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'It was the busiest night of all, we couldn't cope': Nurse who said 81-year-old patient was ASLEEP after she had died blames hospital for not giving her a break

Evelyn Agbeko said: 'We didn¿t have the staff - maybe me, an agency nurse and two carers and that was it.¿

A nurse at scandal-hit Stafford Hospital said she mistakenly claimed a patient was sleeping when she was dead because she hadn't had a break on a 15-hour night shift.

Evelyn Agbeko told the Nursery and Midwifery Council that she made notes saying the elderly patient was asleep at 4am and 6am when she had died at 3am.

Ms Agbeko, the nurse in charge of the ward, said she was overworked because of staffing cutbacks and the night that she made the medical note was, 'the busiest night of all.'

The experienced nurse told the hearing that she was overworked and her ward was understaffed.

‘I couldn’t have a break because I’d have to leave a patient on their own in filth or leave them without having their treatment.

‘That night was the busiest night of all, we couldn’t cope,’ she explained.

‘The hospital didn’t give us the level of care we needed - there would be the same number of staff on a ward where there were just elderly people as there were on our ward which was a gastroenterology ward.

‘I sometimes wouldn’t have a break in a 15-hour shift because we didn’t have the staff - maybe me, an agency nurse and two carers and that was it.’

Along with colleague Theresia Van Der Knaap, Ms Agbeko allegedly failed to provide 'basic life support' when the nurses discovered the 81-year-old was unresponsive.

The Nursing and Midwifery Council heard that there was confusion over whether there was a 'do not resuscitate' order in place for the patient.

As the pensioner's life drained away the nurses did not start chest compressions or summon the hospital's resuscitation team.

On the afternoon of April 16, 2010, registrar Dr Helen Steed began considering whether or not to impose a 'Do Not Attempt Resuscitation' order, in light of the patient's chances of survival if she arrested.

The woman, referred to as Patient A, was on dialysis and had been admitted to A&E at the hospital at the day before suffering from shortness of breath.

Dr Steed decided she wanted to see the woman first, but before she could review Patient A, Susan Voss, acting hospital site manager, received a call stating she had died.

At the time we just had to cut corners to give patients the right care - my priority is providing patient care.’

Ms Agbeko said she ignored hospital policy on note-taking, choosing to fill out patients’ notes at her station rather than at their bedside because she ‘wanted to make them comfortable’ and not ‘disturb’ them.

The elderly patient was also not given a diuretic to aid her kidney problems and when her oxygen saturation levels dropped no further checks were made.

Registrar Dr Helen Steed told the hearing Agbeko and Van Der Knaap acted in the patient’s best interests.

The nurses allegedly failed to provide 'basic life support' when the nurses discovered the 81-year-old was unresponsive

‘It really did seem that this lady was dying and that there was nothing that could be done to prevent that,’ she said.

‘I think the nurses acted in the patient’s best interests.

‘Hospital policy should always be in the patient’s best interests but it can sometimes be frustrating.’

Dr Steed added that Patient A was too weak and frail to be resuscitated and that Agbeko and Van Der Knaap had allowed her a ‘quiet death with dignity’.

‘If Patient A arrested she was very unlikely to survive and she wouldn’t have been on ventilation. ‘Her chances of survival were low.

‘I think it was a common sense decision not to resuscitate her because she was elderly and frail. ‘Technically it was not the right call but it allowed a quiet death with dignity.

‘I felt the nurses were experienced and realised the lady was dying so they didn’t put out the call to the resuscitation team but instead contacted the site manager.'

Ms Stephenson told the panel that the expected procedure would have been for Agbeko to press the emergency alarm and commence chest compressions until the resuscitation team arrived.

Samantha Adams, a nurse who was working that night, allegedly went for a break at 3am and around 15 minutes later Van Der Knaap went to her and told her that Patient A had died, the hearing was told.

'She commented to Ms Van Der Knaap that the patient was for twos, which meant that the patient was for resuscitation,' said Ms Stephenson.

She added that this was a reference to extension '222', which was the number for the resuscitation team.

Ms Stephenson said: 'Ms Van Der Knaap repeated that the patient had already died.

'Ms Adams will state that she was shocked by this and informed the nurses that the call should have been put out if there was no Do Not Attempt Resuscitation order in place.'

Agbeko, who knew Patient A had already died, subsequently made two entries in woman's medical notes stating she was asleep at 4am and 6am.

The nurse admits this, claiming that she was simply confused at the time of making the entries.

She and Van Der Knaap deny all other allegations against them including making inadequate medical notes and failing to provide basic life support when they found the pensioner unresponsive.

Stafford Hospital was the subject of a two-year public inquiry, which concluded last month, into its appalling standards of care.

Official documents suggest up to 1,200 more patients than expected died at the Weston Road site between 2005 and 2008.

Sir Robert Francis QC, who chaired the inquiry, has said the true figure may never be known.

The central London hearing, which Agbeko is attending, but Van Der Knaap is not, continues.


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