bluuebunny/crossref_metadata_2025 huggingface dataset:
Bladder pain from indwelling urinary catheterization: case study
Authors: Nazarko Linda
Published: May 2014

Indwelling urinary catheters can cause severe pain and discomfort and can impair a person’s quality of life. Constipation can cause bladder emptying problems and pain if a catheter is present. If the person is constipated this should be treated. If there are no clinical indications for urinary catheterization the catheter should be removed. If the catheter is clinically necessary it may be possible for the person to use intermittent self-catheterization. If this is not possible the nurse should adopt a problem-solving approach to determine the reasons why pain is occurring. Ensuring that the catheter is the correct size, length and using an appropriate material reduces the risk of tissue damage and associated pain. Catheter drainage bags should be supported if used; this prevents traction and trauma that can lead to pain. A catheter is a foreign body and its presence may trigger bladder spasm and pain. This can be treated effectively with antimuscarinic drugs, but these should be used with caution and in small doses in older people. Treating bladder pain can make a huge difference to a person’s quality of life; however, it is important to discuss treatment with the patient and obtain consent and respect the person’s choices in relation to treatment.
Integrated continence services and the female Bangladeshi population
Authors: Wells Mandy , Wagg Adrian
Published: May 2014

Continence services should be developed to cater for the needs of the entire population, including those of ethnic minority groups. This study undertook focus groups and meetings with the local Bangladeshi community and with local GPs to assess the needs for continence care provision and to assess current understanding of the problem in this community. The aim was to identify appropriate models for provision of care.

Method: Questionnaires were devised which related to access to services for bowel and bladder problems for women and GPs. Focus groups which people’s views and suggestions on improving service accessibility were ascertained.

Results: A 50% return was achieved for the GP questionnaire. GPs did not routinely enquire about bladder and bowel function and did not feel that Bangladeshi women needed any different service to that in the white population. The majority of the women in the focus groups considered bladder weakness as a loss of selfcontrol, and emphasized the major impact on everyday life. There was little awareness of available services.

Conclusion: Despite the cultural differences this study found that women tended to accept their bladder problem; did not consider it important enough to discuss with their doctor (who may also not take the problem seriously) and considered bladder problems as a normal part of womanhood or ageing.
Evaluating an interview preparation process for student nurses
Authors: Tremayne Penny , Harrison Penny , Moriarty Abigail
Published: May 2014

m of this article is to share innovative practice in relation to the recruitment process for nurses. Quality of preparation offered to student nurses prior to interview was variable, therefore, a study day to equip student nurses with the necessary knowledge and skills for interviews was devised. The strategies employed include a range of teaching approaches. Student evaluation indicates that this interview preparation day was successful and popular, with a majority of students receiving immediate offers of posts. Recommendations for educators include addressing the recruitment process earlier within the curriculum and adopting some of the practises of a business school.
Performance indicators – a quest to improve patient care
Authors: Morris Clare , Pritchard Barbara
Published: May 2014

Nurses working in the field of tissue viability constantly strive to improve pressure ulcer prevention and management in their clinical areas, knowing that pressure ulcers cause pain and suffering to patients while costing the NHS millions of pounds to treat. The aim of this initiative was for the tissue viability team to develop an audit tool based on recently devised performance indicators. The purpose of the audit was to provide the mechanism for reviewing the quality of everyday care. The tool utilizes the ‘traffic light’ system to categorize the results. The initiative has improved clinical outcomes for patients and increased the awareness, education, knowledge and confidence of nurses in pressure ulcer prevention and management across a combined primary and secondary care Trust.
Incompetence and empty pockets: all in a day’s work
Authors: Young Lynn
Published: May 2014

A number of surveys recently carried out, exploring how general practice nurses (GPNs) are employed, have revealed much information that should make those of us who are obsessed with patient care, concerned. We should be concerned because a significant number of nurses employed in general practice report that it is not unusual for them to be asked by their employers to carry our nursing activities which they feel incompetent to perform
Care or harm: exploring essential components in skin care regimens
Authors: Voegeli David
Published: May 2014

Skin care is a fundamental aspect of basic nursing care, with the outcome of these interventions often used to gauge the quality of the care provided. However, possibly as a result of the ‘basic’ nature of this aspect of care, little attention has been paid to developing a firm evidence base to guide decision-making in this area. This is compounded by the wide variety of products now available, ranging from simple cleansers and moisturizers, to more complex agents that cleanse, moisturize and protect all in one, which adds to the confusion. This article explores the basic principles of skin care, and considers the evidence available to support the nursing interventions used, and the range of products available. Finally it suggests the adoption of clear skin care protocols, and recommends actions that should form part of these
Nursing interventions for preventing alcohol-related harm
Authors: Littlejohn Christopher , Holloway Aisha
Published: May 2014

