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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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Selection and management of central venous access devices
Vascular access is an important aspect of patient care and management in all areas of healthcare. Safe, efficient and reliable venous access may require a central venous access device (CVAD), which can be used in primary and secondary care settings. Nurses may assist in device selection and be involved in their ongoing management, which includes recognising and addressing device complications. The appropriate choice of CVAD and early recognition of potential issues can improve the reliability and longevity of these devices and reduce the risk of long-term complications. This article describes the types of CVAD and their indications for use. It also outlines the management of CVADs, focusing on three areas: complications during insertion; infection prevention and control; and complications that may arise during the ongoing care of these devices.
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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.
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Understanding and applying personality types in healthcare communication
Understanding personality types can assist nurses in enhancing their understanding of themselves and their colleagues, which in turn can support effective communication. This article outlines the principles of the Myers-Briggs Type Indicator (MBTI) – a personality inventory that aims to improve the understanding of psychological types – and details the characteristics of the MBTI’s 16 different personality types. The article explores how these 16 personality types can influence communication within healthcare teams and between healthcare professionals. It also discusses how these personality types affect styles of nurse leadership and how an understanding of personality types can improve nurses’ communication with patients.
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Introducing mentalization and its role in mental health practice
The theory of mentalization describes the ability of individuals to make sense of their own and others’ behaviour in terms of mental states such as feelings, thoughts, beliefs and intentions. Mentalization is fundamental to people’s ability to manage relationships and emotions. Also, the process of mentalizing is core to the establishment of the therapeutic relationship and is a common factor in all therapeutic approaches. As such, mentalization is relevant to nurses and others working in a range of mental healthcare settings with any age group. This article introduces the theory of mentalization, including an explanation of its central principles, how individuals learn to mentalize during childhood, and how the ability to mentalize fluctuates in response to stress.
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Use of personal protective equipment in nursing practice
A comprehensive understanding of infection prevention and control is essential for nurses when seeking to protect themselves, patients, colleagues and the general public from the transmission of infection. Personal protective equipment (PPE), such as gloves, aprons and/or gowns, and eye protection, is an important aspect of infection prevention and control for all healthcare staff, including nurses. Its use requires effective assessment, an understanding of the suitability of various types of PPE in various clinical scenarios, and appropriate application. Understanding the role of PPE will enable nurses to use it appropriately and reduce unnecessary cost, while ensuring that the nurse-patient relationship remains central to care. This article defines PPE and its components, outlines when it should be used and details its optimal application.
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Biological basis of child health 3: development of the cardiovascular system and congenital heart defects
This article is the third in a series on the biological basis of child health. It outlines how the cardiovascular system develops during gestation and how congenital heart defects (CHDs) may arise in the process. The article details the pathophysiology and treatment of some of the common CHDs, including patent ductus arteriosus, atrial septal defect, ventricular septal defect and transposition of the great arteries. It explains the possible causes of CHDs and explains how these defects are detected and diagnosed. The article also provides an overview of the initial management of acutely unwell infants and children who present with a CHD. The first two articles in the series looked at cells and genetics, and embryology.
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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.
