bluuebunny/crossref_metadata_2025 huggingface dataset:
The Forced Marriage (Civil Protection) Act 2007
Authors: Griffith Richard
Published: May 2014

The government has acknowledged that midwives, along with other health professionals, are ideally placed to offer early and effective advice and support to women who are the victims of forced marriage (Foreign and Commonwealth Office, 2007). It is essential that midwives are aware of the measures that can be taken to help and protect women who are the victims of forced marriage through the provisions of the Forced Marriage (Civil Protection) Act 2007.
Zuo yuezi practice among Malaysian Chinese women: tradition vs modernity
Authors: Chin YM , Jaganathan M , Hasmiza AM , Wu MC
Published: May 2014

Modernity has caused many changes to culture and to a certain extent has contributed to the lapse of many traditional practices. However, Chinese women have continued to practice zuo yuezi all over the world. Zuo Yuezi is traditional confinement which has been practised by the Chinese for at least 1000 years. Studies have shown Chinese women all over the world are still practising the tradition. This article will explore how and why the tradition is still practised in the modern age by Malaysian Chinese women and to what extent. This article will also attempt to explain the reasons for zuo yuezi to be continually practised by Chinese women by analyzing the functionality of the tradition and other factors which could have supported its resilience.
Perinatal mental health education for midwives in Scotland
Authors: Forrest Eleanor , Poat Angela
Published: May 2014

The importance of recognizing factors contributing to the poor mental health of women in the perinatal period has been highlighted both nationally and internationally. As such there is a need for enhanced midwifery services and education provision in perinatal mental health, which has been advocated by practitioners, educationalists, service providers and government documents. Following the publication of the Scottish Perinatal Mental Health Curricular Framework, a national education package was developed and delivered to a cohort of multi-professionals which included midwives. This innovative course was developed by a multidisciplinary team producing educational material that ensured cultural and discipline specific relevance in relation to the learning outcomes of the curricular framework. The team identified key clinicians and educationalists to contribute to each learning outcome. A blended learning approach using workshops and e-learning and the use of inter-professional mentoring was implemented. The development, implementation, evaluation and future plans are presented here.
Trauma surgeons to teach life-saving procedures to Somali health workers
Authors: Daniel Lincia
Published: May 2014

Conflicts in Somalia have led to an exodus of skilled health-care workers, however, it is hoped that with funding for teaching, supplies and health resources, the lives of many pregnant women and children can be saved.
Complementary and alternative medicine: where's the evidence?
Authors: Hall Helen G , McKenna Lisa G , Griffiths Debra L
Published: May 2014

Currently there is very limited research on efficacy and safety of complementary and alternative medicine when consumed by pregnant women. Yet the lack of scientific validation does not appear to be a deterrent and these therapies are becoming increasingly popular with both expectant mothers and midwives. Evidence‑based practice provides a structure to encourage good care in a clinical setting. However, there are a number of limitations when applying this approach to complementary therapies as much of the expertise is based on traditional knowledge and empirical wisdom, rather than contemporary scientific experimentation. This article considers the ongoing debate regarding the role of complementary and alternative medicine in a modern maternity setting and how the effectiveness of therapies should be assessed.
Exploring the learning experiences of final-year midwifery students
Authors: Rogers Kay
Published: May 2014

The student perspective is extremely important when evaluating the success of educational programmes; however, the student voice is muted in evaluations of interprofessional education. Consequently, this study aimed to explore pre-qualification midwifery students' experiences and views of studying within an interprofessional learning context. Heideggarian, hermeneutic, phenomenology was the research approach and a purposive sample of eight final-year pre-qualification midwifery students from one UK university was used. Significantly, the narratives illuminated that interprofessional learning assisted students in the process of dual socialization, enabling them to become both midwifery practitioners and members of the interprofessional team. Inherent difficulties in this process are revealed and explored. Importantly, students valued a humanistic approach to learning and the ability to share dialogues with diverse health professional students. The research concludes with recommendations for local practice.
Guideline for the systematic assessment of perineal trauma
Authors: Stevenson Linda
Published: May 2014

This article discusses the prevalence of occult anal sphincter injuries (OASIS) and highlights the importance of recognition and accurate classification of perineal trauma. It is suggested that many ‘occult’ injuries may, in fact, be ‘overt’ injuries, which have been missed or wrongly classified as second degree tears.

Even with recognition and immediate repair of OASIS the prevalence of distressing symptoms such as anal incontinence remains high and it is vital that practitioners are competent in the diagnosis of anal sphincter injury.

