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Equipping children’s nurses to de-escalate conflict and communicate challenging information
This article considers some of the challenging situations that children’s nurses may encounter when there are tensions and disagreements between the family of the child or young person in their care and the wider professional team. The focus is on disagreements about what some might consider futile critical care. It aims to equip children’s nurses with strategies for dealing with conflict and tensions, and support them to be proactive in identifying situations that might need de-escalation. The options available to support the healthcare team and therefore avoid litigation are explored, while avenues of support available to nursing staff are considered. Suggestions and examples of effective and skilful communication with families receiving challenging news are provided. The legal position designed to safeguard children’s nurses is reviewed and practical strategies are offered to support nurses to protect themselves from physical violence if the situation escalates.
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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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Biological basis of child health 8: development of the gastrointestinal system and associated childhood conditions
This article is the eighth in a series on the biological basis of child health. It describes the embryological development of the gastrointestinal (GI) system and some of the structural anomalies that may arise during that time and later affect GI functioning. The article also discusses the functions of the GI tract – including ingestion, digestion, absorption and defecation – and explains how these relate to GI conditions seen in infants and children. GI conditions are common in childhood and some of these will be medical emergencies, so it is important that children’s nurses have knowledge of the GI system and of the presentation and management of GI conditions in children.
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Biological basis of child health 4: an overview of the central nervous system and principles of neurological assessment
This article is the fourth in a series on the biological basis of child health. It explains the embryological development of the nervous system and describes some of the anatomical and physiological features of the central nervous system, which is comprised of the brain and spinal cord. It also outlines the principles of neurological assessment in infants and children, before detailing the presentation and management of three conditions that can affect the central nervous system in this patient population – seizures, meningitis and raised intracranial pressure.
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Biological basis of child health 2: introduction to fertilisation, prenatal development and birth
This article is the second in a series called the biological basis of child health. It considers the period of development from fertilisation to birth, outlining the three stages of prenatal development – the germinal, embryonic and fetal stages. The article details how tissues and organs typically develop at each stage, and explains how and when deviations in development and congenital anomalies are likely to occur. It also describes some of the common congenital anomalies, their potential effects and their detection before or after birth. Information is also provided about the delivery of full-term infants, including the stages of labour.
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Biological basis of child health 1: understanding the cell and genetics
This article is the first of a series that outlines the fundamental aspects of the biological basis of child health. Cells and genes are the basic units of life. Therefore, it is essential that nurses have knowledge of how cells function to understand normal physiology and pathophysiology, and how specific conditions are inherited. This article describes the components of the human cell, detailing their structure and function. It also discusses genetics, providing examples of inherited diseases including those caused by mutations that affect specific components of the cell. The aim is to provide children’s nurses with an accessible introduction to cell biology and genetics linked to their clinical practice.
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Care and management of children with a totally implanted central venous access device: portacath
Research and advances in technology have enabled children and young people with life-limiting conditions to live longer. To maintain their well-being and quality of life many of these children usually require some form of intravenous access for treatment.Children’s nurses should have the skills and training to ensure they are competent to practise using totally implanted central venous access devices such as portacaths (ports). This article addresses the care and management of these ports in children and the wide variation in practice that exists in the UK, and makes recommendations for practice.
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The Me first communication model
This article explores communication and decision-making with children and young people in healthcare. Children and young people report that healthcare professionals are good at explaining and helping them to understand what will happen to them, but that they do not feel involved in decision-making about their care or treatment. To improve communication with children and young people, they need to be involved in decision-making about their care and treatment. In partnership with children, young people and healthcare professionals Common Room Consulting, Great Ormond Street Hospital for Children NHS Foundation Trust and Health Education England have co-produced a communication model, Me first, to support decision-making with children and young people in health care. This article introduces the Me first model and explores how it can be applied in clinical practice.
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Supporting newly qualified nurses to develop their leadership skills
Leadership is not expected solely of managers. At any stage of their career, nurses are expected to be able to demonstrate leadership in their day-to-day role. However, newly qualified nurses, who often experience a challenging transition from nursing student to registered nurse, may lack the confidence to demonstrate leadership. Nurse managers can support junior nurses to develop their leadership skills, notably through training, mentoring, reflection and action learning. By guiding newly qualified nurses in the use of different leadership approaches, experienced nurses can contribute to enhancing the quality of patient care. This article discusses how nurse managers can support newly qualified nurses to develop their leadership skills.
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Using data analytics to enhance quality improvement projects
With the introduction of electronic health record systems in healthcare organisations, there is a significant opportunity within nursing, and as part of the multidisciplinary team, to access a wealth of data and use this to drive improvements in patient care and outcomes. Quality improvement has often involved the collection of data via manual audit, a time-consuming process with data fed back from small sample sizes over a short time period. In contrast, a data analytics approach enables data collection from larger sample sizes to be automated and for data to be presented in a way that is easy for staff to access and interpret. This article discusses the benefits and challenges of a data analytics approach as well as the resources required, the importance of stakeholder involvement, the setting and review of key performance indicators and how to optimise data presentation to achieve the greatest effect.
