Debate: Hydration

When the normal water content level of your body is reduced, the balance within the body is affected. This has an impact on the way in which it functions. A healthy human body is made up of two-thirds water. Signs of dehydration can include a dry mouth, thirst, light-headedness, tiredness, dark and strongly odorous urine, reduced urine output, and poor cognitive function.

In 2015 NHS England published guidance on Commissioning Excellent Nutrition and Hydration. In this document, Chief Nursing Officer for England Jane Cummings states that: ‘‘the link between nutrition and hydration and a person’s health is a fundamental part of any stage of life’’ (NHS England, 2015).

In Northern Ireland, the Department of Health, Social Services and Public Safety (DHSSPS) created the Promoting Good Nutrition strategy to improve the quality of nutritional care, thus improving the patient experience (DHSSPS, 2011).

In Scotland, NHS Education for Scotland has produced guidance on Improving Nutrition ... Improving Care (2018) and Healthcare Improvement Scotland has released Standards for Food, Fluid and Nutritional Care (2014).

In Wales, the Health and Care Standards include Standard 2.5 on Nutrition and Hydration, which outlines the importance of hydration for patient recovery (Welsh Government, 2015).

These examples show that across the United Kingdom, we as health care professionals are encouraged to actively support our service users to ensure they are adequately hydrated. We closely monitor their fluid balance, charting when their urine is dark and concentrated, or if they have not passed enough urine. Why then is it that some organisations do not follow the same guidance with their staff?

In this culture of cuts and constraints within our working teams, staff often forego breaks to complete their work, cover low staffing levels and ensure their patients get the care they need. It is sometimes said that having water bottles in view ‘doesn’t look good’, or ‘makes staff look lazy’. When a meal break is sacrificed, nutrition is sacrificed. I would in no way condone walking around in clinical areas with a sandwich and snack in our hands, but see no reason for a water bottle not being within view.

In March 2017 Guys and St Thomas’ NHS Foundation Trust launched the HALT (Hungry, Angry, Late, Tired) campaign (Guys and St Thomas’ NHS Foundation Trust, 2017). Its purpose was to make staff aware of the importance of taking enough breaks so that they would be able to make the best decisions for patients. Managers and team leaders were encouraged to lead by example and create a ‘take a break’ culture.

In Wales, implementation of the Nurse Staffing Levels (Wales) Act 2016 should enable nurses and health care support workers to take regular breaks, which will support the maintenance of good hydration.

How many of you are sitting reading this with a drink to hand? If you are thirsty enough to require a drink whilst reading, why would that change when being more physically active during a work day? 

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