Are NHS staff chronically dehydrated?

We are supposed to drink between two and three litres of fluid a day to maintain homeostasis. Some of this is dependent on the size of your body – wee versus big, as well as other complexities such as the health of your kidneys, salt in the diet, function of your heart and so on.

No one is the same and the volume is individualised.

Yet, I am sure most people don’t drink enough.

I remember, when a little boy in the summers of the late 70’s my mum’s exhortations for me to drink otherwise I would dehydrate. I never understood the concept – I thought, surely if I were to become a raisin I’d get some warning. (We call that thirst in healthcare; to me then, as a youngster, it was just a cautionary tale.)

I remember a guy I knew in university who lived with a fear of kidney stones, his mum having suffered with one; he would ensure the adequacy of his hydration was tip-top at all times as he sipped on pints of Coke.

In the 21^st century, hydration has become much more of a thing. My children freak-out if they haven’t got a water-bottle to take to school, or if we go on a long walk in the summer – the panic sometimes set-in soon after we leave the house; ‘Dad, can you buy me some water…Volvic will do.’

In hospitals you see staff arriving in the mornings with bottles; I have a friend who carries an extra-large dumb-bell bottle of water with her; it is something like three litres which she sips through the day.

I have a cup of coffee before the ward round, then if able have as much of my home-made juice as possible. No more teas or coffee before home-time.

I remember the good-old-days, before the NHS began its process of reverse-engineering into a singularity, when there was money a go-go and drinks were available; water machines, tea at meetings. Gosh, my kidneys didn’t know how good they had it.

We assiduously measure our patients’ fluid intake and urine output – it is an important process to ensure people don’t become dehydrated in the passivity of hospitalisation.

We rarely measure our own.

And the effects of dehydration? Of not sitting-down for 12 hours?

First you feel tired, then thirsty, light-headed, achy; your thoughts slow, ideas and thinking become inflexible, rigid; sore head, double vision; taken to the extreme, your kidneys stop working, although for that to happen you’d have to be working an extra-long shift.

Why do hospitals not pay more attention to the needs of their staff? Providing adequate rest is a given which doesn’t always happen; how about a water-cooler? Something to drink? A place for mindfulness?

Statistically, more accidents happen later in the day than in the morning, more surgical errors take place, more wrong prescriptions are written and there are a greater number of mis-calculations in pharmacy; we humans, vulnerable diurnals become weary as the day progresses; this fall-off in performance is hastened by dehydration.

How can we ensure our doctors, nurses and therapists who are busy measuring the intake of patients don’t miss-out, don’t fall victim to a voracious system?

I sometimes forget to take my water-bottle, these are the days that I don’t work to full capacity; sure, I could take a drink from the tap in the kitchen, but I never seem to get round to that either; having something on my desk helps.

We need regular water breaks;

‘Ward-round, halt! Time to rehydrate,’ I might suggest.

But no, we tend to keep going, breaks these days are not considered right, there is often so much to do, you have to keep on going.

I pity the nephrons of an on-call doctor in post-tory England.

The pee of nurses and healthcare assistants, more prone to infection than their forbearers.

Drink, drink.

Dromedaries of the NHS unite.