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How to support nursing students to develop community care planning skills
Care planning for patients is an important element of the nurse’s role, yet some nursing students may miss its relevance to their practice. However, they can learn many skills by care planning thoroughly in partnership with patients. They can also expand their knowledge of the wider aspects of holistic care, including the importance of empowering and educating patients.This article discusses how to structure care planning systematically and assists practice supervisors to guide nursing students working in the community in their learning, showing how to relate certain aspects of care to specific, measurable, achievable, realistic and timely (SMART) goals. The article also describes a structure for developing interventions for a care plan – professional values, assessment, treatment and education (PATE) – which nursing students can use to incorporate a chronological order into care that also encompasses health promotion.
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How to make clear and compelling written arguments: advice for nurses
Nurses are regularly required to make clear and coherent written arguments. Formulating arguments is an important element of academic coursework for nursing students, while nurses are required to demonstrate evidence of their learning, reflection and continuing professional development as part of their revalidation. Improving their practice knowledge and skills also requires nurses to reason and express themselves in writing. This article explains how context contributes to the formulation of arguments and how to differentiate between argument and opinion. It details how premises and supporting information are used to underpin an argument. The article uses a case study to demonstrate how a coherent written argument can contribute to practice improvement.
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Dengue fever
Dengue fever is a viral infection transmitted by mosquitoes. It is endemic in tropical and subtropical regions of the world but is beginning to emerge in other regions, including Europe. Many dengue-endemic countries are popular tourist destinations, so nurses should be prepared to discuss the risks of dengue and strategies to avoid contracting it with patients who are preparing to travel.Rachael Fletcher, travel nurse adviser, National Travel Health Network and Centre, University College London Hospitals NHS Foundation Trust, London, England
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Tracheostomy care in community settings
A tracheostomy can be a life-saving and life-giving procedure, but it can lead to complications that have serious consequences. In the lead author’s (CR) experience, there has been a noticeable increase in the number of patients leaving hospital with tracheostomies over the past two decades.This article will help community teams to recognise and plan for the many aspects to be considered when embarking on tracheostomy care in community settings. It identifies priorities of clinical care, offers advice about preparing the patient’s environment, and discusses the knowledge and skills required to deal with issues arising from tracheostomy. The aim is to enhance patient and carer confidence, and thereby promote independence, safety and quality of life.
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How nurses can promote well-being in personalised care
Between 2020 and 2024, personalised care will be made universal, improving the lives of approximately 2.5 million people in England. This article explores the role of well-being and happiness in health and care and what it can add to the concept of ‘what matters to me’.It describes the evidence detailing how stress affects health and well-being and the factors that enable people to survive and even thrive during challenging moments of their lives.The author examines how nurses can switch between assessing and meeting needs and enabling people to use their strengths to improve their well-being. Several examples of exceptional nursing care are provided and discussed, enabling readers to consider how they can develop their own initiatives to promote well-being in their practice.
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Compassionate leadership: how to support your team when fixing the problem seems impossible
Stress, suboptimal mental health and an inadequate work-life balance are underlying and serious issues in the nursing profession, affecting staff recruitment and retention and potentially having a detrimental effect on patient care.While compassion towards patients is central to the nursing role, often ‘compassion towards the compassionate’ is lacking. The need for compassion is even more important now, and in the months ahead, due to the additional stressors experienced by nurses during the COVID-19 pandemic, whether they are on the front line, furloughed or shielding.This article includes reflections from nursing staff and uses their stories to encourage reflection on ethical and moral dilemmas experienced during the pandemic. The Compassion in the Workplace model is suggested as a tool that can be used by nurse managers to examine their compassion levels and to support the development of a compassionate workplace. In addition, this article offers some practical ideas on what compassionate leadership might look like in day-to-day practice.
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Understanding and managing depression in older people
Clinicians do not always recognise depression in older people as they attribute symptoms to the ageing process and the effects of failing health. Similarly, older people do not always appreciate that their symptoms relate to their mood. Understanding how depression affects older people can improve access to support, thereby improving overall health and quality of life. To ensure these outcomes we need a workforce with excellent communication skills that supports therapeutic relationships, promotes recognition of symptoms, and enhances assessment, diagnosis, treatment and management.
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Extending the Newcastle Model: how therapeutic communication can reduce distress in people with dementia
This article identifies the importance of effective communication in delivering care to people living with dementia when their understanding of the situation may differ to ours. The Newcastle Model’s biopsychosocial framework is revisited to understand the context in which caregiving takes place, and the article goes on to consider the importance of communication to person-centred care delivery. The special case of lie telling or ‘therapeutic untruths’ as a communication tool is considered as an often essential way to join with the person’s reality, and the practical and ethical dilemmas this poses are considered.
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Using Benner’s model of clinical competency to promote nursing leadership
This article explores the concept of leadership in health and social care. All nurses have an important leadership role, which is reflected in the principles of the NHS Leadership Academy and in the new curriculum for nursing students. By critically applying the ‘novice to expert’ model of clinical competence to leadership, nurses are encouraged to consider the skills involved in moving from novice to expert alongside identifying the strengths and skills they wish to develop. Nurses are encouraged to reflect on leadership approaches operating in health and social care and to consider the type of leader they want to be. This article examines what expert or exemplary leadership might involve and some of the characteristics that are required. An expert leader can recognise their own values and beliefs, and the values and beliefs of those they lead and serve.
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Preventing and managing pressure ulcers in patients receiving palliative care
Pressure ulcers are more common in patients being cared for in palliative care settings than in the general population. Patients with life-limiting illnesses are living longer than ever before, and many present with multiple co-morbidities. Palliative care involves improving the patient’s quality of life by achieving a balance between treatment, comfort and maintaining dignity. The length of time required to heal pressure ulcers in this patient population can prove challenging, requiring significant resources and expertise. However, when the appropriate nursing expertise and resources are available, prevention, improvement and healing of pressure ulcers are achievable.
