SHE has been on the frontline of emergency care for 40 years.
But every day, staff nurse Karen Kell is pushed to the brink of exhaustion as a never-ending stream of patients pour through the doors of Hull Royal Infirmary's Emergency Department (ED).
This weekend, seriously ill patients were forced to spend up to 14 hours on trolleys in corridors in the resuscitation area and hours in corridors in the acute assessment unit (AAU).
It was something chief medical officer Professor Ian Philp had pledged was a thing of the past but when a hospital runs out of beds, they cannot turn people away.
Now, as hospital bosses appeal to people to stay away from Hull Royal Infirmary unless they have a life-threatening illness or injury, Mrs Kell has given an insight into life at the sharp end of the NHS.
"We used to talk about winter pressures but now, it's the same pressure all year long," she says.
"I just don't understand where all the people are coming from. But they keep coming and coming."
Mrs Kell's love for her job shines through everything. Now 60, she retired five years ago but came back to work part-time. Patient care is central to everything the ED team does.
But they are being stretched to the limit.
Two Minor Injury Units (MIUs) operate at Bransholme and the Freedom Centre in east Hull and the GP walk-in service is up and running at Story Street, Hull city centre, for urgent but less serious complaints. However, people still turn up at the doors of the ED.
While health bosses are keen for people to use MIUs, few people know of the service and the provision is patchy. Bransholme is open until 8pm seven days a week but the MIU at Freedom Centre is closed at weekends. No MIU operates in west Hull, meaning people are now beating a path to Hull Royal for less serious conditions which could be treated faster elsewhere.
The vast numbers mean staff face a losing battle in meeting the four-hour waiting time treatment. Hull's ED waiting times are currently among the worst in the country.
Mrs Kell says: "I love my job, I must do seeing as I retired and came back.
"But sometimes, at the end of my shift, I'm absolutely shattered. I would do, I'm 60. But we just get by."
They've seen it all at Hull's ED. People who decide to have a bothersome lump looked at "while they're here" after visiting relatives on wards, people with toothache, people who get impatient because they have to wait a week for a GP appointment.
While she would be within her rights to feel aggrieved at the service being used in that way, Mrs Kell's compassion never wavers.
"I understand it because there's not enough publicity about where else they could go," she says.
But what those people do not see is the danger they are putting the lives of others in. While they sit in the waiting room of the minor section of the ED, the person next to them could be suffering chest pains.
It is something Mrs Kell and the team are always on the look-out for, especially in the busiest times when they are already rushed off their feet.
"People register their own symptoms and they often make it worse than it is, so it will flash red because they think they'll be seen quicker," she says. "But someone who is really ill might enter symptoms only showing as green when it should be red. We are constantly keeping an eye on the people in the waiting room."
At the busiest times, announcements are made to divert patients to GPs or the MIUs. Nowadays, the announcements are having to be made every hour.
"We get an awful lot of aggression but it's often down to the waiting time and we try to explain to people why it's taking a long time for them to be seen," Mrs Kell says.
"We do our best to keep people informed. But we get people coming in and then getting something to eat and drink while they wait instead of them thinking this could wait and they could go somewhere else. I can't get my head around that."
With the festive season about to get under way, the pressure on Hull's ED is unlikely to ease any time soon.
But it is the people at the frontline of the NHS who are picking up the pieces.
"For me, the best shifts are when we hit our four-hour targets," says Mrs Kell. "People should not have to come here and sit and wait for ten hours. It's not what we want for our patients.
"I go home happy when I know they've been given the care and treatment they should have been given and they are happy.
"There are some lovely people who come in and they can see the pressure we are under and say thank you. That's when I'm happy."
