bluuebunny/crossref_metadata_2025 huggingface dataset:
The tensions between education and models of nurse preparation
Authors: Kenny Gerard
Published: May 2014

This article seeks to explore the relationship that has evolved between the training and education models of nurse preparation since the creation of the NHS. Through the process of professional reflection it intends to investigate how each model develops the profession and enhances care delivery. It seeks to move away from an either/or approach that has dominated the nurse education debate, and instead seeks to identify the potential benefits, as well as the tensions, of trying to integrate these models into a modern context. In so doing, this article hopes to inform practitioners about the debate so that they can engage with it more fully and effectively.
A static-led approach to pressure ulcers: an evaluation after 3 years
Authors: James Jane
Published: May 2014

Pressure damage has high cost implications to the patient and care providers. The choice of appropriate equipment to help in the prevention of tissue damage is hampered by extensive choice and little guidanceon the most effective product to use. The static-led approach was introduced into Carmarthenshire NHS Trust 3 years ago. This approach simplified the choice of equipment, improving the appropriate usage and reducing expenditure. This article aims to evaluate the approach 3 years after its introduction to determine if the benefits to the patient and the organization still apply.
Improving medication safety is the duty of all nurses
Authors: Tingle John
Published: May 2014

The Chief Pharmaceutical Officer has just published a report on medication errors and how to prevent them (Department of Health (DoH), 2004). The report will be of interest to nurses as they have key roles in prescribing and administering medicines. It explores the causes and frequency of drug errors, highlights drugs and clinical settings that carry risks, and identifies models of good practice to reduce risks. It aims to meet the Government's commitment set out in a previous report of reducing the number of serious errors in the use of prescribed drugs by 40% (DoH, 2000).
Nurses must cooperate with internal and external investigations
Authors: Castledine George
Published: May 2014

The problem with bad nurses or incompetent practitioners is that they may get away with murder because their poor behaviour is not effectively dealt with or challenged. A typical example of this is the nurse who works for an employer and after a period in the job gets into trouble and leaves before any further action can be taken. Many healthcare organizations, such as NHS trusts and private nursing homes, do not want either the hassle or the bad publicity, so they often sack the bad nurse without addressing the issues.
Concordance with pain medication: reflection on an adverse incident
Authors: Matthews Elizabeth
Published: May 2014

This article describes the author's experience of dealing with a patient's non-concordance with medication that she had prescribed. As part of her preparation for the nurse prescriber role, the author has met regularly with her medical mentor to discuss patients she has managed independently and to reflect on the role of prescribing. One prescribing dilemma that arose was compliance with taking medication. Non-concordance with medication is a common problem in health care and there are a number of reasons why patients do not take their medications as prescribed. The author prescribed medication for a patient who seemed to understand how to take the drug, but who later took five times more than the prescribed dose and was then admitted to hospital. This article describes the author's reflection on this incident using a structured model of reflection. The possible reasons for the patient's non-concordance are discussed and methods to improve concordance in the future are suggested. The possible reasons for the patient's non-compliance are explored and suggested methods to improve concordance in the future such as allowing adequate time for consultations, the role of significant others, and the importance of written information are highlighted.
Rationalization of dressings on the NHS contract is not patient choice
Authors: Butcher Martyn
Published: May 2014

During the past few months there has been much debate over the issue of choice in the public sector. In particular, we have seen the various political parties fighting for votes on this particular healthcare bandwagon. However, what choices are really available for patients in our care?
Documentation standards set by the Clinical Negligence Scheme for Trusts
Authors: Dimond Bridgit
Published: May 2014

This article considers the role of the Clinical Negligence Scheme for Trusts in encouraging the establishment of good standards of documentation in those trusts which are members of its clinical risk pool. It considers its assessment scheme, its standards for record keeping and the role of the NHS Litigation Authority.
Has nursing lost the plot? And how can we find it?
Authors: Castledine George
Published: May 2014

During the British Geriatric Society annual meeting in Birmingham recently, I ran a lunchtime session on the current state of nursing in Britain. I was somewhat surprised by the large number of people who attended and even more surprised by what was said. There were very few positive comments about nursing and at one point there was unanimous support for a senior medical consultant who stated that in his opinion, ‘nursing and nurses had lost the plot’.
Staff nurse removed from nursing register for mis-management of drug rounds
Authors: Castledine George
Published: May 2014

David was a staff nurse employed by a large hospital trust in the north of England. He usually worked on night duty and was known for his efficiency in completing nursing tasks. David entered nursing in his forties after being made redundant by the local car manufacturer. During his time in the motor industry he had always worked nights and therefore when he qualified as a nurse he always intended to do night duty.
Male obesity: a gender-specific approach to nurse management
Authors: Peate Ian
Published: May 2014

