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Government calls on nurses to question patient's lifestyle


Patients should be asked about their diet, smoking and drinking habits every time they see a health professional, according to government advisers.

The NHS Future Forum wants lifestyle issues to be discussed as a matter of routine, even when individuals are suffering an unrelated illness.

The changes are designed to prevent ill-health and the massive cost burdens it imposes on the health service.

The forum’s call to make “every contact count” is the centrepiece of a report commissioned by the Health Secretary Andrew Lansley, and due to be published next month.

Professor Steve Field, who heads the advisory body, said all healthcare professionals - not just doctors and nurses, but also midwives, physiotherapists and pharmacists - should pro-actively raise lifestyle every time they see patients.

He told the Guardian: “In future if you come for your flu vaccine at a GP’s surgery or pharmacy, the health professional should give you your injection but also use the opportunity to talk to you about your diet, smoking, alcohol intake and how much exercise you’re taking, discuss any anxieties you may have about these, and offer and advice and support.

“Similarly, a podiatrist who’s looking after the feet of a diabetic patient has an absolute responsibility to talk to the patient about their smoking, because smoking makes diabetes worse and means the patient is more likely to have a foot amputated.”

While raising personal behaviour was likely to be a delicate matter, patients’ trust in health professionals should ensure such conversations resulted in those who need it receiving help, he said.

The damage from “risky behaviour” was so alarming that staff must make “a cultural shift” in how they use their time with patients, he added.

“The NHS needs to change from patching people up when they are ill to promoting healthy living and preventing illness.”

According to the Guardian, the forum’s report states: “Every healthcare professional should ‘make every contact count’; use every contact with an individual to maintain or improve their mental and physical health and wellbeing where possible, in particular targeting the four main lifestyle risk factors: diet, physical activity, alcohol and tobacco - whatever their speciality or the purpose of the contact.”

“A visit from a midwife or health visitor is an opportunity to talk about a new parent’s anxieties and consider options for accessing mental health support. Collecting medication from a pharmacy is a chance to offer someone help with cutting down on alcohol. A pre-surgery check-up is an opportunity to talk over concerns about smoking, diet and physical activity.”


Readers' comments (31)

  • Steady on, I think if the public, and that includes us, is bombarded with all these questions every time they come into contact with any health professional, we'll end up with a paranoid society. I hope there is plenty of funding going into the mental health pot. Collecting medication from the pharmacy is a public place, not very confidential.

    It could have an adverse effect, if the public get sick (excuse the pun) of being asked and eventually turn around and tell us to mind our own bloody business.

    There is the knock-on effect if people live longer on lower pensions, what quality of life will the elderly have then?

    I am not advocating unhealthy lifestyles, just looking at the wider picture.

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  • I have a very healthy life style and if a hc professional starts questioning me about my private life if I visit my practice I shall tell them where to put it unless I broach the subject first and ask advice. I find nothing worse than unsolicited advice and always try avoiding giving any, especially outside my professional sphere, unless asked.

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  • tinkerbell

    Does this include bungee jumping?

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  • @ tinkerbell | 4-Jan-2012 0:22 am

    thanks for the chuckle your comment gave me.

    We already have targets to ask questions about smoking
    We have to ask about drinking
    We also have to ask about advanced statements and decisions,, at a new assessment
    We even have to ask about sexuality..... come on now my client group is 65 and above mostly above how distressing some of the questions can be...... but hey it all comes down to PBR

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  • Natalie Jewell

    This is the sort of topic that may offend some patients. I think we should have more autonomy over asking these types of questions because rapport can, at times, be difficult to establish.
    It depends how often you see clients too. If you see someone every fortnight it is silly to ask at every visit. If you see them annually it makes a lot more sense.

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  • Anonymous | 4-Jan-2012 9:32 am

    it could be as irritating as when you go to the post office to buy a second class stamp and are asked all about your travel insurance!

    as Natalie Jewell says above it should be up to the nurses' discretion and tailored to the patients' needs. Imagine going for a minor complaint or a vaccination and asked what your end of life plans are? It could give rise for serious alarm. I know it would in me, as a very nervous patient, even though I am a nurse too!

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  • Dear Tinkerbell,

    when are you going to write a book about all your experiences (or your memoirs) which you express so well and with so much feeling, caring, compassion, excellent common sense and great sense of humour in your posts? With your excellent gift of expression, I think you would make a great authoress!

    How did you get on as 'Pipi Langstrumpf' by the way and what influence did she have on patient care, your colleagues and on hospital management?

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  • tinkerbell

    Anonymous | 4-Jan-2012 11:29 am

    Happy New Year. Thank you for your kind comments. I think i am probably only palatable in small doses as otherwise could be overwhelming. I'm sure some of my colleagues are breathing a sigh of relief that i am reducing my hours soon.

    The Pippi Longstocking went OK, but as nobody seems to know here who she is i morphed a bit into a panto dame by stuffing 2 inflated latex gloves down my top and some padding in derriere, but think i may have gone too far, so reverted back to the tamer Pippi for the rest of the shift. No comments as yet from management so think i got away with it. Very risky behaviour that needs to be added to the assessment forms for the lifestyle of a nurse. Do you like dressing up as a panto dame?

    We all had a nice christmas morning at work, relaxed and chilled.

    I am trying to upload the photo of my get up to my profile for you to have a look at but its proving a bit tricky. Check back later to see if i managed it.

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  • Seeing as my nurse training course included Health Promotion, I have always incoroprated general health and lifestyle issues into my daily activities. Some patients are open and receptive to this and others more likely to tell you to "eff off" than take advice.

    Lifestyle issues need to be addressed at a young age, not at the general adult population who are already "set in their ways" (myself included!). I mean, for goodness sake, anyone who can read or watch TV knows that smoking is bad for your, too much alcohol is bad for you!
    Having said that, I have worked with people with MS and diabetes and found that they were usually receptive to information about diet.
    As I am always saying, it comes down to effective communication and gauging how much information a person can and will take on board. If the health professional only sees the patient once in a blue moon, it might be inappropriate, if not downright impossible to broach subjects such as smoking cessation as well as addressing the issue(s) at hand.

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  • I think that we should be able to sit down with our patients, pour them a drink, offer them a fag and ask them how the hell things are going with them. I reckon that would be more effective in making 'every contact count', whilst being a much more enjoyable work experience for the nurse. Oh wait, I don't smoke.

    Loving the photo Tinkerbell. It's a cross between a boy scout and Betty Boop!

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