CHRE Viewpoint #5

CHRE Viewpoint #5

This article is the fifth in our fortnightly series ‘CHRE Viewpoint’, which discusses topical issues in relation to health professional regulation.

The person in the patient

Age UK, the leading charity for older people, has recently published their report ‘Still Hungry to be Heard’, which found that an unacceptable number of older people are becoming malnourished when they are in hospital. The accompanying research also found that nearly a third of nurses are not confident that it would be noticed if a relative of theirs was malnourished when entering hospital.

The word ‘nurse’ derives in part from the Latin word ‘nutricius’, which means “that which nourishes or suckles”. The provision of food and water in hospital would be considered by most to be the basic expectation of care; indeed a fundamental human right. So it is all the more alarming to hear that people are becoming malnourished during their stay in hospital.

The report recommends that there are seven steps to end malnutrition in hospital, which are the responsibility of both professionals and institutions. Step 4 recommends that patients are weighed on admission, while Step 6 recommends the use of a red tray system to identify those people who need help at mealtimes. These are very useful, practical recommendations that hospitals might introduce almost immediately.

Step 3, in contrast, states that hospital staff must follow their own professional codes and guidance from other bodies. Whilst less specific, in our view this recommendation is potentially of most significance. The Nursing and Midwifery Council’s Code states that nurses must ‘make the care of people your first concern, treating them as individuals and respecting their dignity’. The other regulators have similar broad requirements of their registrants, many of whom are equally responsible for ensuring that patients on hospital wards are nourished appropriately.

It is these high level principles of human compassion and respect for others which help to ensure that people receive care that is appropriate to them, and which respects their dignity. Specific recommendations are extremely valuable, but cannot succeed in the absence of compassionate health professionals. This is a topic we discussed in our last Viewpoint article.

The notion of compassion is addressed in a recent King’s Fund article, following the very moving and personal article by Dr Kieran Sweeney, written shortly before his death from the asbestos-related cancer mesothelioma in December 2009. In it, he noted that the care and treatment he received was ‘technically impeccable’, but the relational aspects lacked strong leadership and were often insensitive. Such accounts merely reinforce the importance of health professionals seeing the person in the patient, a quality that supersedes what is written in any code or guidance.

John Illingworth, Policy Analyst
9 September 2010
 

You can watch the interview with Dr Kieran Sweeney, sharing his experience of care and interactions with health professionals on the e-learning for healthcare website