NEWS
BARNEY NEWMAN
SEACOLE STATUE IS A STEP CLOSER A plaque marking the spot where a statue of Mary Seacole will stand has been unveiled in the grounds of St Thomas’ Hospital in London. The appeal needs to raise £96,000 more to pay for the statue. Pictured at the plaque ceremony are, left to right, Her Excellency, The Honourable Aloun Ndombet-Assamba, High Commissioner for Jamaica; Sir Hugh Taylor, chair of Guy’s and St Thomas’ NHS Foundation Trust; Professor Elizabeth Anionwu, vice chair of the Mary Seacole Memorial Statue Appeal; Lord Soley of Hammersmith; and actor Suzanne Packer. Go to www.maryseacoleappeal.org.uk
New end of life guidance could lead to conflict with patients’ interests By Katie Osborne
@NS_reporter
A leading nurse has warned that new government guidance on providing nutrition to dying patients could have serious implications for front line staff. The Department of Health last month published a new approach for end of life care, Priorities for Care, which replaces the controversial Liverpool Care Pathway (LCP). The guidance states that a failure to support oral nutrition and hydration when still possible and desired at the end of a patient’s life should be regarded as professional misconduct. But National Nurses Nutrition Group (NNNG) chair Liz Evans has said that dignity and comfort should be prioritised and sometimes it is not in the patient’s best interest to force them to eat. The nutrition nurse specialist said that conflict could arise, for example if a patient’s family perceives no food or drink has been offered when in some cases the patient has refused it, or it is not appropriate to offer it.
NURSING STANDARD
‘As a person comes towards the end of their life they do not feel the same hunger,’ Ms Evans told last week’s NNNG annual conference in Warwickshire. ‘But relatives think we must do something and sometimes do not realise that putting a feeding tube down is going to cause more distress to the patient, could worsen symptoms and may not necessarily sustain life.’
Dignity in death
The new Priorities for Care were drawn up in response to a review into the now defunct LCP, a system that advocated the withdrawal of medication, food and fluids in certain circumstances. Although intended to allow people with terminal illness to die with dignity, the system faced criticism after some patients were placed on the pathway without the consent or knowledge of their families. Concerns were also raised that hospitals were receiving payments for increasing the number of patients placed on the LCP.
The government’s new approach focuses on five priorities, which include the importance of sensitive communication with families, respecting patient’s wishes and regular revision of care plans. Ms Evans added that education for nurses and the public on nutrition at the end of life was essential and has called on the Nursing and Midwifery council (NMC) to provide guidance on the issue urgently. But the NMC has said there will be no specific guidance because the draft NMC code, which is out for consultation, already covers nutrition and hydration. A spokesperson said: ‘The current proposals in the draft revised code include additional information on nutrition and oral hydration of patients, including those who are nearing the end of their life. ‘All nurses and midwives must adhere to the code, which currently states that they must make the care of people their first concern, treating them as individuals and respecting their dignity.’ See analysis page 14 july 16 :: vol 28 no 46 :: 2014 9
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BARNEY NEWMAN
SEACOLE STATUE IS A STEP CLOSER A plaque marking the spot where a statue of Mary Seacole will stand has been unveiled in the grounds of St Thomas’ Hospital in London. The appeal needs to raise £96,000 more to pay for the statue. Pictured at the plaque ceremony are, left to right, Her Excellency, The Honourable Aloun Ndombet-Assamba, High Commissioner for Jamaica; Sir Hugh Taylor, chair of Guy’s and St Thomas’ NHS Foundation Trust; Professor Elizabeth Anionwu, vice chair of the Mary Seacole Memorial Statue Appeal; Lord Soley of Hammersmith; and actor Suzanne Packer. Go to www.maryseacoleappeal.org.uk
New end of life guidance could lead to conflict with patients’ interests By Katie Osborne
@NS_reporter
A leading nurse has warned that new government guidance on providing nutrition to dying patients could have serious implications for front line staff. The Department of Health last month published a new approach for end of life care, Priorities for Care, which replaces the controversial Liverpool Care Pathway (LCP). The guidance states that a failure to support oral nutrition and hydration when still possible and desired at the end of a patient’s life should be regarded as professional misconduct. But National Nurses Nutrition Group (NNNG) chair Liz Evans has said that dignity and comfort should be prioritised and sometimes it is not in the patient’s best interest to force them to eat. The nutrition nurse specialist said that conflict could arise, for example if a patient’s family perceives no food or drink has been offered when in some cases the patient has refused it, or it is not appropriate to offer it.
NURSING STANDARD
‘As a person comes towards the end of their life they do not feel the same hunger,’ Ms Evans told last week’s NNNG annual conference in Warwickshire. ‘But relatives think we must do something and sometimes do not realise that putting a feeding tube down is going to cause more distress to the patient, could worsen symptoms and may not necessarily sustain life.’
Dignity in death
The new Priorities for Care were drawn up in response to a review into the now defunct LCP, a system that advocated the withdrawal of medication, food and fluids in certain circumstances. Although intended to allow people with terminal illness to die with dignity, the system faced criticism after some patients were placed on the pathway without the consent or knowledge of their families. Concerns were also raised that hospitals were receiving payments for increasing the number of patients placed on the LCP.
The government’s new approach focuses on five priorities, which include the importance of sensitive communication with families, respecting patient’s wishes and regular revision of care plans. Ms Evans added that education for nurses and the public on nutrition at the end of life was essential and has called on the Nursing and Midwifery council (NMC) to provide guidance on the issue urgently. But the NMC has said there will be no specific guidance because the draft NMC code, which is out for consultation, already covers nutrition and hydration. A spokesperson said: ‘The current proposals in the draft revised code include additional information on nutrition and oral hydration of patients, including those who are nearing the end of their life. ‘All nurses and midwives must adhere to the code, which currently states that they must make the care of people their first concern, treating them as individuals and respecting their dignity.’ See analysis page 14 july 16 :: vol 28 no 46 :: 2014 9
Downloaded from RCNi.com by ${individualUser.displayName} on Apr 11, 2016. For personal use only. No other uses without permission. Copyright © 2016 RCNi Ltd. All rights reserved.