Harrington-Dobinson and Blows recently provided a three-part series of articles on alcohol, its consequences for health and wellbeing, and the role of the nurse. Their third article outlined the health education and health promotion role of the nurse. They outlined basic principles for nursing practice in relation to the patient with alcohol dependence in the acute general hospital. The authors of this article believe that much more can, and must, be said in relation to the vital issue of nurses’ clinical interventions for alcohol. This article builds on the third article from Harrington-Dobinson and Blows by outlining, in more concrete terms, how nurses in all settings can effectively intervene with patients. It introduces the current evidence-based guidelines in this area and use the ‘consensus model’ contained within them to describe the process of effective alcohol intervention. Using dialogue examples to illustrate the research, the authors introduce the literature on brief interventions and motivational interviewing to the nursing audience
Cranking up the heat on sunbed use
Authors: Bailey Asa
Published: May 2014

A fairly reasonable comment I suppose, but also slightly concerning as it suggests that anyone who could be outside enjoying the sun might choose to be cooped up in a salon or ‘tanning parlour’ paying hard-earned cash to be slow roasted as the filling in a sunbed sandwich. Yet millions do. Regularly.
Professional regulation in nursing. Part 1: an introduction
Authors: Fullbrook Suzanne
Published: May 2014

The preceding articles in this series have addressed the issues that surround the legal principle of owing a duty of care to people. The articles discussed the underlying concept of the application of ‘standards’ to a nurse’s duty to people. Nurses owe to their patients and clients a duty that is underpinned not only by law (or legal principles) but also by reference to a more overtly political understanding. The purpose of this cluster of articles is try to identify how the Government has achieved its purpose of increasing the protection of the public (its underlying rationale for the changes brought to the health care professions). It is intended to approach this subject in a two-fold way: first, a descriptive perusal of government literature will be undertaken; second, in an chronological way, the responses from the health profession’s regulatory bodies will be elucidated by way of analysis.
Use of a modified OSCE to assess nurse practitioner students
Authors: Khattab Ahmed D , Rawlings Barry
Published: May 2014

Assessment of clinical competence in nurse practitioner programmes has been greatly advanced over the last 10 years by widespread use of the objective structured clinical examination (OSCE). This article describes a modified OSCE developed in a nurse education department at a specific university within the UK to standardize evaluation of the physical examination skills of nurse practitioner students. Stations comprise procedure stations, which require students to perform a ‘whole’ examination of the subject, and question stations, which are composed of two forms of viva, involving various cognitive activities. A number of other universities are currently using this modified OSCE as a tool for formative and summative assessment, as a learning resource, and to identify gaps and weaknesses in clinical skills.
Pandemic influenza: implications for infection control in hospital
Authors: Aziz Ann-Marie
Published: May 2014

The World Health Organization states that immediate action is needed to prevent a repeat of the 1918 flu pandemic, which killed an estimated 40 million people globally. The infection control team in hospitals are given responsibilities to implement plans to deal with an event if one should occur. Many healthcare facilities belonging to primary care Trusts and particularly hospitals have been ordered to release a pandemic influenza policy. It is a policy that states the clinical features attributable to avian influenza, its possible transmission and information on general infection control precautions. It is necessary for hospitals to be prepared in its management for a potential influenza outbreak and have the necessary resources to execute infection control practices. This article outlines the infection control precautions that need to be implemented in hospitals in the event of pandemic influenza, and the various practices to adopt when coming into contact with patients with signs and symptoms of influenza. Only by adopting the recommended infection control practices can we be assured that transmission will be minimized.
Tackling patient safety
Authors: Tingle John
Published: May 2014

It cannot be said that in today’s NHS that we have an engrained patient safety culture where patient safety is at the forefront of every nurse’s and doctor’s mind – it is not. Many nurses will not know of the Seven Steps to Patient Safety from the National Patient Safety Agency (NPSA, 2004), nor will many doctors. Their attention is focused on the everyday care of patients in often resource-challenged circumstances, while chief executives are largely focused on the delivery of targets and mergers. There are exceptions to this but patient safety initiatives have had to compete with the reality of an NHS in an almost constant state of reform for many years, and there is a limit to how many balls people can juggle at once.
Professional regulation. Part 7a: mechanisms of government control
Authors: Fullbrook Suzanne
Published: May 2014

Previous articles in this series have sought to present an historical chronology of events that have produced the healthcare environment of today. The government has been examined by reference to direct political materials and to the literature produced by the Department of Health. This article and the next aim to concentrate on a review of the current picture; of the mechanisms created by government designed to direct and oversee the regulation of certain sections of the healthcare workforce.
Why do nurses refuse to use interpreter services?
Authors: Thom Natasha
Published: May 2014

