are planning a same-day strike for the first time on February 6 as they escalate the dispute following the failure of talks with the government.
Carmel O'Boyle, a frontline nurse and chair of the RCN's North West regional board, first spoke to the ECHO about the staffing crisis and its impact on nurses' mental health in June last year. That was four months before nurses started voting on whether to take industrial action.
There was a shortage of under 40,000 nurses at the time. Now the number is higher than 47,000, and nurses feel the government still isn't listening to the alarms they're sounding about the state of our NHS. Carmel said: "If you can't listen to frontline healthcare workers who are telling me about your healthcare services, then I don't know who you are listening to, or what kind of fantasy tales you're thinking about, because we are in crisis.
"This is a really dangerous time, and that's why nurses are taking to picket lines because they know the patients aren't safe. Something needs to change before something horrendous happens."
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