Android or male obesity is increasing. With greater understanding of the causes, development and outcomes of being obese and overweight, the nurse can begin to help men by using a gender-specific approach towards challenging this increasing global epidemic. This article provides a definition of overweight and obesity using the World Health Organization classification. The prevalence of obesity among men in the UK is outlined, and inequalities are highlighted and discussed. Some men from certain social, economic and ethnic groups are predisposed to developing obesity or becoming overweight. The human and financial implications of obesity and overweight are described and the health outcomes associated with the disease are discussed. Methods used to prevent obesity and overweight, such as information giving, pharmacological intervention and bariatric surgery, are outlined. Finally, a call is made for nurses to address male obesity from a gender perspective taking into account the attitudes, hopes and aspirations of men from various social, ethnic and economic backgrounds. Long-term local and national strategic policy is needed if this upward trend in obesity and overweight is to be addressed effectively. Joined-up intergovernmental policy-making approaches are advocated.
The law regarding health records of the deceased in the UK
Authors: Dimond Bridgit
Published: May 2014

Following the death in hospital of a patient, John, a dispute has arisen over his will and the allocation of his property. He married twice and had a son from each marriage, who have never got on well with each other. In his will he left his terraced house to the son, Bruce, who most frequently visited him at home and in hospital. The other son, Ben, however, feels that Bruce exerted undue influence upon the father and that the property should have been equally divided between the two of them in the absence of any other relatives. Ben also believes that his father lacked the necessary mental capacity when he made his will and, therefore, the will is also invalid on those grounds. Ben is seeking to access his father's health records to try and establish the mental state of his father at the time he made the will. He has applied to see the records. Will he be able to access them?
SimCair: a simple mattress system to support pressure ulcer prevention
Authors: Hampton Sylvie
Published: May 2014

Assessing skin is a simple method of reducing pressure ulcer occurrence and is easily accomplished by both trained and untrained staff. The important issue, once the risk has been identified, is to supply equipment in the shortest time possible. A new mattress, SimCair, developed by Hill-Rom Ltd, is designed for just such a reason. It is a lightweight overlay that combines air and viscoelastic foam in order to redistribute the body weight and thus reduce risk. SimCair is easily transported and can be ready for instant and automatic inflation as soon as it is required. It is also durable and simple to clean between patients. A small evaluation was undertaken in one nursing home to assess the benefits to the residents.
Changing pressure-redistributing mattress stocks: costs and outcomes
Authors: Clark Michael
Published: May 2014

There remains considerable confusion regarding the selection of appropriate pressure-redistributing support surfaces, although it is accepted that use of low-pressure foam mattresses is likely to reduce the incidence of pressure ulcers compared with standard hospital mattresses. In this study, a 650-bed hospital replaced its mattress stock with low-pressure foam mattresses with over £100000 cost savings in the first year after implementation. Incidence and prevalence data were recorded but given the challenges of interpreting apparent trends in the data (due to the lack of robust data-collection methodologies and no case-mix adjustment) these data were not included.
Nurse case managers: patient care implications at a Pakistani university
Authors: Walani Laila
Published: May 2014

The role of the nurse in hospital is varied and some are choosing to incorporate more managerial and administrative skills into their clinical role. One such role is that of the nurse case manager (NCM). This particular role concentrates on involving the family and the patient in his or her own care, facilitation of the care plan, and open discussions between the patient, medics and nursing staff. NCMs in the author's hospital have made a remarkable contribution to patient care. It is a challanging and exceedingly demanding role in both developing and developed countries, but one that is increasingly important. The NCMs are involved in coordination, facilitation of core process and mobilization of resources, not only in hospital but at the patient's home. In this short introductory article the role of NCM is highlighted and the author discusses how this diverse role is concerned with patient care. NCMs work with multidisciplinary teams to enhance the patient's care process. Their attention is also given to cost reduction and clinical pathway management.
Care of patients with haemoglobin abnormalities: history and biology
Authors: Khattab Ahmed D , Rawlings Barry , Ali Ibtisam S
Published: May 2014

Haemoglobinopathies refer to a range of genetically inherited disorders of red blood cell haemoglobin and include sickle cell disorders and thalassaemias. They occur most commonly in populations whose ancestors come from Africa, Asia, Mediterranean Islands, and the Middle and Far East. Haemoglobin (Hb) abnormalities (or haemoglobinopathies) are caused by (i) abnormalities of the protein structure; (ii) imbalanced globin chain production owing to reduced rate of synthesis of normal a or b globin chains; or (iii) a combination of the two. This article will focus on the biological basis of sickle cell disorders and will discuss the history and pathology of the conditions.
Treatment decision following a fingertip injury
Authors: Ferguson Anne
Published: May 2014

