An increase in patient falls, pressure ulcers and patients not being fed properly are the result of staff shortages at York and Scarborough Teaching Hospitals NHS Foundation Trust, a meeting of the board of directors heard.
The trust is under severe strain, with nearly 300 Covid patients – a record high – and hospitals unable to discharge patients who are well back into the community because there is nowhere for them to go.
The trust is struggling to attract agency and bank staff to do shifts due to exhaustion.
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There is also a high attrition rate among healthcare support staff, with many unprepared for the realities of life on the wards and staff leaving to work in the leisure and retail sectors.
Asked by a fellow director if nurse staffing levels were safe, chief nurse Heather McNair said: "I think we are spread very thinly. We are running some of our big wards – 28-30 beds – on two RNs (registered nurses) on a night, which is a stretch.
"Is it safe? It’s as safe as we can make it."
The male director asked her: "Are they safe enough?"
Ms McNair replied: "I think they’re safe enough. Are we doing critical things – medicines, turns etcetera – I think we are.
"Where I think we are probably not achieving optimum care would be feeding patients, answering buzzers in a timely way – the stuff that HCAs (healthcare assistants) on the whole would be doing."
The director said: "You're not happy that we're able to deliver nutrition needs to all of our patients?"
"No, not regularly, on every meal time on every shift," Ms McNair said.
The director replied: "That doesn't sound safe to me."
Ms McNair said there was "a clear correlation where suboptimal staffing levels are resulting in patient harm."
Incentives to get more staff onto shifts were not working because "people don't want money – they want a rest," Ms McNair added.
In his update, chief executive Simon Morritt said: "It genuinely is the worst it's ever been in terms of the pressures that we're under. The patients who are coming into our hospitals, the beds that we have closed – around 150 in York and 50 in Scarborough – and we have a sizeable number of acute delays."
On delays in discharging patients, he said: "The response from our partner local authorities is that they're in exactly the same position that we are – that they don't have the packages of care.
"We continue to push…there isn't a significant amount of capacity out there in the system.
"There is not a silver bullet in the short term."