Wards working on goodwill and overtime

GLENDA COOPER

"I run this intensive care unit on goodwill and overtime" said Carol Tate, nurse manager at Leeds General Infirmary. "I'm guilty of putting pressure on people to work - it makes you feel like you're blackmailing people."

Nurses at the children's intensive care unit at the hospital are meant to work thirty seven and a half hours a week in twelve-hour shifts. It can end up 20 hours more than that and still there is an acute bed shortage. The infirmary turned away 80 children from its ICU last year. On New Year's Day alone Dr Mark Darowski, a consultant, turned away six and has turned away 14 in all so far this month.

He estimates that bed occupancy can be as high as 120 percent and is usually running at 90 to 100 per cent. There are five beds funded but the unit often runs six relying on nurses working overtime. Dr Darowski would like ten beds.

"We're moving children right across the country" he said. "We took one child from Burnley the other day - that's 90 miles the family are having to travel so the pressure is unremitting."

The unit itself is small with no windows, a few mobiles brighten up the room as anxious parents keep vigils around the beds. A nurse sits calmly at every one alternately talking to the parents and jumping up as monitor alarms go off.

The winter months are the worst with the majority of children admitted with respiratory illness or meningitis. "It starts around November, we're expecting a breather at the end of February" said Dr Darowski wryly.

Across town at St James's University Hospital the situation is equally grim. There is no separate paediatric unit and children are cared for in the adult ICU.

There are a possible 18 beds but only 11 are open because of a shortfall in funding.

Dr Andrew Cohen its clinical director said that they had even been approached by Alder Hey, a large children's hospital in Liverpool.

But for St James's the bed shortage is not the only problem; recruiting trained nurses is equally bad. "It's an intensely stressful job," said Dr Cohen. "You don't get people to go down the mines unless you pay them to do so. It should be the same principle here."

In the unit at Leeds General Infirmary that quality of care does not go unnoticed. As 13-year-old Emily Day, rushed in a week ago with meningitis, prepared to go home after 24-hour care at the unit, her mother, Lynne, said: "The care has been unbelievable. They never stopped. They did everything and I can never thank them enough for saving my daughter's life."