Max, aged 10years presented to the minor injury unit (MIU) with an infected finger on his right hand following a complicated history of treatment at two other centres. The original injury had been caused 5 days previously when he crushed his finger in a door. He was seen in his local accident and emergency (A&E) department where his finger was X-rayed revealing no bony injury. He and his father could not recall any other treatment apart from a finger dressing. He then went on a school trip to Paris where the finger became swollen and painful. It appeared he had developed a soft tissue infection and this was treated by incision and drainage.
Reductionism and holism in coronary heart disease and cardiac nursing
Authors: Chummun Harry
Published: May 2014

Reductionism and holism are two contrasting philosophies which provide scientific knowledge of disease processes, health dynamics and care interventions. While reductionism focuses on specific and perhaps narrow concepts, it enhances our in-depth knowledge of key health issues. Holism focuses on understanding how all the significant factors affecting the particular health issue are involved, so a more informed decision can be made about health intervention. This article explores the contribution each makes to our understanding of coronary heart disease (CHD) and to the preparation of nurses working in cardiac nursing. It proposes that pre- and post-registration nursing curricula reflect both reductionist and holistic approaches and therefore cardiac nurses are suitably trained to manage reductionist as well as holistic care for clients with CHD.
Telephone advice: advice given to a nursing home for pressure care
Authors: Dimond Bridgit
Published: May 2014

This article considers the law which applies to the giving of advice over the telephone and the respective liability of the adviser and the recipient of the advice. It also covers the law relating to the exclusion of liability.
Alcohol and extended drinking hours
Authors: Higginson Ray
Published: May 2014

Given the research that has been conducted into alcohol-related diseases (Room et al, 2005; Leon and McCambridge, 2006), it beggars belief that the Government should ever have considered, let alone allowed, the changes to drink licensing laws that took place towards the end of 2005.
Time to promote `Healthcare Resolutions'
Authors: Castledine George
Published: May 2014

January is nearly over and I wonder how many nurses have already broken their New Year Resolutions. Of course, we all make them because we want to state a formal expression of what we intend to do about something which concerns us. Losing weight and keeping or getting fitter are common resolutions to make at this time of year.
Exploring the impact of mental health nurse prescribing
Authors: Snowden Austyn WA
Published: May 2014

To illuminate the process of developing a research proposal this article explains the rationale behind the research question: What is the impact of mental health nurse prescribing in NHS Greater Glasgow and Clyde? It then goes on to defend the chosen methodology by considering the virtue of alternatives. It concludes that if the study is as timely, pertinent and sound as it appears it could provide very useful primary data in a research poor area.
Comments on the Equality Act 2006
Authors: Peate Ian
Published: May 2014

Equality is not a matter that concerns only a minority of us, it should – and does – concern all of us; equality is a fundamental human right. Inequality has the potential to prevent a person participating fully in society as a result, for example, of their gender, religion or sexuality. Unjust treatment can make a person feel isolated, scared and misunderstood.
Recognizing problems of loss in patients
Authors: Castledine George
Published: May 2014

During my nursing career I have come to appreciate the importance and significance of loss and grief in nursing practice. It should not be underestimated, and certainly never ignored.
Specialist healthcare law: palliative care
Authors: Dimond Bridgit
Published: May 2014

In this new series of articles, the implications of legal issues in healthcare will be explored using scenarios to give examples of the topic in question. In this first article, based on palliative care, the use of advance decisions (living wills) is explored and the legal requirements are discussed.
Academi Nyrsio Cymru: Yn Canolbwyntio ar Ragoriaeth
Authors: Davies Ruth , Clark June
Published: May 2014

Bydd yr erthygl hon yn dilyn trywydd datblygiad Academi Nyrsio Cymru gan gysylltu hyn â newidiadau eraill a ddigwyddodd o fewn y proffesiwn nyrsio, bydwreigiaeth ac ymweliad iechyd yn ogystal â'r tirwedd politicaidd yng Nghymru. Cenhadaeth ANC yw gwasanaethu pobl Cymru trwy hyrwyddo rhagoriaeth ym myd nyrsio a gofal iechyd trwy gynhyrchu, cyfuno a rhannu gwybodaeth nyrsio. Dangosir sut y bydd hyn yn digwydd yn ymarferol trwy weithgareddau ei aelodaeth mewn perthynas â phob un o bum prif bwrpas yr academi. Dyma'r academi nyrsio cyntaf i'w sefydlu o fewn y Deyrnas Unedig ac mae'n debygol y bydd eraill yn digwydd yn Lloegr, yr Alban a Gogledd Iwerddon. Barn yr erthygl yw y gall hyn arwain at ffederasiwn o academïau ar draws y DU a fydd yn cydweithio a chefnogi ei gilydd ac yn cydgysylltu ag academïau nyrsio mewn gwledydd eraill.
Correct use and deliberate misuse of manual lifting devices provided by the nursing home
Authors: Castledine George
Published: May 2014