Nurses face several challenges when trying to provide care for patients with limited English proficiency. There are now a wide range of nationalities and languages spoken within the UK. Differences in language between patient and care provider can result in miscommunication, misdiagnosis and ineffective treatment plans (Divi et al, 2007). The Government has attempted to address the issue through legislation. The Race Amendment Act (2000) promotes inclusion, while respecting diversity. Subsequently, the Department of Health (2004a; b) argue that nurses need to provide an equitable service. This poses a challenge for healthcare staff in a multilingual society.
Is the cost of regulation spiralling out of control?
Authors: Castledine George
Published: May 2014

The cost of keeping your name on the Nursing and Midwifery Council (NMC) register is escalating every year, and it seems little is been done to explain or justify the costs. Recently, a colleague telephoned the NMC and asked for a breakdown of the expenditure so she could see where the money was being spent. Unfortunately, no satisfactory reply was offered (except some remarks about the spiralling costs of legal fees for professional misconduct cases).
The lion, the witch and the petri dish
Authors: Bailey Asa
Published: May 2014

The last time I heard the word ‘chimera’ was in a rather questionable Tom Cruise fi lm. Chimera was the deadly armageddontype virus that was going to kill the world unless somebody stopped it. In the real world, however, beyond its Greek mythological roots of being a monster and an amalgam of different animals – depicted as an animal with the head of a lion, the body of a she-goat, and the tail of a dragon – chimera is an animal or human which contains cells from a different animal or human (Human Fertilisation and Embryology Authority [HFEA], 2008). And as odd as it may seem, anyone who has undergone any kind of transplant or blood transfusion is a chimera because their body contains cells from a donor
Severe allergic reaction: management of anaphylaxis in hospital
Authors: Jevon Phil
Published: May 2014

Anaphylaxis is an acute, severe, hypersensitivity reaction that can lead to asphyxia, cardiovascular collapse and cardiac arrest. This reaction is sudden, severe, and involves the whole body. Common causes include foods such as nuts, shellfish, dairy products and eggs. Nonfood causes include bee/wasp stings, latex and drugs, e.g. penicillin. Common clinical features include urticaria, angioedema, respiratory distress and shock. Summoning expert help, reclining the patient flat, administering high concentration oxygen, and administering intramuscular adrenaline are key aspects of the nursing management of anaphylaxis in hospital. The aim of this article is to understand the management of anaphylaxis in hospital, with particular reference to national consensus guidelines
Achieving dignified care
Authors: Castledine George
Published: May 2014

Following a recent programme on Radio 4’s ‘Woman’s Hour’there was a large response to a discussion about the way older people were being cared for in various hospitals in the United Kingdom. The programme included a poem that features in a 10-minute video called ‘What Do You See Nurse?’ made by actress Amanda Waring. As the daughter of Dorothy Tutin, who died in 2001, she watched her mother suffer at the hands of many nurses, in various hospitals. She was so appalled that she decided that she would make a film to help change the attitudes of all carers who came into contact with older people. If you have not seen the film then I can highly recommend it to you as I have used it many times in the training and education of nurses and students over the past year
Patient choice, but at what price?
Authors: Bailey Asa
Published: May 2014

on 5 July 1948 the birth of the NHS saw the opening of Park Hospital in Manchester, the climax of Aneurin Bevan’s ambitious plan to bring good healthcare that is free at the point of delivery to all citizens of Great Britain. Sixty years later, the very same NHS is refusing patients life-saving drugs, and then penalizing them for acquiring the drugs elsewhere. Not quite what Aneurin Bevan had in mind, I imagine.
Let’s talk about sex
Authors: Fallon Debbie
Published: May 2014

although biological reproduction forms part of the national curriculum, the provision of sex and relationships education (SRE) in English schools is not compulsory. This subject has been entrenched in moral and social issues for at least two decades, with disagreement between those who advocate early formalized sex education and those who believe this may encourage promiscuity. Individual school governing bodies decide whether sex education should form part of the curriculum, but even if it is provided, the focus on anatomy/physiology often overshadows the emotional and social aspects. Furthermore, parents have the legal right to withdraw their children from these sessions if they wish.
Increasing the uptake of cervical screening programmes
Authors: Gannon Maria , Dowling Maura
Published: May 2014

Successful cervical screening programmes depend on the degree of coverage and the rate of attendance. There are many demographic reasons why some women fail to attend for cervical screening, including lack of knowledge and education and socioeconomic status. Moreover, a woman’s ethnicity and her age also play a role in screening uptake. Community and practice nurses are ideally positioned to identify women’s information needs and provide appropriate information to overcome barriers to screening attendance. This article discusses the main predictors of participation in cervical screening programmes and interventions that can be used to increase cervical screening uptake.
Bladder cancer and smoking. Part 3: influence of perceptions and beliefs
Authors: Anderson Beverley , Naish Wendy
Published: May 2014

