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Role of the nurse in acute stroke care
The recognition of stroke as a medical emergency, provision of specialist services and advances in treatments have contributed to a decrease in stroke-related mortality, but the incidence and burden of stroke continue to rise. A stroke is a life-threatening and life-limiting event, but prompt identification and early treatment can reduce mortality and disability, and enhance the recovery and rehabilitation potential of survivors. Nurses working in acute stroke services have a wide-ranging role that includes assessment, identification and monitoring, as well as rehabilitation, psychological support and end of life care. This article provides an overview of the diagnosis and management of strokes and transient ischaemic attacks, and describes the role of nurses in acute stroke care.
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Basic life support for children and young people with a learning or physical disability and an altered body shape
The number of people with complex health needs is increasing and this includes children and young people with a learning or physical disability. People with a learning or physical disability are at an increased risk of developing an altered body shape due to their lack of movement, which typically affects the chest. This has implications for healthcare professionals who may be required to provide basic life support (BLS) to such people.This article considers how the delivery of BLS for children and young people with a learning or physical disability and an altered body shape may need to be modified while still complying with the Resuscitation Council (UK) paediatric and adult BLS guidelines.
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Responding to people who are experiencing spiritual pain
This article explores the spiritual pain that patients may experience, which is often hidden or overlooked in healthcare settings that tend to focus on managing physical manifestations of pain. As part of their role in responding to patients’ needs, nurses need to be willing to engage with spirituality, which is an important aspect of many people’s lives. This article examines the meaning of spirituality and how spirituality may – or may not – relate to religious beliefs. It describes a whole-person approach to understanding the physical, social, emotional and spiritual dimensions of pain, and how this may assist nurses in recognising and addressing patients’ spiritual needs. The article also explores attributes, skills and resources that can support nurses in responding to spiritual pain, including a caring presence, courage, compassion, and respect for other people’s beliefs and values.
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Implementing trauma-informed care in mental health services
It has been recognised that trauma underpins several mental health conditions, and that retraumatisation, in which a person re-experiences a traumatic event, is common in mental health services.This article explores the effects of childhood trauma on adult mental distress, and describes the symptoms and behaviours associated with trauma. Mental health practitioners, services and organisations need to ensure trauma-informed care is standard practice to enable service users to move beyond the traumatic events they have experienced. Trauma-informed care should be viewed as a concept rather than an intervention to promote a cultural shift from what is ‘wrong’ with a person to what has happened to them.
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Optimising professional communication with patients
Communication between a nurse and a patient may seem intuitive. However, communicating effectively with patients while applying the principles of person-centred care can be challenging. Patients’ perceptions of suboptimal care and healthcare services may be influenced by how nurses communicate with them, since communication may be used as a quality indicator, as well as an indicator of patient experience. This article considers how nurses can communicate effectively with patients to optimise care. It explores the theoretical principles of interpersonal and professional communication, and discusses practical methods of listening and speaking to patients that nurses can apply in their clinical practice.
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Well-being, physical and mental health: part 3. Helping service users cope with schizophrenia
Schizophrenia affects the mental well-being of service users but also their physical and social well-being. This article explores the causes of schizophrenia and how the illness can contribute to self-neglect. The interaction of mental and physical health in people with schizophrenia is explored and how mental health nurses might work with colleagues to help service users to cope. A case study is used to illustrate how healthcare professionals from different backgrounds worked with a service user and his family to help manage his self-care and improve his well-being. This is the third article in a series on well-being, physical and mental health.
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Effective nurse leadership in times of crisis
The emergence of coronavirus disease 2019 (COVID-19) has meant that nurse leaders need to respond rapidly and decisively to the demands and challenges of a pandemic in a context of increased staff shortages and limited resources. This article suggests essential leadership skills and characteristics that nurses can use to underpin effective leadership in a crisis, emphasising the importance of decision-making and emotional intelligence. It also addresses two important questions: ‘what do leaders in a crisis need to do that differs from any other time?’ and ‘what does effective leadership look like in a crisis?’
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Well-being, physical and mental health: part 2. Responding to trauma
Mental and physical health work together to support well-being, and never more importantly than when a patient experiences a sudden and devastating trauma. This article explores the interplay of mental and physical health in the context of acid attack burns to someone’s face. It explains trauma in event terms and how an understanding of types of psychological trauma can be drawn on to advance collaborative nursing practice in a burns unit. While nurses have been educated in separate disciplines, it is argued that working across the traditional divide can be advantageous in trauma situations. This is the second article in a series on ‘well-being, physical and mental health’.
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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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Biological basis of child health 15: understanding the renal system and common renal conditions in children
This article, the 15th and last in a series on the biological basis of child health, focuses on the renal system, in particular the kidneys. It provides an overview of their role, function, anatomy and physiology, and embryological development. The renal system has a crucial role in homeostasis, so renal function impairment can have wide-ranging and potentially serious consequences for a child’s overall health. The article describes some of the common renal conditions seen in children and how these are managed. It explains how to interpret the results of renal function tests and urine sampling conducted to assess renal function and to investigate acute and chronic disease.