The nurse is often required to assist in moving patients in her daily work routine. Such moving involves lifting the patient up in the bed, to the side of the bed, onto commodes and into chairs. As a rule of thumb, nurses should never attempt to lift more than 35% of their own body weight and must always call for assistance if in doubt about their ability to transfer a patient.
Legal aspects of continence
Authors: Dimond Bridgit
Published: May 2014

This article considers the law which applies to the supply of incontinence equipment. It considers the liability of the employee and the primary care trust and possible defences to an action for negligence and the right to acquire records relating to an incident which has arisen. It also looks at the health and safety laws which apply to the provision of safe equipment, and considers the patient's right to access health services and the issues which arise when resources are limited.
Working complementary therapies into mainstream health care
Authors: Laurenson Mary
Published: May 2014

Complementary and alternative medicine (CAM) is speculative and practitioners and policy makers question its validity in the care of people within the NHS. However, increasing numbers of people are using private CAM therapists to address their health needs. This has consequences in terms of cost to the patient, of using CAM instead of traditional health care, and for policy makers and educators raises questions of competency, regulation and research to validate its efficacy. This article provides a personal account of a nurse educator's discovery of homeopathy as a complementary therapy, its impact upon health status, training undertaken and action taken as a result. It outlines the potential use of CAM as a holistic approach that embraces the interprofessional framework and suggests CAM practitioner inclusion within mainstream healthcare provision. The article emphasizes the need for further quantitative and qualitative research of CAM treatment.
Intravenous therapy: duty of care and liability
Authors: Dimond Bridgit
Published: May 2014

This article considers the law which applies when the parents of patients are asked to be involved in the treatment of their children. The instruction and information to be given to parents before they undertake the activity of giving intravenous therapy to their children is considered. The legal significance of so-called disclaimer forms used to exempt the NHS trust or primary care trust from liability if anything untoward occurs to the child is also considered. The possibility of parents obtaining compensation for post-traumatic stress disorder is also considered.
For Marty
Authors: Castledine George
Published: May 2014

I am writing this column in memory of Marty. You will probably never have heard of him as he was not a famous nurse or medic. He was, however, a fantastic patient who loved hospitals and always looked forward to his encounters with the health professionals.
The continuing threat of avian influenza
Authors: Davies Kevin , Higginson Ray
Published: May 2014

According to some elements of the media the threat of an avian influenza pandemic has been exaggerated. Some journalists have claimed the extent of the threat, originally put forward and developed by academics was picked up by a media which feeds on hyperbole and scaremongering. However, Dr Mike Ryan, Director of Epidemic and Pandemic Alert and Response at the World Health Organization (WHO), is quite clear on the threat:
Legal aspects of continence: disclosure of a medical condition
Authors: Dimond Bridgit
Published: May 2014

This article explores the issue of patient confidentiality and the exceptions to that duty. Even if a health professional considers that there would be a public interest in a patient's condition being made known, the patient is entitled to have his confidential information kept secret. There are recognized exceptions in law to the duty of confidentiality, and the guidance issued by the health professional registration bodies should be followed.
Learning for the reality of clinical practice
Authors: Castledine George
Published: May 2014

There is much debate regarding the method and the outcome of preparing student nurses for clinical practice. Ever since nurse education moved into higher education (HE) there have been comments about the suitability of the system. The critics generally seem to follow one of the following themes: a) nurses should be educated at a higher level, but there should be more practical training in clinical skills, b) bring back schools of nursing attached to big hospitals and universities so students can find some closer affiliation and reality to their nursing care, c) the system of clinical support for student nurses (i.e. mentorship) is not working and needs revising, and d) professional nursing itself is to blame because there are not enough experts in clinical nursing to influence students.
Dermatology: obtaining patient consent in clinical trials
Authors: Dimond Bridgit
Published: May 2014

This article considers the law which applies to the conduct of research on health service patients. It considers the ethical approvals which are required and the necessity to obtain consent from the patient. It must be made clear to the patient that a refusal to participate in a research project should have no adverse effect on their ongoing care and treatment.
No more excuses. Jobs and reputations are on the line
Authors: Fletcher Jacqui
Published: May 2014

Tissue viability nurses are, for the first time in their history, finding both their jobs and their actual roles under threat. Is this surprising in an age of evidence-based care that a workforce as ‘expensive’ as tissue viability nurses are, are being asked to justify their existence?
The nurse’s role in promoting a good night’s sleep for patients
Authors: Collis Pellatt Glynis
Published: May 2014

Sleep is a vital activity of daily living as it restores and refreshes. However, there are environmental, physiological and psychological factors that can affect normal sleep patterns. There are many ways in which nurses can help patients achieve a good night’s sleep. This article discusses environmental, non-pharmacological and pharmacological interventions that can be used to promote sleep in hospital and community settings.
ESBL-producing Enterobacteriaceae: controlling the spread of infection
Authors: Bissett Linda
Published: May 2014