This is the third of a four-part series on bladder cancer and smoking. Part one examined the risks factors for bladder cancer, emphasizing that although there are many risk factors, smoking is the main predisposing factor for the disease. Part two presented an overview of bladder cancer, including diagnosis and management of the disease. Part three seeks to determine the extent to which people’s concept of what constitutes good health is influenced by their perceptions and beliefs. It then looks at whether educational support, specifically health promotion and health education, are effective in increasing the individual’s awareness of the dangers of smoking for their health, and consequently in changing existing behaviours or dissuading them from becoming future smokers.
Consequences of workplace violence directed at nurses
Authors: Chapman Rose , Perry Laura , Styles Irene , Combs Shane
Published: May 2014

The consequences of workplace violence (WPV) are far-reaching, and impact on the nurse, the perpetrator and the organization. However, the authors were unable to identify any research in the literature on nurses’ perceptions of the consequences of WPV in non-teaching hospital settings. This study therefore aimed to examine nurses’ perspectives of the consequences of WPV, to identify ways to reduce the impact of these incidents. A descriptive, exploratory approach was adopted to collect qualitative survey and interview data from nurses working in several areas of one West Australian non-teaching hospital in 2006. Three themes emerged from the data: nurse, perpetrator and organizational consequences. The sub-themes included nurses accepting that WPV is part of their job; physical and emotional effects; not feeling competent; avoiding patients; organizational costs of WPV; adverse effects of restraint; and disruption to patient care. Participants experienced several negative consequences as a result of WPV. Recommendations for improving the safety of hospitals for staff and patients are made in light of the findings.
Reducing the risk of needlestick injury
Authors: Bailey Asa
Published: May 2014

The increase of incident reporting in hospitals in recent years, and the way these incidents are dealt with, have contributed to patient safety becoming one of the hot topics of the early 21st century. An important and necessary issue to tackle, yes, but has the safety of nurses been cast aside in the pursuit of patient safety?
Nurse training and disabled students
Authors: Roberts Lorraine
Published: May 2014

This question comes from Sally, a 23-year-old girl who has a spinal injury, independently uses a wheelchair to get around but cannot stand. What is your first reaction? Yes? No? Maybe? This should be an easy question to answer but current legislation and guidance, or in some cases the lack of it, make it extremely difficult.
Nutrition through the life-span. Part 2: children, adolescents and adults
Authors: Anne Shepherd Alison
Published: May 2014

A healthy child who achieves both their peak of physical fitness and their optimal nutritional status is more likely to progress through the life-span as a healthy adult. However, children, adults and older adults in the UK are failing to achieve both adequate nutritional and fitness status. Individuals are now living longer due to improved social conditions and advances in medical care. Despite this, many children, adults and those aged 65 years and over are suffering from malnutrition or obesity. The second part of this article seeks to educate healthcare professionals regarding the nutritional requirements for school-age children, adolescents and adults between the ages of 19 and 64 years. The nutritional requirements of older adults aged 65 years and over, including a review on nutritional support within this age group, will be addressed in a further article. Healthcare professionals have a responsibility to assist the population in achieving their optimal nutritional status. This may be achieved through health promotion, which, if appropriate, may instigate and sustain behavioural change in relation to both nutritional habits and physical exercise.
Third-level nurse education: learning from the Irish experience
Authors: Ryan Denis
Published: May 2014

Nursing and nurse education is rapidly changing internationally. The profession and the different branches of practice have moved in a relatively short period of time from a ‘handmaiden’ status to have an evolving professional standing as equal members of interdisciplinary teams. This has coincided with the evolving trend to locate nurse training programmes within the higher education sector. Differing models of nurse preparation exist internationally, but there is an inexorable trend to higher education. Ireland has moved away from traditional ‘hospital-based’ schools of nursing in the past decade or so to a system of universal preparation of nurses within higher education structures. Unlike many other countries, entry to any branch of nursing in Ireland now requires honours degree level education. It seems timely, therefore, to consider the lessons that can be learned from this development and consider the key challenges that face nursing, the healthcare system and the higher education system as a result of this development.
Antimicrobial resistance or resisting responsibility?
Authors: Bailey Asa
Published: May 2014

And so it begins – barely 2 months into 2008 and already the number of newspaper column inches racked up by a selection of NHS Trusts regarding shoddy infection control procedures and meticillinresistant Staphylococcus aureus (MRSA) rates is snowballing. Happy New Year! And unfortunately, everyone involved has been lightening quick to apportion blame – the Government now blames patients for being too pushy when asking for antibiotics, patients blame hospital staff and cleaners for not doing their jobs properly, hospital staff apparently blame the cleaners and upper management, and management blame everyone but themselves. Is it not time for everyone involved, including patients, to realize that it is everyone’s responsibility?
Getting to grips with migraine and headache
Authors: Anthony Alli , Rickarby Liz
Published: May 2014

