NHS Corridor Care – Urgent and Emergency Care Daily Situation Reports

If politicians & policymakers regularly 'walked'
 all the corridors of Hodges' model -
 they would see the false economy 
of their combined incremental works.

Incremental? Yes, in first being a 'temporary measure', then having a deleterious impact as the duration per patient and number of patients on corridors increased.

Now to the situation when the standard of care is unsafe, sub-standard, and denigrates the NHS as a social institution.

The fact of insufficient beds and its effect on care (pathways) and patient (and family) experiences severely affects staff morale, as they recognise subtle abuse, a precursor to structural and attitudinal changes that foster, encourage and establish institutionalised harm.

Staff also realise that they risk being de-skilled, 're-educated' -
becoming less compassionate ... (a 'lesser Nurse') as corridor care 
and its consequences are normalised.

Ignoring demographic trends and without an alternative concerted 
preventive/health education and health promoting plan, this is the result 
of the health and social care funding and policy
of successive governments, enacted by NHS management.

NHS England: Corridor Care – Urgent and Emergency Care Daily Situation Reports
https://www.england.nhs.uk/statistics/statistical-work-areas/corridor-care-urgent-and-emergency-care-daily-situation-reports/

RCN Congress 2025 ii - Losing direct nursing skills

No longer an issue for me, but in the mix of careers: health, education, work - professional; employees often find that they are pulled away from what originally brought them to their chosen career. "I want to help people, care for them, make them better." Especially, if they are ambitious, seek better pay and prospects, for themselves and (a) their family. 

This was an issue and tension for discussion at the RCN Congress:

'Climbing the ladder often means leaving the “bedside”, this is something that can leave mixed emotions for the individual. As a result, we are losing years of clinical experience and expertise which could impact on the future training and on-the-job development for early career or inexperienced colleagues.

The secondary issue that arises with nurses leaving the bedside is skill decay, where a person loses the skills developed in the clinical area through lack of everyday practice. This is being increasingly acknowledged in health care literature (Maehle, 2017). However, the biggest barrier is the resulting lack of confidence in personal skills and ability, particularly where someone is now seen as a senior colleague by those at the bedside.' cont. ...

Discussion - Losing direct nursing skills

I didn't make notes but reflected on how your 'basic training' (for me ...) registered mental nurse (RMN) and state registered nurse (SRN) provides the foundation for professional (and lifelong?) learning? This is, after all, what continuing professional development and post-registration refer to. I did realise that in returning to mental health nursing after qualifying as a SRN, I would surrender much learning - instead of consolidating.

Lecture 101, sets in train the scope of your theory and practice. This is why, and where I see Hodges' model having a role at this point in our professional education, whatever the discipline, or profession. Congress included a resolution for debate: Physician associates. 

We really do need to get this right. Get it wrong, and the quality of care and safety of the public are threatened. If existing standards and professional relationships are perturbed, the effects can be long-lasting and (grossly) injurious. Especially at a time of increasing demographic pressures globally for health systems and services.

individual

|

INTERPERSONAL : SCIENCES

humanistic ------------------------------- mechanistic

SOCIOLOGY : POLITICAL

|

group

1. Is the divide represented by parity of esteem in healthcare MIND :: BODY associated with the fact that in mental illness patients do not ordinarily need to be nursed, cared for in bed?	png image from pngtree.com
2. But, wait! What does history, medical sociology have to say?	3. Is the 'bed' the signifier of instititionalised care? It appears to be. The pejorative term 'big bins' seems to epitomise the mechanisation of care. In prisons do they throw away the key?

Previously: 'RCN' : 'skills' : 'beds'.

Also at Congress was the RCN Northwest Multicultural Group, which may be of interest if you are UK based (and not just in the NW). The following is edited from an email ...

Dear All,

I would like to congratulate everyone for an amazing Congress 2025 and take this opportunity to welcome the new members. It was really lovely to meet all of you in person.

Please see below the link to the webpage of multicultural group:

https://www.rcn.org.uk/northwest/Get-Involved/NW-Multicultural-Group

I will be sharing the details of the next meeting and other information via the group and email.

Kind regards,

Olanike Babalola (She/Her/Hers)
Chair/Cofounder RCN Northwest Multicultural Group
Email: olanike.babalola AT reps.rcn.org.uk

"Jason and the adventure of 254" c/o Wellcome Collection

"A work by artist Jason Wilsher-Mills is displayed at the Wellcome Collection ahead of the opening of a solo exhibition at the London museum. "Jason and the adventure of 254" reimagines the gallery space as a hospital ward and features huge sculptures, illustrations and interactive dioramas that draw on the artist's experience of becoming disabled at the age of 11.

The exhibition's title alludes to 2.54pm at Pinderfields Hospital, Wakefield, on August 1 1980, when Wilsher-Mills watched from his hospital bed as his parents were told he was suffering from an autoimmune condition brought on by a bout of chicken pox.

The free exhibition opens tomorrow (21st March) and runs until January." p.2.

INDIVIDUAL
|

      INTERPERSONAL    :     SCIENCES               

HUMANISTIC  --------------------------------------  MECHANISTIC      

 SOCIOLOGY  :    POLITICAL 

|

GROUP

	'Figure in the bed', 2024, part of Jason and the Adventure of 254, an exhibition by Jason Wilsher-Mills at Wellcome Collection. Gallery Photo: Benjamin Gilbert. Attribution-NonCommercial 4.0 International (CC BY-NC 4.0).

Body of work, Artist relives diagnosis, Financial Times, 20 March 2024, p.2. 

Previously - 'beds'

Identity: Self and Social

Hodges' model

Forms of Identity - The search for the self

"Beckett's first play, Eleutheria (written in French shortly after the war, but so far unpublished and unperformed), is also concerned with a young man's efforts to cut himself loose from his family and social obligations. Eleutheria is in three acts. The stage is divided in the middle. ..."