Extended spectrum ß-lactamase (ESBL)-producing Enterobacteriaceae were first reported in Europe in the 1980s and have since become a worldwide problem. This has resulted in increased morbidity, mortality and cost in treating the infections they cause (Paterson et al, 2001; Bisson et al, 2002). In the UK the prevalence of ESBL rose from 5.4% in 1997 to 22.7% in 1999 (Goossens, 2000). ESBL are not the only ß-lactamases to present resistance to 1st, 2nd and 3rd generation cephalosporins but are the most important. New strains produce a particular type of ESBL, the CTX-M type, which is able to break down a wider range of antibiotics. These strains were unrecorded in the UK prior to 2000. They have spread rapidly since 2003, causing infections such as urinary tract infections (UTIs) in hospital patients as well as those treated in the community (Livermore and Woodford, 2004). Enterobacteriaceae are a well-known cause of healthcareassociated infection (HAI). Their antimicrobial resistance is commonly caused by the production of ß-lactamases, therefore this article discusses methods used to limit the emergence of ESBL producing strains and to prevent the spread of those already present.
Confidence vs competence: basic life support skills of health professionals
Authors: Castle Nick , Garton Helen , Kenward Gary
Published: May 2014

The provision of prompt effective resuscitation is fundamental in ensuring successful outcomes following cardiac arrest but historically nurses and doctors have lacked competence in performing basic life support (BLS), despite being confident in their abilities. The object of this study was to assess BLS confidence as assessed against competence of doctor’s in-training, qualified nurses and healthcare assistants (HCAs) following the development of structured resuscitation training. This study has highlighted that the introduction of a structured resuscitation training programme has resulted in a noticeable improvement in BLS skills, particularly with regard to doctors. Registered nurses have improved with regular training compared with previously published data but HCAs tend to perform poorly and are under-confident. There remains a mismatch between confidence and competence, with only doctors demonstrating both confidence and competency and therefore changes to training programmes may be required to address this mismatch.
Renal nursing and the Human Tissue Act 2004
Authors: Robertson Abbe , Noble Helen
Published: May 2014

The Human Tissue Act of 2004 was introduced in the UK on 1 September 2006. It replaced all Acts that previously governed the procurement and utilization of tissues, cells and organs. It has promoted changes in requirements predominantly in transplantation settings. Past research has highlighted a shortage of organs for transplantation, particularly in renal donation. The new act hopes to remedy this so that future renal transplantations will occur more frequently, therefore improving choice and quality of life for patients with end stage renal disease. For UK renal nurses, the implementation of the Human Tissue Act 2004 presents challenges requiring adaptations of prior learning with new nursing roles. Recommendations can be made to help during the change process. Kurt Lewin’s model of change provides a foundation for the understanding and recognition of change processes that occur in the implementation of individual and organizational change.
An update on the simulation project
Authors: Wilson Ann , Godson Nina
Published: May 2014

The Nursing and Midwifery Council (NMC) recently called for universities to submit ideas for using clinical skills laboratories (CSLs) to teach student nurses nursing skills, and to evaluate this teaching and learning experience. The idea was to collect evidence to decide whether CSL time can be counted towards students’ practice hours. Thirteen universities had their proposals accepted and undertook their different projects. All their results were sent back to the NMC who collated and analysed the data.
Ethical issues regarding live kidney transplantation
Authors: Murphy Fiona , Byrne Gobnait
Published: May 2014

There are many ethical issues regarding kidney transplantation as the supply of cadaveric (deceased) organs does not meet the increasing demand for organs. The proportion of organs from living donors is increasing in the UK. This has many benefits for the recipient but raises many ethical issues. The aim of this article is to outline these ethical issues that the nurse and other members of the multidisciplinary team need to consider when caring for both donors and recipients of living kidney transplantations.
The duty of care 2: risk assessment and risk management
Authors: Fullbrook Suzanne
Published: May 2014

In this second article in the series, the issue of risk assessment and management, in the context of a recent case, is revisited. The case in question is outlined in the previous article ‘Compliance with directives and protocols’
Driving confidence in tomorrow’s nurses
Authors: Karstadt Lyn
Published: May 2014

Nursing and midwifery education has evolved over the past few decades, making many in the profession — as well as education — slightly confused as to what is going on. In this fifth column, Lyn Karstadt discusses this year’s Chief Nursing Officer’s Annual Summit: Driving Confidence in Care.
Bladder cancer and smoking. Part 4: efficacy of health promotion
Authors: Anderson Beverley , Naish Wendy
Published: May 2014