More prevalent than diabetes, epilepsy and asthma combined, migraine is the most common neurological condition in the developed world. Migraine affects at least 6 million people in the United Kingdom (UK). An estimated 190 000 people have a migraine attack every day in the UK, and more than 100 000 people are absent from work or school every day as a result of migraine. Yet, 50% of sufferers never consult their GP, and of those who do, less than half are satisfied with the care they receive
Huntington’s disease. Part 1: essential background and management
Authors: Aubeeluck Aimee , Wilson Eleanor
Published: May 2014

Huntington’s disease is a neurodegenerative disorder that manifests in motor, cognitive and behavioural symptoms, gradually progressing over a number of years, if not decades. The complexity and unpredictability of the disease poses challenges for health-and social-care professionals. This article provides an essential background to the understanding and management of care for people with Huntington’s disease, presenting a discussion of the main stages to highlight the symptoms and challenges associated with the disease. The article then moves on to discuss potential management and therapy issues identifying some key considerations in the treatment of the disease. Finally, the combined role of the multidisciplinary team is highlighted in providing health and social care to people with Huntington’s disease as it progresses and increasing professional support is required.
Patients’ experience of privacy and dignity. Part 2: an empirical study
Authors: Whitehead Juliet , Wheeler Herman
Published: May 2014

In May–June 2006, a self-report questionnaire was completed by 40 inpatients to assess their experience of privacy and dignity in hospital. The questionnaire comprised closed and open questions, where the latter, among other things, required the patient’s own narrative. Results indicate that patients view privacy/dignity as crucial. Although the staff and inadequate ward layouts compromise and conspire against patients’ privacy and dignity, patients appear to sympathize with how hospitals are run, even if the caring environment fails to provide full privacy. Women have greater concerns, and both genders indicated how their privacy and dignity could be met. Recognizing problems relating to meeting patients’ privacy and dignity, the article challenges clinical staff and hospital designers to address the issue, especially as central government initiatives and law demand serious attention to ensuring patients’ privacy and dignity. Research is indicated to ascertain hospital designs, preferred care strategies and education to address the problem.
Nurses’ knowledge of constipation in people with learning disabilities
Authors: Marsh Lynne , Sweeney John
Published: May 2014

Constipation is considered a preventable problem in health care, yet this condition has received little attention in terms of preventive interventions and management in people with intellectual disabilities. While constipation is acknowledged as an important general health issue for this population group, symptoms are frequently masked as the intellectual disability often takes precedence, resulting in diagnostic overshadowing. Underestimations of the condition may result in delays in recognition and treatment which are further compounded by an inability among people with an intellectual disability to express discomfort verbally. Long-term, untreated constipation can have serious and potentially life-threatening consequences if symptoms go unrecognized or are not treated promptly. Therefore, all registered nurses supporting people with intellectual disabilities must possess an in-depth knowledge of the condition to be able to prevent and manage this common condition.
Galvanising the role of learning disability nursing
Authors: Barber Chris , Garnham Liz , Lovell Sandy , Camus Heather , Persaud Michelle
Published: May 2014

Welcome to the first edition of the BJN Learning Disability Supplement, a supplement which has been sadly and regrettably missing from the pages of the BJNfor a number of years. First, I would like to introduce you to the supplement’s editorial board. Heather Camus is a registered learning disability staff nurse working in Devon. Sandra Lovell is a learning disability senior healthcare assistant with about 25 years experience of working with people with learning disabilities. Liz Garnham is a mother of two teenagers with Asperger’s syndrome. Michelle Persaud is director of learning disability nursing services in Nottingham and also current Chair of the Royal College of Nursing’s (RCN) Learning Disability Forum. Lastly, Chris Barber (me), is a learning disability registered nurse of many years standing, a parent of a teenage son who has Asperger’s syndrome. I also considers myself to be an emerging Asperger’s.
Joined-up thinking: enthusing frontline clinicians
Authors: Eustice Sharon
Published: May 2014

Many specialist clinicians in the field of continence have preached about the importance of clinical assessment, yet it is still poorly done and services struggle to enthuse frontline clinicians of the importance of classifying common conditions that lead to the symptom of incontinence. A recent Royal College or Physicians audit of continence care in older people across the United Kingdom (UK) found that care was inadequate for the over 65s (Wagg et al, 2006). Even if guidelines for best practice are available, education must accompany this to support staff in delivering therapeutic care (Coffey et al, 2007).
A natural history and framework for managing diabetic foot ulcers
Authors: Edmonds Michael
Published: May 2014

