Values Exchange

DEBATE - The Bed Manager, Duty of Care & the 4 Hour A&E Target - All Health Professionals - Values Snapshot

17 Sep 2018 4 Respondents
Vanessa Peutherer
Boss (11803 XP)
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DEBATE - The Bed Manager, Duty of Care & the 4 Hour A&E Target - All Health Professionals - Values Snapshot

You are the professional in charge of a busy unit. You currently have 16 patients on the ward who are awaiting treatment or recovering from very recent treatment interventions. 

You have 2 registered health professionals who have been allocated 8 patients each, one registered health professional is off sick. During the busy shift, the bed manager for the NHS Trust in which you work, rings to inform you that they wish to transfer another patient, Mr Smith, onto your ward.  Mr Smith suffers with dementia and is also recovering from major surgery, carried out the previous day following a recent fall at home.  He is highly dependent at present and has not commenced mobilsation as yet.

You inform the bed manager that you currently have a staff nurse off sick, so you have no extra capacity, and that the professional to patient ratio is already at the nationally recommended limit, being 1:8. You also inform her that the patients you do have are in need of a high level of care due to the nature of their individual needs.  There is also no other assistance available to you, due to high sickness levels throughout the hospital.

Although you do have two spare beds, and you would like to take care of this patient, you feel you do not have the resources to do so safely, without placing your existing patients and staff at risk of harm. The bed manager becomes hostile in her manner, refuses to accept this explanation and informs you that as you have an empty bed the patient should be transferred over to you anyway, as there is no room on the other wards due to patients waiting to be transferred from Accident and Emergency department and the trust is under pressure from the CQC to meet the 4 hour target in the unit. (set out in the NHS Mandate that at least 95 per cent of patients attending A&E should be admitted to hospital, transferred to another provider or discharged within four hours

What should you do?

It is proposed that you agree to accept Mr Smith on to the ward on this occasion

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