Calling older patients "dearie" or "love" is set to be ruled out as offensive by new guidelines from the Nursing and Midwifery Council. Nurses should speak "courteously and respectfully" and use patients' preferred names, the NMC recommends.

But terms of endearment can be used in some areas if they are part of everyday speech - it may appear unusual if they are omitted, the draft guidance says. The Conservatives said the guidance was "ridiculous".

Guidance for the Care of Older People, which is awaiting approval from NMC Council members next week, advises against behaviour that could be deemed patronising, Nursing Standard magazine reveals.

Dignity drive

It says effective communication is one of the most essential skills that a nurse can have. Poor communication can have serious consequences and can damage the relationship between a nurse and an older person.

The guidelines, constructed around the views of older people, fit with the government's drive for dignity in care.

They say nurses should communicate with older people not only by talking to them, but also by listening.

Nurses and midwives must also "make the care of people your first concern, treating them as individuals and respecting their dignity".

Although most nurses know that they should be doing this, the NMC said it was aware that nurses do not always do it.

Benchmark

An NMC spokeswoman said: "The guidance sets out what older people should expect when receiving care and therefore provides a framework to help nurses and midwives focus on the issues which matter most to them."

She said the guidance could be used to challenge poor standards of care and judge staff performance against.

They cover issues including respecting privacy and providing fundamental care like adequate fluids assistance with eating and personal hygiene when required.

Dr Peter Carter, chief executive and general secretary of the Royal College of Nursing, said: "We completely support these guidelines. Everyone has the right to be treated with dignity and respect and that doesn't change when it comes to healthcare.

"For a long time we've been saying that nurses should ask patients how they would like to be addressed.

"The RCN Dignity campaign is about making sure that every nurse can take steps to make patients feel comfortable in potentially difficult circumstances. Addressing patients properly is one small step that staff can and have taken to improve care."

A spokeswoman from Age Concern said: "How hospital staff talk to older people is a small, but important part of considering their needs and wishes."

In a recent poll of more than 2,000, eight out of 10 nurses said they had left work distressed because they had been unable to treat patients with the dignity they deserved.

However, Shadow health minister Anne Milton said: "This is ridiculous and does not do justice to nurses' professionalism and understanding of patients' needs.

"We all want to see the very highest standards of care, with patients treated with respect and dignity, but using terms of endearment does not conflict with this.

"I think most people will see guidance such as this as the world having gone mad."