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Doctor attacks ‘demeaning’ hospital rules

Rules banning hospital doctors and visitors from sitting on patients’ beds or bringing flowers are branded as dehumanising by a medic today.

Scottish Government guidelines warn doctors, friends and relatives against sitting on beds in a bid to prevent the spread of potentially deadly infections such as MRSA and Clostridium difficile (C diff).

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Some also prohibit visitors from bringing flowers to sick relatives on the grounds that stagnant water and dust gathering on plants could pose a hygiene risk.

However, the practice has been described as “an illusion of activity with no substance” by a London GP who is critical of parallel advice followed by a number of NHS Trusts in England and Wales.

Writing in today’s British Medical Journal (BMJ), Dr Iona Heath says there is “no hard evidence” that banning either flowers or sitting on beds prevents the spread of infections, and claims it owes more to hospitals wanting to appear to be taking action against hospital superbugs.

The practice makes the hospital experience demeaning for patients, she argues, particularly where it is applied to dying patients.

“Some of the most intimate and effective interactions between doctor and patient that I have either witnessed or experienced have occurred while the doctor has been sitting on the patient’s bed,” she says.

“Such interactions are precious and should be made easier rather than more difficult.

“‘Do not sit on the bed’ and ‘No flowers’ are injunctions that are all too similar to ‘Do not walk on the grass’ and ‘No ball games’, rules that mostly diminish the joys of life rather than enhance them and such rules, unless absolutely necessary, have no place in hospitals where joy is too often in short supply.”

However, her comments were lambasted as irresponsible by Margaret Watt, chairwoman of the Scotland Patients Association.

She told The Herald: “The patients are fundamentally the most important issue here, and there’s no way that anybody, after sitting on a bus or sitting anywhere in their outdoor clothes, should come in and sit on our patients’ beds.

“It’s totally unacceptable. I’m gobsmacked at her remark and I think it’s an absolute embarrassment that she should come out and say that. What more diminishes life than someone getting an infection and dying? I’ve never heard anything like this in my life.”

Claire Murray, spokeswoman for Age Concern/Help the Aged Scotland, said she felt the ban on flowers was a bit harsh, but that it was vital to err on the side of caution.

She said: “Older people are especially vulnerable in hospital and we have to do everything and anything to reduce the risk of infection. That said, we’re on board with the dignity in hospital campaign and we want people to be treated with respect and be comfortable and have a good rapport with the medical staff.”

NHS Fife said visitors to its hospitals are asked not to sit on hospital beds or to touch medical equipment such as drips located around the bed.

A spokeswoman said: “This policy has been in place for a number of years and is in line with the Chief Medical Officer for Scotland’s top tips for visitors, published in 2004.”

However, there was no overall ban on flowers, she added. “Their display in individual wards is at the discretion of the individual charge nurse. For example, it may not be appropriate to display flowers in a ward with immunocompromised patients or around patients with respiratory problems. This decision is taken in terms of both the patient’s care and the patient experience.”

In NHS Greater Glasgow and Clyde, where a total of 18 people died following an outbreak of C diff at the Vale of Leven Hospital in West Dunbartonshire, visitors are not allowed to sit on hospital beds.

Flowers are also banned in departments such as Intensive Care and High Dependency.

A spokeswoman said: “The infection control risk is in relation to the water in the vases as it is considered to be an environment in which bacteria can grow. There is also a health and safety risk in that spilt water could affect medical equipment.”

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