Surgical and orthopaedic ward:

• high acuity, high turnover of patients, one room (High visibility room- HVR) dedicated to 4 falls risk delirium/dementia patients with one staff allocated to this room.
• if bed base is 13 only 3 staff, which can be the in charge RN, TRN, EEN, or In charge RN and 2 EEN (one staff allocated to HVR leaving 2 to 9 patients)
• if bed base is 17 only 2 night staff which is unsafe if the HVR is left unattended to attend to other patients on ward and vice versa.
• CNE is being used as part of the nursing hours to take patient load, not able to support staff.
• High visibility room has one staff allocated and cannot leave patients as high falls risk, cannot prevent 4 patients at once from falling, no IPS approved, although tag team nursing, this puts alot of stress on all staff as unable to provide the nursing care we want to as workload is excessive
• no meal breaks or very late breaks taken impacts on staff health
• staff doing overtime in same ward and even providing overtime to assist other wards which is causes fatigue and affects health
• skill mix an issue- eg In charge RN counted in numbers, with TRN and EEN for 13 patients. Some shifts having to work short numbers
• Scrub nurses being deployed to work in the ward and take patient load- unsafe as they have not given medications the entire time they have been a scrub nurse and has not been given the time to familiarise themselves with EMeds and medications- this can lead to medication errors.
• increase in documentation required

All these points highlight some of the issues faced on our ward. This impacts directly on patient safety and nursing staff’s health and well being. These experiences happened prior to covid and even worse in current times. We are unable to provide the care we want to give to our patients and patients unable to receive the care they deserve.