Nickriviera +1
Poor bed managment is also a factor: wards may have 'cpapcity' in terms of clinical comploication/risk, and manual handling needs but not how well the patients can feed themselves. You can cope with the medical and care (moving/handling/toileting) needs of a suprisingly ill and incapacitated bunch of people with three staff nurses and 3 health care assistants, but that does not translate to feeding what with the particularly small window of time you get with hot meals.
Typical 'acute' medical ward in a district general hospital:
-Six nursing staff (3 of each).
-35 patients.
-Meal trolley takes 20 minutes to get from one end of the ward to the other.
-Hot main course takes 10 minutes to get cold and is cleared up 20-25 minutes after it is served regardless of what is or isn't left on the plate.
How many people unable to feed themselves do we reckon the six nursing staff can feed in that time frame, if they run to the next patient/feed as soon as they have finished the last one and follow the dinner trolley up the ward?
In practice, with the phone, the doctors, other hospital workers coming in and out of the ward needing help/stuff doing, the immediate/acute clinical needs of the poorliest few patients, and the magical process by which old folk sat in hospital beds all day always need an urgent plop about six forkfuls into their dinner, means those six nurses/HCA's can feed about eight patients if they are really on it and the planets are all in alignment. On a ward like I just described in my experience, any more than eight that need feeding and you barter with housekeepers to be able to clear up cold dinners a bit later than they are told to, you bend the visiting hours considerably to draft in relatives to help or old folk go hungry.
I no longer work in general but was well used to having to move patients to adjacent beds so I could sit between them and feed 2 at a time, (literally, a spoon in each hand!) and then go to the other end of the ward and do the same again, and we still often couldn't manage to get everyone fed. I really hope things ave moved on in those eight years, but in my old and overall really rather good hospital (lord knows what it was like in the Mid Staffs' of the NHS...) we were still well used to having ten or twelve 'feeds' per medical acute ward and the numbers for mealtimes simply didn't add up.