Individual
|

      INTERPERSONAL    :     SCIENCES               

HUMANISTIC  --------------------------------------  MECHANISTIC      

 SOCIOLOGY  :    POLITICAL 

|

Group

	"On the right the hero lies in his bed, apathetic and passive."
"On the left his family and friends discuss his case without ever directly addressing him."

"Gradually the action shifts from left to right, and eventually the hero summons up the energy to free himself from his chackles and cut himself loose from society." p.35.

Esslin, Martin. Chapter 1 Samuel Beckett, The search for the self. The Theatre of the Absurd. London: Pelican, 1982. (3rd Ed.). p.35.

Note: "Does he take sugar?"

https://www.theguardian.com/society/2012/mar/19/berit-stueland-obituary

Chairs and Beds: The Theatre of the Absurd [balance!]

Hodges' model: Stages of Care/Despair

Individual
|

      INTERPERSONAL    :     SCIENCES               

HUMANISTIC  --------------------------------------  MECHANISTIC      

 SOCIOLOGY  :    POLITICAL 

|

Group

Beds needed for 'treatment' mental illness and physical, preparedness for public health events. Reduced beds for 'modern medicine', sustainable health care, reflecting health education, preventive approaches and improved health literacy (. . .?).

NHS hospital beds data analysis We look at NHS bed data in England compared to other countries, bed stocks over time, the impact of COVID-19, safety breaches and intensive care capacity.

"The Theatre of the Absurd, on the other hand, tends toward a radical devaluation of language, toward a poetry that is to emerge from the concrete and objectified images of the stage itself. The element of language still plays an important part in this conception, but what happens on the stage transcends, and often contradicts, the words spoken by the characters. In Ionesco's The Chairs, for example, the poetic content of a powerfully poetic play doe not lie in the banal words that are uttered but in the fact that they are spoken to an ever-growing number of empty chairs." p.26.

Bed Availability and Occupancy – KH03 "Bums on seats" (Lecture theatres)

Esslin, Martin. The theatre of the absurd. London: Pelican, 1982. (3rd Ed.).

What's in a Name?

  Or, The First Rule of First Aid* ... #SafeStaffing

Health care is often described as complex ...

there are tools to help simplify, conjoin 

and help care navigation and learning ...

Despite this and even if people are listening

politics, politicians and policy makers seem determined to turn health care into a maze ...

INDIVIDUAL

|

INTER-PERSONAL : SCIENCES

HUMANISTIC -------------------------------------------------- MECHANISTIC

SOCIOLOGY : POLITICAL

|

GROUP

*Protect yourself first.	"WAITING ROOM" "WAIT HERE"

RCN Safe Staffing Campaign:
https://www.rcn.org.uk/employment-and-pay/safe-staffing

patient safety learning hub:
https://www.pslhub.org/

'Named Nurse' 25 years ago.
Mitchell G, Strain J. The role of the named nurse in long-term settings. Nurs Older People. 2015 Apr;27(3):26-9. doi: 10.7748/nop.27.3.26.e679. Review. PubMed PMID: 25809049.

My source (and image):
https://twitter.com/helenh49/status/1210956380636663813

Dynamism - Stasis : Demand - Supply :Bed-blocking

individual

|

INTERPERSONAL : SCIENCES

humanistic ---------------------------------------  mechanistic

SOCIOLOGY : POLITICAL

|

group-population

Gibbons, K. (2016). NHS crisis deepens as bed blocking costs £6bn. The Times, August 12, p.1.

Image source:

Hospital Bed By Wojciech Zasina, PL, Noun Project

Architecture and Design: 4 beds in 4 domains

'Privileged' is definitely the wrong word. Perhaps it is the advantage of experience and the passing of almost four decades and more....

Times have changed since arriving at Winwick Hospital on a bike as a student nurse for an early shift at 0655. I would  leave my bike just down a small corridor to the right of the main entrance. I don't think I locked it. Then depending on the ward allocation I walked through the red carpeted front of the hospital to the increasingly rough and seemingly lost corridors beyond.

Hospitals have changed markedly. Winwick and other asylums have gone - thank goodness.

Cockroaches, leaking roofs, two-storey blocks where when necessary the patients would carry the meals up the stairs. A charge nurse set about ensuring that the patient's were provided with proper safety equipment if there were no lifts. The dormitories were large: 40+ bedded and more. There were lockers of some description I think, but personalised clothing was still to follow in 1977.

Despite the emphasis on community care, a project that in reality is still a work in process, the need for hospital beds remains. I have worked to keep people out of hospital, to help provide crisis support at home. When beds are needed the experience for members of the public and their families is radically different today. As taxpayers we recognise the need for efficiency in design, procurement, commissioning and managing new buildings. So it is within the NHS. Visiting new modern facilities, and this includes private nursing homes, you really appreciate the benefits good design can bring for patients-residents, staff, students and visitors.

individual
INTERPERSONAL : SCIENCES

humanistic ------------------------------------------- mechanistic

SOCIOLOGY : POLITICAL

group

My space Private space - observations permitting/negotiated Space to wander Space for wheelchairs Colour Personalisation Temperature Why is Joe staying in bed? Why is Mary not going in the lounge? ...?	4 Bed Multi Bed Bay c/o ProCure21+
Public space Quiet spaces (who says?) 'Community' Lounge Dining areas Activities room Noise levels Meeting rooms Interview rooms ...?	Public Engagement Staffing Volunteers Project Management Value for Money Savings Security Policies Safety Services ProCure21+ ...?

Image source: http://www.procure21plus.nhs.uk/standardshare/