Annex A > Chapter 9 - The Split Service > Comments by nursing staff in the UBH/T
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Comments by nursing staff in the UBH/T
37 Fiona Thomas, Clinical Nurse Manager, stated in her written evidence to the Inquiry:
`The set up [at the BRI] was that children and adults were nursed together in the same ward. The segregation of children was attempted to the best of the staff's ability by using beds 1 and 2 to care for the children. This was not always possible due to the pressure on beds. ... The staff level to manage the ITU was about 70 full-time nurses, but with holidays, nights and days off, to a lay person it may seem that there was always new staff coming and going, but this was due to the very large number of staff employed on ward 5. The nursing staff do not work in a trial and error way, they do what is appropriate for the child at that time. A child's condition can change very quickly and care needs to be adapted accordingly.' [35]
38 Ms Pauline Chinnick, who has held various nursing posts at the BRHSC since 1983, stated in her written evidence to the Inquiry that as regards the mixed adult and child environment:
`... it was recognised that the situation was difficult as it could upset adult patients and the parents of children on cardiac ICU. It also, in my opinion, diluted knowledge and skills and made nursing staff less able to build up expertise.' [36]
`Parents also became frustrated with the split site in that the cardiac surgeons were not so readily available on the ward at BRHSC. Parents could make comparisons with surgeons of other specialties on the ward, who appeared more available.'
`The cardiac surgeons would visit BRHSC even if it was very late. For example, on occasions, they came after midnight.' [37]
40 Mr Graham Brant was a staff nurse on Ward 5B from March 1991 until he was promoted to senior staff nurse later that year and then to charge nurse in May 1993. He stated in his written evidence to the Inquiry that children on Ward 5 in the BRI, `missed out on some of the facilities of the Children's Hospital, e.g. child sized tables and chairs, paintings on the wall ...'. [38]
`Most of the nurses at the BRI were not RSCNs [Registered Sick Children's Nurses], but they had paediatric nursing experience.' [39]
42 He described the wards at the BRHSC as `very cramped'. [40] He stated that there was more space in the ICU at the BRI, such that children were separated from the adults as much as possible. Mr Brant expressed the view that the nursing care of the paediatric patients at the BRI was of the highest order and `at times the care may have been better for paediatrics than the adults as the senior nurses had looked after the children while the adults tended to be looked after by the junior staff'. [41] He stated that from a nursing point of view, communication and collaboration between the two centres (the BRI and the BRHSC) was very good. He stated that he did not think that there was a problem between doctors on either site. He concluded:
`... with hindsight it is easier to say that it is better for the patient for all cardiac surgery to have been performed at the BRHSC, but as it was not we did the best we could and I did not think that the care was at all compromised.' [42]
43 Ms Joyce Woodcraft, an RSCN and RGN who worked at the BRHSC from 1977 to April 1994, told the Inquiry that, although there were difficulties in the surgeons integrating their ward rounds at the BRHSC with their work at the BRI, it was something they were able to achieve. [43] She was asked by Counsel to the Inquiry about the transfer of patients from the BRI to the BRHSC in the following exchange:
`Q. And how well did communication between the two sites work, to manage a transfer, in your experience?
`A. The staff at the BRI would phone us and inform us, as I say, of drips and drains and particular drugs that the child was on before they were transferred up.
`Occasionally we would get - they would forget to phone us to say that the child was actually on the way, and that could cause a problem if we were in the middle of an acute situation. If they phoned we might have said "can you hang on for half an hour or an hour" or something. That was not a frequent occurrence.
`It did happen occasionally, but not - I would not have said it was a routine, that they all came up without being announced, not in my experience.
`Q. Again, "occasionally" can mean once a year, twice a year, once a month?
`Q. Something that you can remember occurring, but not with great frequency?
`A. Yes, but not as a big deal, really.' [44]
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Footnotes
[35] WIT 0172 0006 Fiona Thomas
[36] WIT 0532 0041 Ms Chinnick
[37] WIT 0532 0041 Ms Chinnick
[38] WIT 0513 0013 Mr Brant
[39] WIT 0513 0013 Mr Brant
[40] WIT 0513 0013 Mr Brant
[41] WIT 0513 0013 Mr Brant
[42] WIT 0513 0014 Mr Brant