This is the last of a four-part series on bladder cancer and smoking. Part 1 presented an overview of bladder cancer and the role of smoking in its development (Anderson and Naish, 2008a), part 2 discussed diagnosis and management of bladder cancer (Anderson and Naish, 2008b) and part 3 examined perceptions and beliefs related to smoking and health (Anderson and Naish, 2008c). Part 4 examines evidence for the efficacy of health promotional measures in helping people to stop smoking. It aims to provide an insight into whether health education and health promotion increase awareness of the impact of smoking on health and wellbeing, and whether a person’s subsequent behaviour changes enough for them to stop smoking. Finally, it discusses the role of the healthcare professional in helping people to achieve this objective.
Education and training in tissue viability is readily available to all
Authors: D Foss Tara
Published: May 2014

When it comes to tissue viability and wound care, nurses are always on the front line. When things go wrong, the patient looks to the nurse to fix it. When the doctor diagnoses a wound infection, he or she looks to the nurse to treat it with specialist knowledge.
Unpacking the question of graduation
Authors: Karstadt Lyn
Published: May 2014

Into the New Year and I find myself asking whether the problems of 2008 will be different to those of last year, the year before, or any other year in recent memory? The first month of this year will certainly be frantic for many, with nurse educators marshalling their own staff and gently encouraging others to respond to the two consultations that I mentioned repeatedly in 2007
Pain management for the opioiddependent patient
Authors: Wintle Dawn
Published: May 2014

This article describes the development, introduction and implementation of ‘Guidelines for Pain Management in the OpioidDependent Patient’ in Yeovil District Hospital NHS Foundation Trust, Somerset. It incorporates the relevant background experiences within the organization and establishes the rationale for the development of the guidelines. An outline of the consultation processes with the different professional groups involved is given, together with the strategy for implementation across the Trust. This project challenged old ways of working and embraced new expanding roles. Indications are that both the quality of care and the patient experience have improved as a direct result of the implementation of these guidelines
Questioning the Council’s ability
Authors: Karstadt Lyn
Published: May 2014

Nursing and midwifery education has evolved over the past few decades, leaving many in the profession — as well as education — slightly confused as to what is going on. In her ongoing column, Lyn Karstadt discusses a report reviewing the performance of the Nursing and Midwifery Council (NMC) and discusses why it was so scathing on the NMC’s statutory function.
Reality of undertaking research: the experience of novice researchers
Authors: Barnes Rhian , Ward Susan , Edmunds Linda
Published: May 2014

The reality of conducting research can pose many challenges for novice researchers. The aim of this article is to describe novice researchers’ experience of conducting their first collaborative study and shows the difference between research as presented in texts and the reality of the experience. These differences include the policy-practice gap, which impacts on sample size; the reaction and motivation of nurses to be part of the study sample; and the collaboration between lecturers and clinicians. A brief overview of the research study is provided with a discussion of successes and challenges encountered.
Are we witnessing the deterioration of nursing?
Authors: Castledine George
Published: May 2014

Critical times occur in the history of a profession, when radical and searching questions need to be asked, and clarification is sought. Nursing today seems to be in that position where it is in danger of losing its direction and fundamental purpose. There are several possible reasons for this predicament in our practice and the loss of confidence in how to maintain our standards and traditional values. It is perhaps too simplistic to blame the political interference in health care and the economic stringencies we are going through. Even though we have never before been under such pressures regarding the funding of nursing care and qualified nurses, there is something else which is affecting nursing commitment. Perhaps it is our traditional professionalism in nursing that is changing and with it a new form of professional nurse is emerging.
Measures of outcome in patients with inflammatory arthritis
Authors: Palmer Deborah , Miedany Yasser El
Published: May 2014

Background: Musculoskeletal disorders account for 15–20% of general practitioner (GP) consultations and cause significant morbidity and disability. Although rheumatology nursing is regarded as a partnership between the practitioner and patient, it remains a relatively tough task to generate a letter summarizing the outcome of clinical assessment and decisions made regarding the patients’ management. Objective: To assess the validity of a developed pro forma letter that summarizes the outcome measures of patients suffering from inflammatory arthritis, as assessed in secondary care, and to assess the comprehensibility of this new model. Methods: The outcome measures of 184 patients with rheumatoid arthritis (99), as well as seronegative inflammatory arthritis (85) were reviewed. A pro forma was designed to summarize the outcome of the clinical assessment. Results: Fifty-five males (29.9%) and 129 (70.1%) females were included with a mean age of 44.3 years and standard deviation of 14.5 (age range 22–81 years); duration of illness was variable and ranged between 4 months and 28 years. The pro forma showed a strong validity when compared to patients’ data records (range 0.89–0.97). All GPs rated it as comprehensible (comprehensibility rate 80.8%). Conclusion: The pro forma is a valid instrument that can be used in clinical practice. It offers an option that is well accepted by rheumatology nurses, rheumatologists, as well as GPs. The letter was found to be a significantly better tool for informing GPs about patients’ medical condition, possible risks and management plan.
Professional regulation. Part 8: Government and NMC proposals
Authors: Fullbrook Suzanne
Published: May 2014

