THE long-running debate over the state of the NHS has never been more in the limelight after recent events concerning the treatment of 94-year-old Rose Addis.

Pressures on the accident and emergency department have put nursing staff under increasing strain, and long waiting times and rising numbers of patients being admitted have taken Whipps Cross Hospital to its absolute limit.

The A&E department at Whipps Cross is as busy as ever. On average, 200 people turn up at the casualty department every day and only two weeks ago, the department experienced its busiest period ever.

A hospital spokesman said that waiting times could be reduced if patients were more aware of what was available at their GP surgery or if they took advantage of the NHS direct help-line.

He added: "A&E isn't like a supermarket. You can't just go in and leave immediately. We have to prioritise and treat the most serious injuries first, which means we can't always see people straightaway."

For staff in the casualty department, such demands put pressure not only on the patients who are waiting long hours to be seen but also on the nurses who have to deal with an ever-growing list of patients.

Indeed, a day in the life of a nurse is no mean feat. Whether you are a nurse in intensive care or accident and emergency, the pressures are just as great.

I visited two unsung heroines of the medical profession, who work in the intensive care unit at Whipps Cross Hospital.

Pamela Munro and Veronica Andrews are two nurses who acknowledge that the system is not perfect and are generous enough to point out that their contribution would be greatly diminished without the support of all the members of the hospital team.

They are quick to point out that the modernisation of this anarchic system is slowly starting to take effect.

Nurse consultant Pamela is a new breed of nurse combining the clinical knowledge of a doctor with the skill and expertise of a nurse.

She said: "We are faced with a history of funding regimes and a new building programme which takes time so in the interim we have to work in an environment that we accept is not ideal.

"With our modernisation programme we are hoping to improve the way patients move through the system and their access to critical care."

Intensive care unit head of nursing Veronica is sympathetic to patients' plight and recognises the frustrations they may have.

She said: "There is still a lot of good stuff going on and a lot of positive things. The changes in the health system have brought a lot problems for patients.

"We do recognise that they have a right to expect a certain level of care and frequently with the system in place it does go wrong when under pressure."

Veronica, who has been a nurse for 30 years and loves her job, added: "As a nurse you are constantly challenged and you are required to interact with so many different people on so many different levels, and have to communicate with people at some critically difficult and emotionally stressful times.

"Working in intensive care, you are part of someone's worst nightmare and to support them through that is very rewarding.

"We do far more than just deliver technical support. We are an integral part of patients' lives. We are support for the family, relatives and the children. Nursing is a good grounding in life, society and realism."