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Health promotion in emergency care: rationale, strategies and activities
The concept of health promotion emerged in the 1970s, prompting global health leaders to adopt a perspective on maintaining and improving the population’s health that accounts for the underlying causes of ill-health and mortality. Health is affected by social, economic and environmental factors, which explains why there are health inequalities within and between countries. Health services have been partly reoriented to focus on promoting health as well as treating ill-health, but health promotion is still misunderstood, including in the nursing profession. Health promotion is often viewed as being concerned with addressing patients’ lifestyle behaviours, but this is only one aspect of a much broader framework of health promotion strategies.This article introduces the concept of health promotion, explains its relevance to nurses working in the emergency department (ED), and identifies activities ED nurses can undertake to promote the health of patients, staff and the wider community. It also explains how ED nurses can play a role in health activism to better understand the social determinants of health and address health inequalities.
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Ethical practice in dementia care
This article draws on a range of case study examples from dementia care and explains how ethical theory can be applied to enhance professional practice. Ethical concepts are critically examined in this context and tensions between them are explored. The article demonstrates how an established ethical framework can assist with application in practice situations. It also argues that cultivating virtues, such as courage and receptivity, is an essential aspect of providing ethical nursing care for people with dementia.
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Promoting healthy eating in nurses
Across the world obesity rates in the general population have been increasing in recent years, a trend that has also been seen among nurses. Alongside the negative health effects of obesity such as type 2 diabetes mellitus and cardiovascular disease, the condition affects an individual’s ability to work and results in increasing rates of absenteeism. However, the nature of nursing shift patterns and the healthcare workplace itself can influence a nurse’s ability to eat healthily.This article discusses how obesity and healthy eating can affect the nursing role, as well as examining leadership and management practices that can support healthy eating in the workplace. The article is aimed at supporting nurse managers to reflect on their own lifestyle behaviour, which in turn will enable them to engage more with the topic of healthy eating among staff.
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Use of individual formulation in mental health practice
Formulation is a collaborative process that promotes shared understanding of a service user’s narrative to ensure their care is meaningful. This article provides an overview of individual formulation in mental health practice. It explores the interaction between formulation and interventions, and how mental health practitioners can work with service users by using formulation to plan and implement care. The article also presents two models of formulation – the five-area and 5Ps models – and explains how these can be used across a wide range of clinical presentations to understand a service user’s immediate problems and longer-term challenges, thus supporting the selection of appropriate evidence-based interventions.
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Using the STARTER model to talk about sex in mental health nursing practice
People with mental illness are more likely to contract sexually transmitted infections and blood-borne viruses than the general population. They are also at higher risk of becoming victims of domestic or sexual violence and of having an unplanned pregnancy. Despite this, the sexual health of people with mental illness is often overlooked in the healthcare environment. This has an adverse effect not only on morbidity and mortality but also on quality of life and recovery outcomes.This article introduces a systematic approach for including sexual health enquiry and promotion in holistic mental health nursing practice. It is relevant for staff who work in inpatient and community settings.The STARTER model is a step-by-step tool that has been designed by the author for mental health nurses to encourage conversations about sexual health. It considers that mental health nurses may be limited by lack of training, and by personal or organisational barriers, but encourages them to look at how these can be overcome, as well as when it is necessary to refer to external agencies that can provide support and services that may be more appropriate for the individual patient.
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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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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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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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Management of haemorrhage and haemorrhagic shock
Haemorrhage is defined as the acute loss of blood from the circulating volume, while haemorrhagic shock is characterised by suboptimal perfusion caused by bleeding. Their prompt recognition and management is vital to ensure optimal outcomes. This article discusses the assessment and management of patients experiencing haemorrhage and developing haemorrhagic shock. It also outlines how these conditions are classified, and explains their pathophysiology. The article emphasises the importance of a thorough ABCDE (airway, breathing, circulation, disability, exposure) assessment and prompt identification of the source of bleeding, along with the initial management of a patient who is bleeding.