When treating diabetic foot ulcers it is important to be aware of the natural history of the diabetic foot, which can be divided into five stages: stage 1 – normal foot; stage 2 – high risk foot; stage 3 – ulcerated foot; stage 4 – infected foot; stage 5 – necrotic foot. This covers the entire spectrum of foot disease but emphasizes the development of the foot ulcer as a pivotal event in stage 3, demanding urgent and aggressive management. Diabetic foot wound care in all stages needs multidisciplinary management to control mechanical, wound, microbiological, vascular, metabolic and educational aspects. Achieving good metabolic control of blood glucose, lipids and blood pressure is important in each stage, as is educational control to teach proper foot care appropriate for each stage. Aggressive management of diabetic foot ulceration will reduce the number of feet proceeding to infection and necrosis and thus reduce the number of major amputations in diabetic foot patients.
Cycloidal vibration for the treatment of cellulitis in a community setting
Authors: Tyrer Alison , Thornalley Claire
Published: May 2014

Cellulitis of the lower limb is a common infection seen in primary care resulting in a significant number of hospital admissions per year. The NHS is proposing and developing services to treat patients more effectively in the community to prevent hospital admission. Cycloidal vibration (CV) therapy is a medical device that when combined with standard antibiotic therapy for cellulitis results in an effective treatment. This retrospective analysis is a review of patients with cellulitis seen in a community medical centre before and after the introduction of CV therapy. This therapy in conjunction with antibiotics resulted in the successful recovery of patients with cellulitis that previously required hospital admission for treatment. As a consequence a significant reduction in the cost of treating these patients has been determined.
A concept analysis of nurse–patient trust
Authors: Bell Liz , Duffy Anita
Published: May 2014

The aim of this article is to provide a greater understanding of the term ‘trust’ in relation to the nurse–patient relationship through the use of Rodgers’ concept analysis framework. The concept of trust is of particular interest to nursing as it has been identified as an important element in the nurse–patient relationship; however, the concept is loosely used in everyday discourse with confusion apparent and the true meaning of the concept of trust unclear. Patients’ trust in the nursing profession cannot be taken for granted simply due to a requirement for nursing care. This article describes and examines the attributes, antecedents and consequences of trust in nurse–patient relationships in order to clarify the meaning and improve the current nursing knowledge base.
Focus on dementia research is missing the point
Authors: Beckford-Ball Jason
Published: May 2014

Dementia care is big news at the moment and it feels like every day there is another news story detailing a fresh technique for keeping those ‘senior moments’ at bay.
Stiff upper lip is driving male cancer rates
Authors: Beckford-Ball Jason
Published: May 2014

As the saying goes, men are from Mars and women are from Venus, and judging from the welter of statistics that have emerged recently about the respective disease profiles of the two genders, the difference between the males and females of the species is not just confined to sexual politics.
Damned if we do, damned if we don’t
Authors: Black Peter
Published: May 2014

Bad press is better than no press. I think the NHS will staunchly disagree. Across the Atlantic, right-wing healthcare pressure group, Conservatives for Patients’ Rights, has launched a series of television adverts attacking the NHS, in a bid to undermine Barack Obama’s healthcare reforms. It seems Americans are split over private and public health care. They agree that change needs to take place, but exact details on improvement are ubiquitous to say the least.
Principles of non-invasive ventilation: a critical review of practice issues
Authors: Pertab Dhanishwar
Published: May 2014

This article is the second of a two-part review on mechanical ventilation, with particular emphasis on the practice of non-invasive ventilation. Part 1 explored the principles underpinning artificial ventilation. It went on to explain the difference between positive and negative pressure ventilation, and differentiated between invasive and non-invasive modes of ventilation. Finally, it examined the various operational features, flexibility in use and limitations that artificial ventilation therapy presents. In this second part, the article focuses on the practice of non-invasive ventilation. It addresses the indications and contraindications, patient selection, initiation, maintenance, weaning processes, and problems specifically associated with non-invasive ventilation. Practical remedies are explored and potential areas for research are indicated.
Accessories or necessities? Exploring consensus on usage of stoma accessories
Authors: Rudoni Caroline , Dennis Heather
Published: May 2014

Usage and opinion of accessory products in stoma care vary enormously. The aim of this study was to identify what constitutes an accessory product and to find out whether there is any standardization regarding their recommendation. Views of both patients and stoma nurses were examined. Patients identify accessory products as being necessary both physically and psychologically in improving their quality of life. While stoma nurses identify that the psychological effects of having a stoma should never be underestimated, there is still concern regarding the cost of recommending these products and their clinical necessity. It would appear that clinical necessity is based on nurses’ opinions and is not always evidence or research based. Since accessory products have been shown to be essential to many patients with a stoma, should stoma nurses be more empathetic when considering their recommendation?
The dangers of using Google as a diagnostic aid
Authors: Black Peter
Published: May 2014