Two years ago, the Department of Health released a report entitled: Modernising Nursing Careers, Setting the Direction. The opening line in the forward of this report said: ‘no one can doubt that healthcare services across the United Kingdom are going through a period of profound change. In her message, which set the tone of the report, Christine Beasley, Chief Nursing Officer of England, said: ‘there have been medical advances that we could hardly imagined ... society is also changing ... people’s health and recovery is affected by a complex array of factors that bring added challenges. This article discusses the remit of Nursing and Midwifery Council (NMC) and its basis of statutory authority over its registrants, and begin to explore NMC’s position with regard to nurse education.
Learning disabilities is bigger than a cursory review
Authors: Caan Woody , Toocaram Jill
Published: May 2014

With funding from the Department of Health, a small team at King’s College London (Griffiths et al, 2007) has produced a ‘rapid’ review of a decade’s nursing research about learning disabilities. Its conclusion is that
A concept analysis examining the vulnerability of older people
Authors: Brocklehurst Hilary , Laurenson Mary
Published: May 2014

Many people associate vulnerability with old age, resulting in negative stereotypical views. This concept analysis of the literature on vulnerability examines how and why older people are considered vulnerable, to assess whether the attitudes and assumptions of society at large, or the approaches of health and social care professionals in particular, contribute to this view. The authors used data collected from the literature review, which incorporated holistic approaches to caring for older people, to construct a psycho-social definition of vulnerability and define the attributes of vulnerability according to categories, causes and effects. This definition was underpinned by theoretical knowledge and practice experience of working with older people and teaching nursing students about older people. Understanding the concept of vulnerability should enable nurses to recognize the centrality of older people in service provision, and to contribute positively to their autonomy and act as their advocates. It will also help nurses to educate older people about the rights and choices available to them, enabling them to participate fully in society.
Concerns about death and dying well
Authors: Castledine George
Published: May 2014

In recent years there seems to have been an increase in the number of patients taking direct control over the circumstances of their death. For example, the cases of the 13-year-old girl who has chosen to die rather than undergo a heart transplant operation, after spending much of her life in hospital; the young Worcestershire man who, following a rugby injury, was left so badly paralysed that he sought assisted dying in another country where it was legal to do so; and the woman with severe multiple sclerosis who challenged the law in Britain regarding assisted suicide.
Assessment and management of patients with pleural effusion
Authors: Allibone Liz
Published: May 2014

Pleural effusions are a common medical condition with a significant source of morbidity, and there are wide variations in management. Over the past 5 years there has been rapid advancement in the knowledge and treatment of pleural diseases and effusions. This article provides an overview of the anatomy and physiology of the pleural space and pleural membranes, and an update on assessment and management of patients with pleural effusions in line with new developments and related national guidelines.
Minority branches in the balance
Authors: Karstadt Lyn
Published: May 2014

Nursing and midwifery education has evolved over the past few decades, leaving many in the profession — as well as education — slightly confused as to what is going on. In this seventh column, Lyn Karstadt discusses the move to a ‘generalist’ education programme in the minority branches of mental health, learning disability and children’s nursing
What’s in your lunchbox?
Authors: Castledine George
Published: May 2014

How active are you at seeking out ways to alter your personal health habits and style of living? It would seem from recent government initiatives that there is now a gathering shift in mood towards either penalizing or rewarding people for their health behaviours. For example, refusing corrective surgery to people who do not follow the right instructions on healthy living, or rewarding those who are unhealthy if they improve their health with vouchers to spend on healthy food in supermarkets. The idea is that those who manage to lose weight could be given cash prizes
Shaping education for tomorrow’s workforce
Authors: Fox Jane
Published: May 2014

Recently I found myself reflecting on the maintenance of appropriate professional standards, and how it seems to emerge regularly as a substantial challenge or at least as an item worthy of public and professional interest. (Indeed one only needs to peruse recent editions of BJN to find evidence of this.)
The Mental Capacity Act 2005: children and young persons
Authors: Dimond Bridgit
Published: May 2014

In this final article of the series the author considers the extent to which the Mental Capacity Act relates to children. While the Act applies to those over 16 years, certain provisions only apply to those over 18 years: these are advance decisions, and the power to set up or be appointed under a lasting power of attorney. However, there are provisions which could apply to a child under 16 years old, if he or she is unlikely to have the requisite mental capacity at 16 years. There are powers set up to enable easy transfer of proceedings between the Court of Protection and the Family Division of the High Court and vice versa
An honest account or fuel for the media fire?
Authors: Cole Mark
Published: May 2014

Recounting his experiences of August last year, Lord Mancroft, the 50-year-old Vice-Chairman of the Countryside Alliance, has caused considerable controversy by suggesting that following his inpatient stay in the Royal United Hospital in Bath, it is a miracle that he is still alive.
Nursing aspects of phantom limb pain following amputation
Authors: Richardson Cliff
Published: May 2014

