Malnourishment and food etiquette in hospitals

@JayneMCox and I have experienced difficulties first hand with feeding patients in hospital/hospices. We came to chat about the subject over Skype, and I desperately wanted to use it for an upcoming #nurseshift discussion, and I’m glad we did, as the response from all the nurses and healthcare professionals that took part in the discussion was inspiring.

Issues such as food not always being delivered at the correct temperature, lack of variation on menu options and quality of meals were raised. Inasmuch, @mikkywatt tweeted about the value of nutrition provided by hospital food: ”The calorie thing is important, most of the menus wouldn’t give the 2000 needed, let alone extra for infection #nurseshift”

The conversation progressed on to a more central topic that got a lot of nurses tweeting, which discussed the issue of nurses not having enough time to sit and feed patients, and perhaps recruiting volunteers who were willing to be trained in feeding:

@switchedonduhhh tweeted: “training a volunteer would take less than half an hour and I am sure they would benefit from it :) and so would the patient.”

Along with @jessie_curtis who commented: “If the league of friends just attend a session for an hour or two about the importance of feeding the patient.”

@l_a_h_c: “volunteers and family are a massive help and often have more time to spend with patients, allowing them to eat at their own pace.”

@JayneMCox: “Yes a patient often shares if they think you have the time #nurseshift.”

Conversely, Jenni Middleton (@nursingtimesed) made an important point: “Yes - that is true. But I don’t want nurses to lose out on what is best part of the job either #nurseshift” along with @moseraphina: “Patients are admitted with all sorts of dietary requirements diabetes etc. not sure this should be a job for a volunteer?”

These two comments highlight the importance of qualified medical professionals spending time with patients. If volunteers ever were to become qualified in feeding, a time and a place for their skills would always be tested. For example:

Scenario 1: A busy 36 bedded Rehabilitation Ward: Feeds: 15. Staff: 8. Available staff to feed: 5.

Scenario 2: Acute Assessment Unit: Unsure of how many patients need feeding or dietary requirements. Short stay patients. Plenty of staff on shift today.

The staff in scenario one may appreciate an extra pair of hands. However, it may be inappropriate for volunteers to take part in feeding in scenario 2. Or, in a high dependency/critical care unit.

The idea appears cost effective and became progressively popular and innovative with nurses and dietary professionals alike.

Inasmuch, it is important to highlight what is already successful in our feeding system in hospitals, as we can learn and build from what works already. @jojoplural tweeted: “It is, our trust have made great leaps in many areas. Protected meal times are fiercely ‘protected’ as it needs to be - #nurseshift”.

“We also have out of hours hot meals available 24/7 which I think is great. Trust have added extra ‘snack rounds’ but meals too #nurseshift”.

The topic of protected mealtimes (a period in the day which staff devote their time to feeding patients and distributing food without disruption) was highly supported among the nurse shifter’s and seems to be something that has improved mealtimes in hospitals in the UK.

All the points raised during the chat were highly significant and all tweeters involved could relate to points being made in one way or another. Feeding is a skill, something that takes time and requires the full attention of the carer. The predominant progression of innovation in regards to recruiting volunteers and training existing ones naturally occurred throughout the discussion, and I’m glad it was considered. It’s not without its teething problems, but it could be a positive step in the right direction.

I’d like to conclude with our #tweetofthechat winner for this week, which was Laura Anne Helen Carter (@l_a_h_c) who tweeted this: “Volunteers at my hospital are massive help at mealtimes and well trained. Same hospital that recently got rid of its burger king!” Thanks for your contributions, Laura!

Mikey Whitehead @STNNurse_Mikey

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