Abit better than tossing a coin. That’s the odds of Google searches revealing the correct diagnosis. A study by Tang and Ng (2006), to determine how often searching with Google leads to the correct diagnosis, found that in 15 cases (out of 26) it was correct.
The impact of the NHS (Charges to Overseas Visitors) Regulations (1989)
Authors: McLeod Amy C
Published: May 2014

This article discusses the NHS (Charges to Overseas Visitors) Regulations 1989 and subsequent amendments in relation to refused asylum seekers. It explores the impact of the regulations on the health care experienced by this group. The regulations have been chosen because of their contentious nature in relation to refused asylum seekers (Amnesty International, 2004). First, the evidence and rationale behind the formation of the regulations is examined. The article then considers how the restricted access to health care impacts on the health of refused asylum seekers and how this relates to international law. Lastly, it discusses inconsistencies within the regulations
The global melt-down: implications for nursing
Authors: Maynard Alan
Published: May 2014

Due to inadequate regulation of the banking sector, the credit base of most countries has been severely damaged. Current pessimistic forecasts indicate that this may cut national income by 5–10% in 2009. If this were to happen, this would mean either considerable unemployment and/or reductions in our incomes. Furthermore, while the Government can run a large budget deficit in the short-term to attempt to restore the economy, in time the deficit will have to be reduced by tax increases and public expenditure cuts.
The legal system. Part 1: it’s not just for lawyers
Authors: Boylan-Kemp Jo
Published: May 2014

This article is the first of two providing an introduction to the foundational elements of the English legal system. The ‘English legal system’ is a rather generic term that is often used to refer to the different sources of law and the court system in which the law is practiced. Students of law will study the English legal system as a specific topic, but it is as equally important for those who work within a profession that is regulated by the law (as nursing is) to also develop an understanding of the legal boundaries within which such a profession works. Part one, therefore, will consider the matters that form the cornerstone of our legal system, such as the constitution, and it will also explain the specific legal terms and doctrines that influence how our law is made and developed. Part two will then go on to consider the different sources of law that can be found within the English legal system. The aim of these articles is to describe these principles in a way that makes them easily understandable by those who are not involved with practicing law but who instead work within other disciplines, such as nursing.
Tough start to the New Year
Authors: Castledine George
Published: May 2014

Work at this time of year is never easy for nurses, with the usual winter pressures exacerbating post-Christmas blues. This year seems to have been especially difficult, with many health resources stretched to their limits. One of the main causes has been a variety of nasty bugs, affecting all age groups, but especially the vulnerable. Some hospitals have been pushed to the limits and have had to close wards because of the effect of the norovirus.
A sensible approach to obesity? Fat chance
Authors: Haslam David
Published: May 2014

At the same time levels of obesity in the UK are rising at an astonishing rate, (having trebled since 1985) (Department of Health (DH), 1991; 2009), attitudes towards obesity are becoming just as difficult to comprehend. Ipswich’s Paul Mason, who recently hit the tabloids as The World’s Fattest Man, couldn’t cook for himself, or access food in any other way at over 440 kg and confined to his bed; yet he somehow remained a compulsive eater. What went through the minds of the people providing his enormous calorific intake? Would it have been considered to be discrimination against him to withhold food rather than accelerate his impending demise by feeding?
Plans to make nursing allgraduate: the debate continues
Authors: McGrory Charlie
Published: May 2014

Earlier this month, the Government approved plans to ensure all new nurses are degree educated. The Royal College of Nursing welcomes the change, Unison are unsure, and nurse opinion is divided. BJN was overwhelmed with letters on this historic change, and here is just a small representation of the letters we received.
Investigation and management of congenital hyperinsulinism
Authors: Gilbert Clare
Published: May 2014

Insulin is a powerful hormone produced by the beta-cells in the pancreas. Its major function is to regulate blood glucose levels, facilitating the transport of glucose into the body’s cells. Congenital hyperinsulinism is characterized by the presence of insulin that is inappropriately high for the concentration of blood glucose. Because high levels of insulin also switch off all alternative fuels for the brain to use, this condition can cause brain injury if not detected quickly. Nurses are in a unique position by the bedside to identify the symptoms and treat the hypoglycaemia through very simple nursing interventions, such as safe administration of glucose and frequent blood glucose monitoring. Congenital hyperinsulinism can be transient or persistent. Persistent congenital hyperinsulinism can be further divided into focal or diffuse disease. Focal congenital hyperinsulinism can now be cured, and the management of congenital hyperinsulinism has radically changed with the help of genetics and research. Now pancreatectomy surgery is only used as the last resort.
Modern negligence law: Contribution of the medical cases
Authors: Hodgson John
Published: May 2014