Phantoms (painless and painful) occur following the removal of virtually all body parts. Phantoms of the limbs, including phantom limb pain (PLP), are the most studied. As yet there is no agreed theory to explain phantom limb pain but the neuromatrix and cortical reorganization theories have come to prominence over recent years. Multiple treatment strategies have been applied to PLP; however, none of these strategies have been proven to be effective for the majority of amputees. As a result of knowledge acquired through the cortical reorganization theory, new avenues for treatment have opened up. These include pre-emption and normalization strategies which have significant nursing aspects. This article explores all of these issues and identifies the implications that they have for the nursing treatment of patients with PLP and those that are expected to develop it. This involves the care of people pre-, peri- and post-amputation. All aspects of phantoms and phantom pain need to be taken into account by nurses and other healthcare workers when planning rehabilitation packages for this group.
Duty of care and political expectations. Part 3: law and the new code
Authors: Fullbrook Suzanne
Published: May 2014

Current expectations of nurses, in terms of professional standards, are high. These expectations are dictated from Government manifesto literature from 1997–2001, which reveals the stark political agenda and political promises given to the electorate.Traditionally, the ‘standard’ expected of a professional was defined according to law – to the precedents set down in common law. Case law reveals that the standards expected of professionals may be different to those expected of nurses, as written in political literature. This article explores the definitions as found in the legal and professional literature. The Nursing and Midwifery Council’s Code of Professional Conductwill be reviewed, including the new Code (2008), in order to identify the basis for determining standards expected of, and by, nurses practicing in the clinical arena. The suggestion is that the current level of expectation of professional behaviour of nurses may relate more to the political agenda than the legal definition, and this has resulted in nurse confusion.
A centralized storage system for the delivery of subcutaneous infusions
Authors: Stuart Peter , Lee Jane , Arnold Gill , Davis Melanie
Published: May 2014

Symptom control is an important part of maintaining a palliative patient’s comfort and dignity, particularly in the end stages of their illness. Within the discipline of palliative care the use of continuous subcutaneous syringe drivers is an important way of administering drugs at the end stages of a patient’s illness to maintain symptom control. This study identified that ward staff had difficulty in obtaining the correct equipment, such as administration sets and Luer-lock syringes, leading to significant delays in patients being given drugs, affecting patient care and, when unable to obtain the correct equipment, the incorrect equipment was used. It was also identified that there was no consistent approach to the use or maintenance of syringe drivers, with a clear risk to patient safety. The study aim was to identify whether the introduction of a centralized storage system of set boxes containing all the relevant equipment would resolve these issues and improve patient care and safety. The audit showed that a centralized storage system enhanced practice by ensuring that there was a standardized approach to the initiation and care of syringe drivers, including equipment when used in the palliative care setting. The system also provided easy access to the correct equipment, reducing in the delay of commencing treatment, as well as the risk of any adverse events.
The use of language in nursing care
Authors: Castledine George
Published: May 2014

It’s not just what you say in nursing it’s also how you say it that matters. One of the problems of introducing nurses into a situation where they have only a basic grasp of the host country’s language is that it can lead to problems in the delivery of quality nursing care. For example, some patients have complained that in Britain it is difficult to understand clearly what some of the foreign nurses are saying. The shortages and expense of qualified nurses often leads to some countries admitting nurses who barely meet the minimum standard of the English language test. This can result in problems of communication, not only with the patient but also with the rest of the healthcare team.
Provision of products: should we be concerned?
Authors: Williams Julia
Published: May 2014

The field of stoma care and incontinence nursing is currently crossing murky waters while revisions are being made to the reimbursement and remuneration provision of stoma care and incontinence products. It will change the future of stoma care and incontinence nursing as we currently know it, and concerns have been highlighted within the media that these changes may well be detrimental to patient care (Staines, 2007).
Towards tomorrow, today
Authors: Williams Julia
Published: May 2014

This year’s World Congress of Enterostomal Therapy (WCET) conference to be held in Glasgow, Scotland, in October, is entitled Towards Tommorrow, Today. The philosophy of WCET highlights the need for nurse specialists in stoma care (or enterostomal therapists) to have dual responsibility for providing individualized care as well as sharing their knowledge, skills and expertise with all healthcare professionals with an interest in the patient with a stoma, wound or incontinence.
A new and practically challenging transition
Authors: Hudek Jenny
Published: May 2014

The transition from student nurse to staff nurse was never going to be easy, but as expected it has been a hard and interesting experience. I had never imagined that it would test me quite as much as it has. I was sure that doing a degree in nursing would fully equip me for life on the ward, but what I found in reality was that there are some things that you cannot learn as a student, and can only be experienced first-hand once working on a ward.