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Continuing professional development: lymphoma in primary care
Lymphoma encompasses a heterogeneous group of haematological malignancies that require complex management. Patients with lymphoma experience a wide range of physical, social and emotional issues.This article summarises the diagnosis, treatment and long-term consequences of lymphoma, and outlines the role of the primary care practitioner in the lymphoma care pathway.
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How to get care right for people with learning disabilities in the emergency department: ask and engage
Healthcare professionals are legally obliged to make reasonable adjustments to ensure that people, including those with learning disabilities, can access appropriate and timely care. However, although people with learning disabilities are high users of general health services, staff have little understanding of learning disability with a negative effect on patient experience and outcomes.This article explores some of the challenges experienced by people with learning disabilities in the emergency department (ED). Each section focuses on a different aspect of how to adjust the delivery of healthcare to meet their needs, along with exercises to ensure those adjustments have been understood and to provide practical learning outcomes. Personal stories are also used to identify examples of when and where these adjustments could have been used to provide equal healthcare in the ED.
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Understanding the health risks of varicella zoster virus in pregnancy
Varicella zoster virus (VZV) is a common illness that causes varicella (chickenpox) and shingles. It is prevalent mostly during childhood but there are additional co-morbidities from this disease for a woman and her fetus, if she contracts it during pregnancy. Many developed countries vaccinate children who have not acquired immunity to prevent their developing complicated varicella as adults. Countries that have implemented widespread vaccination have fewer hospital admissions for such complications.The UK does not have a national VZV vaccination programme and there is no strategy for reporting and documenting the incidence of the illness, so it is difficult to determine the potential prevalence of gestational VZV and its associated outcomes. The aim of this article is to provide an understanding of the aetiology of VZV and the potential health risks to unimmune women who may contact it during pregnancy, to advise them about their healthcare choices.
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Chairing and managing formal workplace meetings: skills for nurse leaders
Few nursing staff from band 6 and above receive formal training on how to chair and manage formal business meetings, which can be a challenging experience for novices and when participants fail to engage with the discussion. This article gives an overview of how to lead and manage effective meetings, focusing on process, content, managing conflict and how to engage participants fully. This will give meetings more purpose and ensure participants feel their time is being used efficiently. Learning how to conduct effective meetings will enhance the quality of team working and team effectiveness.
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Supporting staff who are second victims after adverse healthcare events
Healthcare delivery is challenging and complex, At some point, most healthcare professionals, including nurses, will be directly or indirectly involved in adverse events, such as medication errors, patient safety incidents, witnessing adverse events and near misses. While the patient is considered the first and most important ‘victim’ of such events, the healthcare professional involved is often considered the ‘second victim’. Second victims often experience negative psychological effects due to the event, may feel they have failed the patient and can doubt their clinical skills and knowledge base. This may lead to absenteeism and their leaving their profession.This article explores the concept of healthcare professionals as second victims, as well as the effects of adverse events on these individuals, their managers and healthcare organisations. It also details the investigation process, the healthcare professional’s legal and professional responsibilities after an adverse event, and the resources and services available to support second victims.
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Action learning: staff development, implementing change, interdisciplinary working and leadership
Action learning (AL) is a process that supports problem-solving by applying a questioning formula to challenge issues and prompt actions. Initially developed to support organisational change, AL is now recognised as a motivating and influencing process for team development, individual goal setting, change initiatives, quality improvement and leadership development. Learning from observation and practice is central to its approach, which lends itself to healthcare settings. It is especially useful to managers seeking to implement change, enhance quality and promote teamwork in multidisciplinary settings.
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Teamwork in nursing: essential elements for practice
As any nurse working in the NHS knows, teamwork can be powerful. Successful teamwork can make a huge workload of unmanageable tasks manageable. However, unsuccessful teamwork can leave people struggling to cope. This article explores readers’ knowledge and skills related to teamwork and provides them with new skills and techniques to improve practice.
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Importance of reflection in revalidation
Reflection is a hallmark of professional practice and an important element of the Nursing and Midwifery Council revalidation process. Following two previous continuing professional development articles, on reflection and professional learning and on reflection and personal learning, this article will aim to explore the specific elements of reflection required for revalidation. This publication should help demystify and support registrants embarking on the process.
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‘Guiding Lights for effective workplace cultures’: enhancing the care environment for staff and patients in older people’s care settings
While much attention has been given to organisational culture, there has been less focus on workplace culture. Yet workplace culture strongly influences the way care is delivered, received and experienced. An effective workplace culture is crucial for the well-being of individual staff members and teams as well as for patients’ experiences and outcomes of care.This article describes the ‘Guiding Lights for effective workplace cultures’ which were developed by the authors and provide a framework to assist in understanding and promoting effective workplace cultures and creating environments where staff and patients feel safe and valued. There are four Guiding Lights: ‘collective leadership’, ‘living shared values’, ‘safe, critical, creative learning environments’ and ‘change for good that makes a difference’. Each one articulates what good workplace cultures are through descriptors and intermediate outcomes and together produce a set of ultimate outcomes. The Guiding Lights provide nurses working in older people’s care settings with an opportunity to learn from, and celebrate, what is going well in their workplaces and to consider areas that require further development.
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Osteoporosis and fragility fractures: risk assessment, management and prevention
Osteoporosis is a chronic skeletal condition characterised by low bone mass and microarchitectural deterioration of the bones that disproportionately affects older people. Older people with osteoporosis are at increased risk of sustaining fragility fractures, and this risk is compounded by factors such as falls and frailty. Fragility fractures can have several physical and psychological effects, potentially affecting an older person’s quality of life and reducing their life expectancy. Therefore, it is important that nurses can identify individuals at risk of osteoporosis and recognise the factors that may predict fragility fractures. This article outlines the main risk factors for osteoporosis and details the assessment and management of patients with this condition. It also explains the pharmacological interventions and lifestyle changes that can reduce the risk of fragility fractures in older people with osteoporosis.
