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Respiratory assessment: undertaking a physical examination of the chest in adults
Nurses frequently encounter patients in respiratory distress or with respiratory complications, whether from acute disease or a long-term condition. A physical examination of the chest should be conducted as part of a comprehensive respiratory assessment of the patient, and should follow a systematic approach that includes inspection, palpation, percussion and auscultation. Nurses undertaking these hands-on components of respiratory assessments need to have adequate knowledge of the procedures involved, as well as practical skills that need to be practised under supervision. This article outlines how to undertake a physical examination of the chest in adults.
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Practising cultural humility to promote person and family-centred care
The concept of cultural humility in nursing involves an awareness of diversity and how an individual’s culture can affect their health behaviours. Nurses can use this awareness to develop sensitive, tailored and person-centred approaches to patient care, which ultimately contribute to a positive healthcare experience. This article examines the concept of cultural humility with reference to person and family-centred care. It also explores how individuals and organisations can challenge discriminatory attitudes and behaviours in the workplace.
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Heel pressure ulcers: understanding why they develop and how to prevent them
Because of its anatomical location and the fact that it has no muscle or fascia and little subcutaneous tissue, the heel is highly vulnerable to pressure damage and pressure ulcer development. Heel pressure ulcers are often severe and challenging to heal. Heel pressure ulcers are caused by factors such as pressure, shear and friction and the vulnerability of the heel to pressure damage is increased by immobility, the patient’s skin status, the presence of previous pressure ulcers and/or scar tissue, and suboptimal tissue perfusion. The risk is also increased in patients with diabetes mellitus. The role of nurses includes assessing the risk and preventing the development of heel pressure ulcers. This article discusses the causes of, and risk factors for, heel pressure ulcers and describes techniques and devices that nurses can use to prevent them.
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Enhancing the care of transgender and non-binary patients through effective communication
There is increasing evidence to suggest that transgender (trans) and non-binary people encounter significant societal discrimination, stereotypical and misleading representation in the media, and frequent misgendering. They may also experience several barriers to accessing healthcare, as well as discrimination from staff and other patients. This article explores how and why trans and non-binary people experience discrimination, and discusses how healthcare professionals, including nurses, can enhance the care experience for these patients, with a particular emphasis on language and communication.
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Identifying people with deteriorating mental health using a mental state assessment
Research indicates that approximately one in six people will experience a common mental health condition such as depression or anxiety, while people with severe mental illness commonly experience significant health inequalities. Nurses will come into frequent contact with people experiencing mental health issues in hospitals and in the community. Mental state assessment is a tool that enables nurses to develop an understanding of an individual’s mental health that will be universally recognised across healthcare services. This article provides an outline of the various elements involved in a mental state assessment, so that clinicians such as non-mental health nurses can identify people experiencing deteriorating mental health.
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Managing the effects of cancer and cancer treatments on patients’ nutritional status
Adequate nutrition is a basic requirement of the human body, supporting cell growth and optimal organ function. The nutritional requirements of patients with cancer can increase due to systemic inflammatory responses caused by cancer and cancer treatments. Nurses have an important role in providing nutritional interventions to patients undergoing treatment for cancer, through education and person-centred nutritional care. This article examines which nutritional interventions provided by nurses can relieve symptoms and side effects, improve nutritional status and enhance quality of life in patients with cancer.
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Recognising the importance of language in effective pain assessment
Pain is a highly personal experience that can be challenging to define. In addition, evidence has indicated that the assessment of pain by healthcare professionals is often suboptimal and its severity often underestimated. In clinical practice, the use of language can be a significant influencing factor in the effective management of pain, with terms such as pain, discomfort and comfort used interchangeably. This article explores how language can both act as a barrier to, and assist, nurses to understand the patient’s pain experience.
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Early diagnosis and effective management of sepsis
Sepsis is a complex condition defined as one or more life-threatening organ dysfunctions caused by a dysregulated host response to infection. Nurses have a vital role in the early identification of those with or at risk of developing sepsis. Prompt early treatment delivered using care bundles such as the ‘sepsis six’ can optimise patients’ chances of survival and reduce the debilitating effects of this condition.
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Understanding the causes, symptoms and effects of young-onset dementia
Young-onset dementia refers to dementia that develops before the age of 65 years. It can present with a wide variety of symptoms including cognitive, behavioural, neurological and systemic symptoms, which reflects the wide range of possible causes. Young-onset dementia profoundly affects all aspects of people’s lives, including relationships, employment and finances, and it will also profoundly affect relatives and carers. This article outlines the causes, symptoms and effects of young-onset dementia and describes the role of nurses in providing care and support to people with this progressive condition.
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Understanding equality and diversity in nursing practice
Equality and diversity are terms that are used frequently in nursing, healthcare and workplace settings. Nurses’ professional standards of practice and behaviour are underpinned by values of equality and diversity. This means that nurses must treat people as individuals, avoid making assumptions about them, recognise diversity and individual choice, and respect and uphold their dignity and human rights. This article explores what equality and diversity mean in nursing practice, the legal framework that underpins these terms, and the inequalities and discrimination that patients and staff may experience in health and social care settings. It discusses the role of organisational culture in supporting nurses to uphold the values of equality and diversity and encourages nurses to reflect on this topic to enhance their practice.