Clinical assessment at the time of delivery, before and following suturing, is the optimum method to accurately diagnose OASIS. It is recommended that systematic assessment, including a rectal examination, should be carried out following all vaginal births or, at the very least, where genital trauma is identified, with referral to a more experienced clinician if required. Clarification of the preferred method for performing this examination is necessary and a guideline has been drafted to assist in the accurate diagnosis of OASIS at Nottingham University Hospitals NHS Trust (NUHS).
Neonatal skin care: Advocating good practice in skin protection
Authors: Hughes Kim
Published: May 2014

Caring for neonatal skin is a key area where parents will seek advice from midwives and health professionals. It is important therefore to have an understanding of the composition of neonatal skin and differences to adult skin that make it more delicate. An overview of current research into bathing, cleansing of the nappy area and the cord area is provided. Health professionals need to provide guidance and yet it important not to raise anxiety levels in parents with too many rules about what is right and what is not, particularly as there is room for further evidence in this field.
Potentially changing health behaviour using nappy ‘nudges’
Authors: Miller Janice , Bennett Carol , Cumming Grant
Published: May 2014

The aim of this study was to investigate whether or not a website ( www.health-e-space.com ) could be used as a conduit to influence the public to change healthcare-related behaviours. The environmental and financial issues surrounding the use of disposable and reusable nappies was used as an example to investigate if providing information in a certain way could ‘nudge’ people to consider the possibility of using reusable nappies at the cost of convenience. An online survey was completed by staff and students at Moray College, Elgin. A total of 188 surveys were completed. The study found that showing responders the health-e-space website was an enabling process with 73.4% stating the website encouraged them to think about using reusable nappies in the future. Of those who said that they would use disposable nappies prior to viewing the online information, 39.1% said that they would now use reusables, with 30.5% willing to consider using this type of nappy. Of those who did not know if they would use reusables, after viewing the site, 36.4% said they would now use reusables, and 54.5% said they would now consider this method. Being able to tailor and bring together in one place ‘kitemarked’ information and links to online health care information which the user may find useful (a form of personalization) is a novel and promising way of promoting self-care through education and empowerment which could ultimately help make health care more sustainable.
Decision-making in maternity care: How women infuence decisions
Authors: Smith Debbie
Published: May 2014

This article addresses the theme of decision-making in clinical practice and is based on a teaching and learning session for third-year midwifery students. The focus of this article is on the processes of decision making. Scenarios are presented that can be used as problem-based learning exercises with student midwives and discussion questions are suggested.
Perceptions of changing practice in the examination of the newborn, from holistic to opportunistic
Authors: McDonald Sharon , Allan Helen , Brown Anna
Published: May 2014

This paper presents selective findings from a larger grounded theory study of midwifery and continuing professional development. A grounded theory approach was used to analyse data concerning what motivates midwives to undertake the examination of the newborn post-registration midwifery course and then to utilise their skills or not. Key issues identified in the study related to the midwives'views and perceptions. They found that practice is changing and they are moving away from the holistic perspective of examination of the newborn baby to opportunistic examinations. The midwives' perceptions are that there is a difference in the knowledge and training for midwives compared to paediatricians and although the National Screening Committee has set standards and competencies adhered to by Universities across the UK, from the data in this study midwives do not observe paediatricians using them in practice. The study findings suggest a change of culture and practice may be required by all practitioners who carry out the examination of the newborn.
Open education resources for interprofessional working
Authors: Williams Jacqui , Gregory Bernadette
Published: May 2014

Transforming interprofessional groups through education resources (TIGER) has released the ‘parenting and disability’ materials as open education resources to be used by a range of practitioners in the care of parents who live with a disability. They are particularly relevant to the maternity services. The materials can be used by midwives independently or with other health professionals in a virtual learning environment. This case study highlights the benefits of the TIGER repository for midwives continuing education.
Does eating placenta offer postpartum health benefits?
Authors: Beacock Michelle
Published: May 2014

Eating one's own placenta (placentophagy) is undergoing a small revival in Western cultures. Some view this as a way of celebrating the placenta's significance and/or promoting postpartum physical and mental health. Placenta encapsulation is becoming a popular method of preparing the placenta for consumption. This article considers the potential of placentophagy to benefit human and non-human mammals and also evaluates placental encapsulation. Several credible theories and mothers' and midwives' experiences support placentophagy, but evidence is limited, dated and inconclusive. Current and systematic research is needed. Midwives should be aware of the evidence in order to support mother's decisions.
The impact of a clinical practice guideline on infants with neonatal abstinence syndrome
Authors: Murphy-Oikonen Jodie , Montelpare William J , Bertoldo Larry , Southon Sarah , Persichino Nancy
Published: May 2014

Objectives: to evaluate the effectiveness of a clinical practice guideline (CPG) on increasing identification of neonates with neonatal abstinence syndrome (NAS) symptoms based on a toxicology screening protocol, decreasing the mean NAS score for neonates and, decreasing the average length of hospital admission, based on standardised treatment and weaning protocol of morphine or phenobarbital. Methods: A retrospective cohort comparison design compared hospital record data from neonates born in the 6 months prior to, and neonates born in the 6 months following the implementation of the CPG. Results: In addition to the significant decrease in the overall average NAS score, there was also a significant difference in the number of measures taken over time between the two groups. Similarly, the change in CPG led to a significant overall reduction in length of hospital stay among the post-intervention neonates. Conclusion: A high proportion of neonates born to opiate-using pregnant women develop the withdrawal condition known as NAS. This study was successful in describing the benefit of implementing new CPG for managing neonates identified with NAS, and mothers suspected of using substances during their pregnancy.
Physical examination of the newborn: service provision and future planning
Authors: Clarke Paula , Simms Mabel
Published: May 2014

It is recommended that a physical examination of the newborn (PEN) is carried out within 72 hours following birth ( National institute of Health and Clinical excellence (NICE), 2006) . Historically, these examinations have been carried out by junior paediatricians or general practitioners (GPs). However, it is now increasingly likely that PEN will be done by midwives and advanced neonatal nurse practitioners (ANNPs) instead. This move has been made to embrace the government ethos for the NHS where midwives and nurses take on extended roles, traditionally carried out by doctors ( Department of Health (DH), 2007 ; DH, 2009 ). There is variation in how maternity services are providing PEN nationally. Locally, we became increasingly aware that there are factors that need to be considered to ensure optimal service provision. This paper describes the models of care that are used by midwives carrying out PEN locally, and highlights the catalysts for change to provide a flexible women-centred, efficient and cost-effective service.
Midwives' experiences of sphincter tears
Authors: Lindberg Inger , Mella Ellinor , Johansson Jessica
Published: May 2014

Perineal tears are very difficult to prevent, thus one of the midwife’s responsibilities during childbirth is to minimise trauma to the perineum. This study examines the experiences of eight midwives who attended births that resulted in a sphincter rupture. Midwives from two maternity clinics in northern Sweden were interviewed using semi-structured questionnaires. Data were analysed using qualitative content analysis and four themes were identified: feeling guilt, shame and failure; working through feelings; needing support from colleagues, and feeling confident with their skills. The category ‘striving to be good at her job’ was found to be common to all four themes. A midwife may feel guilty and unprofessional when he/she is singled out and criticised. Therefore, in order to reduce these feelings and to further develop professional skills, midwives should be offered mentoring throughout their career.
Regulatory reform: Revalidation as professional crisis or critique and change opportunity for midwifery?
Authors: Spendlove Zoey
Published: May 2014

Since 1902, regulation has been integral to midwifery practice and indeed the professionalisation of midwifery. Midwives have practised for decades within the conceptual hallmark of ‘professionalism’ ( Freidson, 1970a ) where the profession has benefitted from ‘autonomy’ and ‘self-regulation’. However, this conceptual hallmark of ‘professionalism’ will find itself challenged by ‘revalidation’—a government-led, regulatory reform policy of proactively ensuring continued fitness to practise ( Department of Health (DH), 2007 ). Planned for implementation by the Nursing and Midwifery Council (NMC) in 2015, this regulatory reform evokes iconic questioning of the historic sociological foundations from which the midwifery profession has emerged, posing implications for midwifery and its future professionalisation. The response of the midwifery profession to revalidation is critical to its implementation and outcome. Is revalidation a ‘professional crisis’ posing cause for concern regarding the future of midwifery professionalisation, or a ‘critique and change opportunity’ in reaffirming midwifery as an independent, autonomous profession, preserving future professionalisation?
High dependency care: Education of midwives and preparation for practice
Authors: Hardy Dawn
Published: May 2014

This paper explores issues around the education and competencies of midwives who are involved in the delivery of high dependency care. It argues that all midwives who provide this specialist care should possess the appropriate clinical skills and knowledge relevant to the management of this cohort of women. It also discusses the rational for the development of high dependency care in midwifery and the role of the midwife, as well as the location for care delivery and preparation for practice. The evidence base for this paper comes from research currently being undertaken into the organisation, provision and education of high dependency care within the midwifery setting. The study is being conducted in maternity units in England with a delivery rate in excess of 3000 per year, and is using a series of individual semi-structured interviews with midwives, consultant obstetricians, consultant obstetric anaesthetists and midwifery educationalists. The study will contribute to the debate on the delivery of high dependency care in the maternity setting and highlights the importance of specialist education relating to this area of practice.
Mother-to-mother breastfeeding peer support: The Breast Buddies project
Authors: Youens Karen , Chisnell Debbie , Marks-Maran Di
Published: May 2014

This article presents a case study of a local social initiative in Gravesham, Kent, of a mother-to-mother breastfeeding peer-supporters programme, known as ‘Breast Buddies’. The geographical location in this study has areas of high deprivation and the aim of the Breast Buddies programme is to increase the uptake and duration of breastfeeding in order to improve the health of children in this area. The background and history of the Breast Buddies scheme is presented followed by the findings from an evaluation that was undertaken into the scheme. The training programme for Breast Buddies has now been accredited by the University of Greenwich and offers successful participants the opportunity to gain academic credit for their training, which is improving their educational and employment opportunities and increasing their potential for social mobility.
Is the White Paper beneficial for nurses?
Authors: Scott Helen
Published: May 2014

There is much about the new NHS White Paper that is to be welcomed (Department of Health (DoH), 1997a). Any large organization needs to change if it is to progress. The White Paper, however, contains less structure for change than publicity would suggest. For example, primary care groups commissioning their own services and the emphasis on quality and collaboration is a natural progression from what has already been happening at local level.
Incapable adults and informal admission: another scenario
Authors: Dimond Bridgit
Published: May 2014

The Court of Appeal has once again caused a flurry of consternation with its decision that patients incapable of giving consent to admission to psychiatric hospital must, if the statutory provisions are present, be admitted compulsorily under the Mental Health Act 1983. This article submits that this decision can only cause increased bureaucracy and distress for thousands of mentally incompetent adults. The long-term solution is for the Law Commission's proposals for decision making for mentally incompetent adults to be enacted.
Homeostasis: a framework for integrating the life sciences
Authors: McVicar Andrew , Clancy John
Published: May 2014

Nurse education curricula continue to emphasize the holistic nature of health and ill-health. As a concept, holism recognizes that the interactions between a person and his/her environment are significant factors in shaping the individual, and important determinants of wellbeing. Psychosocial interactions as a basis for health now figure prominently in nursing curricula. In contrast, the applied biological sciences have increasingly become marginalized, yet knowledge of the biological construct of the individual, and an understanding of how it is influenced by psychosocial interactions, are also necessary if holistic care is the aim. Nursing models attempt to reinforce holistic principles, but the integrative nature of health and illness needs to be established before their application. This article proposes that the concept of homeostasis, and its relationship to systems theory, provides a workable framework for teaching the basis of health, and so forms a foundation for the application of nursing theory and nursing models.
Consultation on a strategy for nursing
Authors: Scott Helen
Published: May 2014

The Government has set out the background and issues for consultation to inform the development of a strategy for nursing, midwifery and health visiting (Health Service Circular (HSC), 1998) as part of its programme to implement its White and Green Papers (Department of Health (DoH), 1997a,b).
Helping communities to live more healthily
Authors: Castledine George
Published: May 2014

The proposals outlined in the White Paper The New NHS: Modern, Dependable (DoH, 1997) and the Consultation on a Strategy for Nursing, Midwifery and Health Visiting (Health Service Circular (HSC), 1998) are exciting developments for nurses.
Providing paediatric palliative care: collaboration in practice
Authors: Farrell Michael , Sutherland Pauline
Published: May 2014

One of the main aims of palliative care is to enable clients to receive and access services in a way that maximizes their choice in relation to where, when and how they receive care. To achieve this end, it is essential that statutory and voluntary care agencies collaborate to provide an effective range of services. This article offers for consideration the experience of a children's hospice service and a paediatric oncology outreach service who collaborated to provide a service for children requiring paediatric and terminal care. It identifies a number of elements which are important for positive and effective collaboration.
Nursing must find its raison d'etre
Authors: Scott Helen
Published: May 2014

At a time when the NHS is celebrating its 50th anniversary it is perhaps time to re-examine what it is to be a nurse. No succinct, commonly accepted statement of what it is to be a nurse exists. In order to create a definition, it is necessary to capture what is unique about that which is being defined. Nobody has succeeded in creating a definition of the uniqueness of nursing, such that, if a person in the street was asked to state the role of the nurse, a clear answer would be given in reply. The same could not be said of the police or the teaching profession, both of which have clear and accepted roles, respectively, enforcing the law and teaching the national curriculum.
Proactive Risk Management: Effective Communication
Authors: Wilson Jo
Published: May 2014

Communication is the most powerful tool in clinical practice. Repeatedly, research has shown that good communication skills result in better clinical outcomes, a greater propensity to follow clinical recommendations and reduced risk of clinical negligence and complaints. In using a proactive approach to communication, healthcare professionals must become increasingly sensitized to the stresses associated with illness and hospitalization and must learn the importance of good listening and effective communication to ensure high quality patient care. A study by Lester and Smith (1993) demonstrated that time-limited, negative communications by doctors is associated with increased litigious intentions among patients, even when outcomes were neither adverse nor negligent. The qualities of caring and concern exhibited by doctors make a difference in healthcare outcomes.
Three major issues in infection control
Authors: Perry Christine
Published: May 2014

In considering the three major issues in infection control the author decided upon education and empowerment, community practices, and research availability and application as they span a range of infection control practices and healthcare settings. Education and empowerment of staff is needed to ensure safe practice. This requires collaboration between education providers and infection control personnel and should be available to all disciplines of staff. Infection control needs to be seamless across the primary and secondary care interface and must include infection prevention advice to the population in general. Evidence relating to infection control is either lacking or not achievable. When it is available, it is not always implemented because of lack of resources.
Nursing must hold fast to its long-term vision
Authors: Scott Helen
Published: May 2014

The concept of the consultant nurse was one of a number of initiatives proposed by Tony Blair, the Prime Minister, in a speech given at the recent RCN/Nursing Standard awards ceremony in London. The concept of a nurse consultant and the return to a hierarchical clinical structure within nursing is wholly to be welcomed. The problems of a lack of nursing leadership and subsequent professional disorientation were, in part, caused when nursing's clinical hierarchy was abandoned in the 1970s.
The role of the clinical nurse consultant
Authors: Castledine George
Published: May 2014

The announcement by the Government that it supports the recognition of nurse consultants has caught everyone by surprise. My first reaction was similar to Betty Farmer's (Pp. 1004). My second was that at long last here is support for senior clinical nurses and the work currently being undertaken by the UKCC. However, many questions need answering before cavalier healthcare trusts jump the gun and start misusing and abusing the title. Are nurse consultants going to be part of a nursing or medical framework? Will they be undertaking medical work? Who should take on the role? What will the educational preparation be? What standards will they follow and how will public confidence and protection be assured?
Government once again side steps over nurse's pay
Authors: Scott Helen
Published: May 2014

Frank Dobson, the Health Secretary, announced at the recent Labour Party Conference that action to carry out the Government's election manifesto pledge to reduce the length of NHS waiting lists is still going from strength to strength. He promised to provide a further £320 million from the NHS £5 billion modernization fund to help the Government's ‘relentless war on waiting’. He also announced a national inquiry to ascertain how many NHS beds are needed in total, and the use to which they should be put, combined with a new award scheme as part of a £10 million programme designed to ‘spread best practice’ (see p. 1064).
Value of higher education to nursing professionalism
Authors: Castledine George
Published: May 2014

According to Nelson Mandela: ‘Education is the great engine of personal development. It is through education that the daughter of a peasant can become a doctor, that the son of a mineworker can become the head of the mine, that a child of farm workers can become the president of a great nation’ (Mandela, 1994).
Review of mental health law must be courageous
Authors: Scott Helen
Published: May 2014

It has been announced recently that a team of 10 people is to review the Mental Health Act 1983. The review is being carried out in response to public and government concern that some people with mental illness have been discharged without proper supervision into the community rendering them, in some cases, a danger to themselves and to others.
How can the clinical credibility of nurse lecturers be improved?: 2
Authors: Murray Cyril , Thomas Mike
Published: May 2014

The movement of nurse education into the university sector has put futher tension on the theorypractice gap and the clinical credibility of nursing lecturers. If the ideal is for the lecturer to guide the learner in applying theory to practice and vice versa (Jarvis and Gibson, 1985), this can only realistically be achieved if lecturers of nursing have experience as practitioners within the field(s) they teach and are viewed as being clinically credible (ENB, 1996). In the first article (Vol 7(8): 4902) an innovative way of enabling lecturers of nursing to engage in practice was presented. In this second article a variety of other approaches which enable lecturers to engage in clinical practice will be explored.
Healthcare litigation protocols under review
Authors: Tingle John H
Published: May 2014

Times are changing in the arena of healthcare litigation. An important document is currently being circulated among key professionals. Pre-Action Protocol for the Resolution of Clinical Disputes (Clinical Disputes Forum (CDF), 1998) will alter the ways in which clinical negligence claims against doctors, nurses and other health carers are handled. The CDF is a multidisciplinary body formed in 1997 as a result of Lord Woolf's ‘Access to justice’ inquiry.
Interventions for confusion and dementia 5:Changing cultures
Authors: Woodrow Philip
Published: May 2014

Previous articles in this series (Vol 7(15): 891–94; Vol 7(17): 1018–20; Vol 7(19): 1145–49; Vol 7(20): 1247–50) have explored the promotion of quality of life for people with dementia and how this can be achieved through existing interventions. This final article moves from discussing specific interventions to cover wider issues around healthcare beliefs and values. A brief historical overview of dementia care is given, outlining the inherited structures and values. Much valuable work has been carried out by the Bradford Dementia Group, who has described changes in dementia care as moving from an ‘old’ to a ‘new’ culture. This ‘new culture’, offering a comprehensive person-centred approach to holistic care, is explored with reference to the work of Kitwood, who has done much to promote quality of life for people suffering from dementia.
Nurses must be protected by law from assault
Authors: Scott Helen
Published: May 2014

The assault of a nurse carrying out his/her professional duty is completely unacceptable and the severest sentences possible should be meted out to those who are found guilty of this type of offence.
An update on the UKCC's work into higher level practice
Authors: Castledine George
Published: May 2014

In the last specialist nursing supplement Sarah Waller described the background to the consultation process for recognizing and regulating a higher level of practice (Vol 7(16): 960–4). This article gives an overview of the responses to the consultation exercise and outlines what a higher level of practice will mean for the nursing profession. It was generally agreed that the present system of specialist practice is too complex and therefore confusing. In addition, the UKCC has recognized that professsional practice has moved on since PREP and that there is a need to move away from a task-oriented and functionalist paradigm. It was also felt that the specialist framework is too narrow and does not cater for expert nurses who wish to stay in general, as opposed to specialist, clinical areas.
Should nurses and doctors have combined training?
Authors: Castledine George
Published: May 2014

In Sweden, where I am at present working as a visiting professor in Uppsala, many of Sweden's nursing colleges are moving into the university setting where the idea of combining the training of all healthcare disciplines is being introduced.
An alternative training approach to clinical supervision: 2
Authors: Cutcliffe John R , Proctor Bridgid
Published: May 2014

In this, the second of two articles focusing on the issue of training in clinical supervision, the alleged benefits of training students to be supervisees is highlighted. These are: a substantial reduction in training costs and time; a possible standardization of training; the creation of greater equality and intentionality in the working alliance; an increased student awareness and understanding that supervision is for their benefit; the sharing of values, ground rules, terms and aims between the supervisee/supervisor and the organization; a sense of comradeship between peers in a culture that is often described as having a sense of divide and rule; and a greater sense of team cohesion. The development of basic intrapersonal skills (e.g. reflecting on practice, choosing issues, asking for and using help appropriately) in a non-threatening forum is also of great benefit. The authors conclude that an educational model would include both theoretical and experiential components with the theory preceding the clinical supervision experience. Evaluation of this training could be carried out using a methodology similar to that used by Butterworth et al (1997) in evaluating the impact of receiving supervision.
Pathway to all-graduate professions may be chaotic
Authors: Farmer Elizabeth
Published: May 2014

Should the nursing, midwifery and health visiting professions welcome the newly formed Council of Deans and Heads of UK University Faculties of Nursing, Midwifery and Health Visiting (Council of Deans, 1998) as the selfappointed ‘authoritative voice’ on all matters concerning education and research? Or should we prepare for another round of power struggles on the journey to integrated professions?
The RCN Congress: that was the week that was!
Authors: Castledine George
Published: May 2014

Acertain je ne sais quoi surrounds the RCN Congress and this year's event in Bournemouth was no exception. Aptly named ‘Change & Challenge’ it got off to a flying start with an angry reception for the Health Secretary, Frank Dobson. He apologized for the staging of this year's nursing pay award and then tried to make his audience believe that the Government was committed to nurses and nursing. He did not sound very convincing.
Can doctors' work really be expert nursing?
Authors: MacAlister Lynn I
Published: May 2014

There can be little doubt that most nurses are more than capable of undertaking a wide range of the clinical skills more commonly associated with the work of doctors. Indeed, since the need to reduce junior doctors' hours was first raised (NHS Management Executive, 1991) there has been a proliferation of new roles for nurses, e.g. night nurse practitioners, cardiac assistants and surgical assistants.
Confidentiality 4: patient confidentiality and the courts
Authors: Dimond Bridgit
Published: May 2014

Arthur Green, a staff nurse at Roger Park Hospital, had been told by a patient, Dan Davies, that his injuries occurred when he was attempting to burgle a house and fell from a window. Arthur promised Dan that he would never disclose this information. Arthur is then summoned as a witness for the prosecution of Dan who has pleaded not guilty to the offence. Arthur considers that Dan gave that information to Arthur because he trusted him and is reluctant to give evidence against Dan. What is the legal position?
Cervical cancer 2: colposcopy, treatment and patient education
Authors: Peate Ian
Published: May 2014

In the first article in this two-part series (Vol 8(11): 730–34) the issue of cervical screening and the cervical smear test was described and discussed. This article looks at colposcopy. When a woman receives an abnormal smear test result, she will often require further examination of the cervix in order to identify the degree and area of dyskaryosis. Colposcopy can often provoke feelings of fear and anxiety in women and the nurse must help to alleviate these fears and anxieties. Colposcopy and cervical intraepithelial neoplasia are discussed and the treatment (if any) is outlined.
Protecting people with disabilities from abuse
Authors: Kitson Deborah
Published: May 2014

A decade ago disability services were slowly recognizing that their service users had the right to develop their own sexuality and personal relationships. Craft (1987) discussed the right of people with a learning disability not ‘to be at the mercy of the individual sexual attitudes of different caregivers’, and ‘not to be sexually abused’. Work on sexuality and personal relationships had an impact both on the sex education offered to service users and the recognition of the importance of information to enable them to form relationships and avoid unwanted experiences.
Confidentiality 5: the rights of transplant recipients and donors
Authors: Dimond Bridgit
Published: May 2014

Staff Nurse Fawn works on a transplant unit and is approached by a journalist who is seeking to write a report on a recent transplant success. Nurse Fawn knows that the recipient patient is happy to be interviewed, but the journalist wants her to find out the name and address of the donor family, so that the public can have both sides of the story.
Learning disabilities: supporting nurses in delivering primary care
Authors: Stanley Robert
Published: May 2014

This article introduces an educational project supported by The Queen's Nursing Institute and sponsored by the Hertfordshire Nursing Trust. It reports on the initial results from a literature review and its implications for nursing. There is broad acknowledgement of a problem in the delivery of primary care nursing for people with a learning disability, but little consensus on how to move either medical or nursing practice forward. It was proposed, therefore, to systematically assess the learning needs of nurses delivering primary care and to develop an evaluated methodology for responding to those needs. A comprehensive literature review was undertaken. Three consistent themes emerged: knowledge and training needs; role definitions and liaison; and clinical issues. Implications for nursing, and the future development of the project are considered.
Mediating factors in the grieving process of the suddenly bereaved
Authors: Vanezis Maria , McGee Anna
Published: May 2014

This article explores the role of the staff of accident and emergency (A&E) departments in managing events surrounding sudden death. Key aspects, such as the way in which initial contact with relatives is made, reception and resuscitation procedures, viewing of the deceased, and the bureaucratic elements of these events, are discussed in terms of the impact that they may have on the subsequent adjustment of the bereaved to the sudden death of their relative. The management of death may be problematic, particularly if it involves children or if the body of the dead person is mutilated. This article suggests ways to support health professionals in facilitating the processes of grieving, and raises awareness of the potential influence the experiences in the A&E department at the time of bereavement may have on the grieving process.
Should children be able to request euthanasia?
Authors: Scott Helen
Published: May 2014

The Dutch Parliament is expected to effectively legalize euthanasia in Holland next year following the publication of a Bill that guarantees doctors immunity from prosecution so long as they follow certain guidelines. The guidelines state that the patient must make a voluntary and informed request and be suffering irredeemable pain, and all other medical options must have been exhausted and a second opinion sought. All cases will have to be reported to the coroner and a regional panel which can recommend prosecution if the doctor has not followed the correct procedures.
Nurses have an important role in consent issues
Authors: Parker Sue
Published: May 2014

Autonomy is the fundamental principle underlying consent to treatment. It gives every competent adult the right to decide what may and may not be done to him/her. Any treatment, investigation or deliberate touching carried out without consent may amount to an assault or battery. This could potentially result in a legal action for damages, a criminal charge or allegations of professional misconduct.
Confidentiality 8: role of the NHS trust and patient confidentiality
Authors: Dimond Bridgit
Published: May 2014

Nurse Salmon worked in the gynaecology ward at a hospital and was known to gossip about her patients over lunch with colleagues. She did not usually mention their names. However, on one occasion a well known television star was admitted to have a termination and in confidence Nurse Salmon told her friends about this, mentioning the person by name. If this comes to the notice of her employers, what action, if any, should they take?
A surgical approach for patients with endstage emphysema
Authors: Scullion Jane
Published: May 2014

For patients with emphysema who experience deteriorating lung function and concomitant comorbidity, there has been little to offer apart from best supportive care and more recently pulmonary rehabilitation. The early promise of lung transplantation for these patients has failed to materialize — a shortage of donors has meant that younger patients are more likely to receive donor lungs. A renewed interest in lung volume reduction surgery (LVRS) appears to offer hope for selected patients. This article looks at the history of LVRS and illustrates its benefits with a case study. However, if LVRS is a clinically significant approach to the treatment of emphysemic patients, then it requires careful clinical trials so that its benefits and costs can be fully evaluated.
Radiation-induced skin reactions 2: development of a measurement tool
Authors: Noble-Adams Rae
Published: May 2014

Radiation-induced skin reactions occur commonly in clinical practice and cause various problems for the patient. Assessment and treatment of these reactions is an important part of the healthcare professional's role in the radiotherapy unit. To accomplish this effectively a specific, yet comprehensive, measuring tool is needed. The first article in this threepart series (Vol 8(17): 1134–40) examined the phenomenon of radiationinduced skin reactions, including descriptions of how radiotherapy affects the skin and the prevalence and significance of these skin reactions. Using the literature, the most common signs and symptoms were isolated. This provided the basis for the development of a specific yet holistic assessment tool. In this article, an explanation of the methods used to collect and analyse data for the development of an assessment tool to measure radiation-induced skin reactions is described. The tool is called the Radiation-Induced Skin Reaction Assessment Scale (RISRAS). In the third article in the series, the results of RISRAS's initial evaluation is reported along with its efficacy for clinical practice.
Communication skills workshops in learning disability nursing
Authors: Chatterton Sarah
Published: May 2014

This article investigates the effects of a combination of direct speech, language therapy and staff training on the communication skills of nursing and support staff working with people who have a severe learning disability and challenging behaviour. The approach aimed to help staff choose, prioritize and implement changes in communication. The input was effective in increasing the knowledge of the staff group with regard to challenging behaviour and communication breakdown, and in changing the communicative behaviour of staff. The changes measured were those of longer interactions occurring between staff and service users, and the use of non-verbal communication to support interactions. The implementation of the communication strategies is being audited.
Acute MI: analysing health status and setting immediate priorities
Authors: Cook Neal F , Melby Vidar
Published: May 2014

This article uses a case study approach to demonstrate how awareness of recent research findings and a sound understanding of pathophysiology enable the nurse to become an effective practitioner. A scenario is described in which the nurse is faced with a man admitted to the coronary care unit with a diagnosis of suspected acute myocardial infarction (AMI). Through analysis of the patient's health status, with frequent reference to pathophysiology, the nurse can perform an accurate nursing assessment and so determine immediate priorities for nursing care. The priority objectives were identified as pain control, management of cardiogenic shock, reperfusion of the myocardium, cardiac monitoring for complications of AMI and the effects of treatment, and management of anxiety. Research-based rationales are provided for all objectives.
The symbolism and myth surrounding nurses' uniform
Authors: Richardson Malcolm
Published: May 2014

This article addresses nurses' uniform from the perspective of the symbolic, myth, legend and competing discourse. The analysis touches upon why nurses working with people who have learning disabilities discarded the nurses' uniform and why other nurses may consider doing so, particularly if suitable alternatives exist. The analysis draws from various areas of nursing practice, including the nursing of disabled people, elderly people and people with learning disabilities. Nurses' uniform is revealed as a totem of considerable potency such that to wear a uniform in just any setting or context has to be cautioned. The practicalities of protective clothing are addressed. A differentiation is drawn between uniform and protective clothing such that much of the undesirable symbolism associated with uniform may be discarded with a consequent enhancement of the image of the nurse.
Nursing is not positively portrayed to children
Authors: Castledine George
Published: May 2014

Last year the Government ran a nursing recruitment campaign called ‘Nursing — have you got what it takes?’ It was aimed at changing public perceptions about nursing and encouraging more entrants into the profession. This year the focus of the campaign has intensified and there have been renewed efforts to attract school leavers. However, an official Department for Education and Employment (DFEE) document, aimed at school children, falls far short of adequately describing what nursing is about. Job File — Which Way Now? (DFEE, 1998) gives a brief snapshot of various jobs.
The road to conversion for enrolled nurses: a literature review
Authors: Allan Irene , McLafferty Isabella
Published: May 2014

The literature concerning the plight of the enrolled nurse (EN) is extensive. This article examines published material from the last 10–12 years to consider the problems that ENs experience in relation to professional development and career advancement. For many ENs, conversion to first-level registration is seen as the only means of progress and possibly the only means of retaining a career. However, does conversion actually achieve progress? The literature on this subject is scarce but reports suggest that converted ENs do go on to achieve promotion and make use of educational opportunities (Crotty, 1990; MacGregor and Hill, 1996). Nevertheless, there is a substantial number of ENs who have no desire to convert to first-level registration and their role should be valued.
The use of music and colour theory as a behaviour modifier
Authors: Barber Christopher F
Published: May 2014

For many centuries various aspects of healing have been linked to the use of the arts, in particular music and colour because of their innate ability to bring about a mental, emotional and physical calmness. Although much has been written on the use of colour and music as relaxants specifically within a nursing/medical context, there appears to be little information available as to why music and colour have this calming effect. This article examines music and colour as relaxants by briefly describing the neurological and physical mechanisms that bring about the effect of relaxation. This brief exploration is placed within the context of learning disability care. The aim is to provide ideas for a more peaceful and relaxing environment for an adult with learning disabilities who also has autism and exhibits severe challenging behaviour. The results of a small case study and implications for other areas of nursing are discussed.