The law on medical negligence is part of the law of negligence generally. It has played a significant part in developing two key aspects of the law. There are special rules to determine the standard of care expected of experts when advising and solving problems, and medical cases have largely shaped the law. Although cases on causation may arise in any area, several of the key cases happen to be medical ones. They are particularly likely to assist where there are alternative causes, as it is often difficult to distinguish the effects of disease from those of inappropriate treatment.
An evaluation of nurse prescribing. Part 1: a literature review
Authors: Creedon Rena , O’Connell Elizabeth , McCarthy Geraldine , Lehane Brenda
Published: May 2014

Background: Prescriptive authority for nurses was first introduced by America in 1969, followed later by the UK, Canada, New Zealand, Australia and Sweden. A review of research conducted internationally was performed to inform the development of prescribing policies and practice and to guide future research. Aims: This article, the first of a 2-part literature review, aims to provide a summary of the research conducted in relation to nurse prescribing and confidence in prescribing, the impact of prescribing on relationships, and education for prescribing. Method: A number of electronic databases were searched in March 2009 and 155 results were retrieved. Forty-four studies satisfied the criteria for inclusion. Twenty-two of these studies are included in this part of the review. Findings: Seventeen studies were UK based, with USA, Australia and Sweden represented by a minority of studies. Seven studies addressed nurse prescribers’ confidence, while eight studies focused on the impact nurse prescribing has on interprofessional relationships. The final seven studies addresses the knowledge base and educational preparation of nurses for the prescribing role. Conclusion: This review has demonstrated the diversity of research conducted in the area of confidence in prescribing, interprofessional relationships and education. It has identified areas which require further investigation, which will inform the future development of nurse and midwife prescribing.
Clostridium difficile infection: A critical analysis of the guidance
Authors: Aziz Ann-Marie
Published: May 2014

A recent report by the Department of Health, Clostridium Difficile Infection: How to deal with the problem – a board to ward approach, is a revised set of guidelines based on best practice and key recommendations for the NHS to ensure the control of Clostridium difficile infection (CDI). It takes into account a national framework for clinical governance which did not previously exist, a framework that gives significant weight to infection control as a matter of patient safety, and highlights that all clinicians have a personal responsibility for infection prevention and control. It puts the onus on Trust management and PCTs to ensure that measures are in place to prevent and manage CDI according to best evidence. However, the report fails to explain how these measures will have an impact on finance and resources on an already burdened system. The author explains how much of the report is comparable with the one published in 1994, and highlights many of its limitations within the busy hospital setting. Reducing CDI is achievable, as many hospitals are showing large reductions in their CDI rates. Healthcare workers must be applauded for their success in reducing CDI, but there is more to be done.
The changing patient
Authors: Castledine George
Published: May 2014

It is interesting to see how the person behind the ‘patient’ has changed with the development of the modern health service. Many textbooks paid little attention to the individuality and sensitivity of the patient who was the focus of many nursing procedures and functions. Even the Handbook for Ward Sisters (Scales, 1952), which devoted 16 pages to the subject, refers to ‘The Patient’ like an object that is passed around and cared for by nurses who should know what to do at various stages or steps in the busy routine of hospital life.
New guidelines on assisted suicide: will nurses be prosecuted?
Authors: Smith Stephen W
Published: May 2014

In the recent decision by the House of Lords, in R (on the application of Purdy) vs Director of Public Prosecutions, the Director of Public Prosecutions was directed to publish a prosecutorial policy on when to seek charges under Section 2(1) of the Suicide Act in cases relating to assistance with dying. Consistent with that decision, the Director of Public Prosecutions published an interim policy in September. This article describes the purpose and scope of that policy. It further provides an analysis of the factors relating to prosecution, which are included in the DPP’s guidance. Finally, the effect that the guidance may have on healthcare workers is considered.
The place of religion in nursing practice
Authors: Pollard Tom
Published: May 2014

There are few topics more likely to raise the temperature of a conversation than religion. Whether you adhere to a faith or – like me – choose not to, you will have an opinion on its place in society, in education, or in the workplace.
A positive impact on recruitment
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 regular column, Lyn Karstadt considers the impact of the recession on applications to nursing schools, perceptions of the nursing profession, and whether attaining graduate status may change these.
New strategy for improving dementia care in the UK
Authors: Hunt Neil
Published: May 2014

The Government’s much-anticipated national dementia strategy (Department of Health, 2009), which was launched in January, marks a significant change in the way dementia care is viewed in the UK. The Strategy sets out 17 recommendations under four themes, which have the potential to revolutionize how we care for people with dementia in the UK. The four key themes are: