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Nurses should not take all the blame for poor nutrition

All health professionals should share responsibility for patient nutrition, rather than the blame falling solely on nursing, according to a leading patient safety nurse.

National Patient Safety Agency nutrition lead Caroline Lecko has analysed data on patient safety incidents involving nutrition between September 2010 and August 2011.

She found patients were continuing to suffer harm on a regular basis from misplaced gastrointestinal feeding tubes, mismanagement of patients with disphagia who had difficulty swallowing and patients being kept nil-by-mouth for too long.

As part of Nutrition and Hydration week, which runs until Sunday, Ms Lecko is urging all professions to cross disciplinary boundaries for the benefit of patients. For example, she called on nurses to arrange multi professional meetings or invite catering teams onto the ward at mealtimes to carry out joint observations and identify improvements.

She said: “Nurses faced a lot of criticism for poor patient nutrition last year. What healthcare needs to understand is that, yes, nurses have got a fundamental role in getting things right, but all health professionals have a part to play.”

Readers' comments (8)

  • Nurses seem to get the blame for everything, and are seen as an easy scapegoat. That is grossly unfair.

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  • ultimate responsibility lies with those who have undertaken to provide a health service. they are responsible for seeing to it that there are enough staff with adequate training to guarantee the safety and welfare of patients in their care!

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  • People don't see nurses as intelligent practitioners - they just see them as the ones who do what doctor says, mop brows and wipe backsides. Nurses are an easy target.

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  • ALL Health Professionals, should wherever possible have relevant say and input, into ALL aspects of Patient Care - and take professional responsibility when doing so. As the old saying goes - its NOT just Doctors and Nurses!

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  • Lets not forget the amount of patients who refuse to eat for example dementia patients still nurses get the blame. In these cases MUST recordings dietician referals make no difference, what is needed is a carer or relative who has the time to sit and offer food in tiny amounts all day long. Nurses are used as an easy target to blame.

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  • AHPs are involved in assessments, for example positioning, adapted cutlery, specific diets, etc., but then it is usually left to the nurses to implement the outcomes. I have advocated for some time now that APHs could be involved more at mealtimes to ensure that patients have the most adequate intake, at the right time by the right method. The culture of MDT working needs to change drastically. It not only goes for mealtimes, but many other aspects of care. If you add up the amount of staff that are available to assist patients, both nurses and AHPs, sometimes the patient:MDT (including nurses) ratio can be 1:1 or 1:2. Therapeutic input can be made more tailored to patient's daily activity, and not just in the specific AHP areas.

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  • I have personally spent an hour and a half feeding a patient. I realise that this is not possible in many settings.

    It IS NOT the sole responsibility of the nurse to ensure that patients are eating and drinking.

    If, for example, due to limited staffing levels, a nurse has to choose between certain tasks and feeding a patient then in some case of course he/she is going to have to choose the task that takes top priority.

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  • While I agree that it is vital to offer assistance to those patients who need help and encouragement to eat and understand the importance of good nutrition there is a fact that is overlooked.

    Generally speaking, most people who are in hospital are ill.

    How much do you eat when you are ill?

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