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The BAPEN and PINNT report highlighted communication as one of the issues that needs addressing

those experienced by patients receiving home enteral or parenteral nutrition. The report highlighted yet again that service provision and the experience of patients and their families are variable across the NHS. Not surprisingly, the most vulnerable patients are often experiencing the greatest inequalities. The report sets out these findings: Being proactive, not reactive, is key when addressing nutrition and hydration issues. Individuality is key for care given. thought. Then, as middle-age spread takes hold, we lose sight of them, so they tend to get neglected. When older, they cannot be reached, even if they are in view. So there they are, out on a limb, so to speak. Without one’s feet it is hard to stay healthy. Exercise when they are not fully functioning or pain-free is not easy, and without the freedom to walk around, one’s social interactions can become curtailed, leading to isolation and loneliness. So, if someone wants to talk about these overlooked, underappreciated appendages, it is more than okay by me. Jane Bates works in outpatients in Hampshire

Monitoring and following up of patients is vital when they are screened for malnutrition, not just initial treatment. Check advice and never assume that a patient is comfortable with information provided. Patients and their carers must be able to play a proactive role. Transition periods between care settings must be planned. Out-of-hours service provision must not be a ‘tick box’ exercise. Patient training is crucial for those on complex therapies. Patients, families, carers and patient organisations represented in the report stand ready to be involved directly in improving care; they can contribute if they are involved in a meaningful way. Nurses need to be aware of this report and find ways to work with their colleagues and patients to ensure patients are genuinely involved in their care and the development of services. Communication is key, and nurses need time to exchange information and effectively communicate with patients and carers. Wendy-Ling Relph is matron for nutrition and quality improvement at East Kent Hospitals University NHS Foundation Trust and BAPEN communications officer

Quiet please David Newnham would rather not hear some things I am never quite sure why there is so much anxiety about sharing medical records. If the government made it a criminal offence for private companies to profit from our data, I suspect that our fears would evaporate overnight. After all, most people will share the most intimate medical details with strangers at the drop of a hat. The size of your gallstones? Tell me about it, mate. Or try stopping you, more like. And when they are done giving us the low-down on their own dodgy tickers and dicky bladders, they will happily spill the beans about their nearest and dearest. How else would I know so much about Fiachra’s father’s abscess? But the abscess is only half the story. Fiachra’s dad can hardly get a wink of sleep in his hospital bed, what with the lights and the beeps, the to-ing and fro-ing, and the general racket. And that is affecting his health. ‘He is 87. He’s been in there six weeks, and I doubt he’s had more than a couple of hours sleep in all that time,’ says Fiachra. ‘So guess what? When he does get out of bed, he falls over and does himself an injury. Surprise, surprise.’ I know exactly what Fiachra means. I think we all do. What struck me during my own recent stay in hospital was the lack of darkness at night, and the fact that conversations seemed to be going on at normal volume in the very room where SOME OF US WERE TRYING GET SOME SLEEP! A professor was recently sounding off in the media about how the blue light from our electronic devices is interfering with our sleep rhythms and cycles. Failure to get at least seven hours of sleep each night, he said, could result in weight gain, heart disease, diabetes and cancer. It is no secret that patients find it hard to sleep in hospital. I have no idea how you fix this, but perhaps we ought to talk about it. David Newnham is a freelance journalist

NURSING :: vol uses 28 no 34 :: permission. 2014 27 DownloadedSTANDARD from by ${individualUser.displayName} on Nov 24, 2015. For personal use april only. 23 No other without Copyright © 2015 RCNi Ltd. All rights reserved.

Quiet please.

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