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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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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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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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Preventing, identifying and managing delirium in nursing homes and acute settings
Older people, particularly those in nursing homes, are vulnerable to delirium, which is a condition characterised by confusion. This article outlines the risk factors, prevention, identification and management of delirium in older people in nursing homes and acute settings. It uses a case study approach to encourage nurses to consider the challenges faced in these settings and how they could address delirium. The article also details the multicomponent interventions that can be used for prevention, as well as the available delirium assessment tools, with a focus on selecting tools based on the person’s health status and the healthcare setting.
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Sexually speaking: person-centred conversations with people living with a dementia
While sexuality is integral to being human and supporting sexual expression is fundamental to delivering person-centred care, many nurses find this area challenging. This is particularly true when working with people living with a dementia, irrespective of their age. However, it can be especially challenging in older adults.This article aims to support nurses in their work with individuals and couples living with a dementia. After briefly defining the term ‘sexuality’ and acknowledging the effects of the most common types of dementia, the article discusses the importance of person-centred conversations. It details a new person-centred paradigm that can assist nurses to learn about people’s sexuality and sexual wishes. Through enhanced understanding and increased objectivity, nurses can be better equipped to support people to continue living fulfilled sexual lives according to their choices and priorities. The article concludes by summarising the legal and professional context and nursing responsibilities involved in addressing sexuality with people living with a dementia, specifically when mental capacity becomes an issue.
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Making reasonable adjustments to cancer services for people with learning disabilities
People with learning disabilities do not access or engage with proactive cancer screening in line with those without learning disabilities. As a result, they often experience delays in diagnosis and treatment for cancer, leading to suboptimal health outcomes and, in some cases, premature mortality. This article explores how the legal requirement for public bodies to make reasonable adjustments to ensure people with learning disabilities can use their services can have a positive effect on patient outcomes and experience. In cancer services this applies across the patient pathway, from access to screening, assessment, diagnosis, treatment and discharge. The authors use case studies to illustrate how reasonable adjustments can be made for individuals with learning disabilities in accessing cancer care. They also provide readers with the opportunity to reflect on their own practice and explain how to make small, achievable reasonable adjustments in their clinical areas.
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Best practice in the transition to adult services for young adults who had childhood cancer
This article discusses the importance of a successful transition from children’s to adult services for young adults who had childhood cancer. It considers the role of nurses in children’s and adult services in supporting young adults to adequately prepare for the transition to adult services. Historically, the responsibility has been with children’s services to prepare young adults to transition to adult services; however, a joint approach between children’s and adult service providers is now recommended. A well-organised, person-centred, transition plan commenced early can contribute to a young adult’s successful transition to adult services.
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Conducting holistic pain assessments in patients with cancer-related pain
The incidence of cancer is increasing and people diagnosed with cancer are living longer, with and beyond cancer, and experiencing acute and long-term effects of their disease and its treatment. One such effect is pain, which may occur at any stage, from diagnosis to survivorship or end of life. The exact incidence of cancer-related pain is challenging to determine but it is estimated to affect between 39% and 66% of patients, according to the stage of their disease trajectory. Cancer-related pain is complex, multifactorial and multidimensional, and nurses need to be equipped with the knowledge and skills to assess it in a holistic way. This article explores how nurses working in cancer settings can support people in their care by conducting holistic pain assessments.
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Prehabilitation in cancer care: preparing people for treatment physically and mentally
Prehabilitation is the process of enhancing an individual’s functional capacity by optimising their physical and mental health to prepare them for treatment. Prehabilitation is the first stage of the rehabilitation pathway and comprises pre-assessment, interventions and follow-up. It is designed to reduce the risk of the physical and psychological complications of cancer and its treatment, thereby improving patients’ ability to recover as well as their long-term outcomes.This article highlights the principles of prehabilitation in cancer care and its benefits for patients, and explores the role nurses can play in delivering prehabilitation assessments and interventions and in encouraging positive behaviour change in their patients.
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Adult primary brain tumours: presentation, diagnosis, treatment and complications
Primary malignant brain tumours are aggressive tumours with limited treatment options, and as such they remain the largest cause of cancer-related deaths in men aged under 45 years and women aged under 35 years. Benign brain tumours are frequently treated with the intention to cure them. Both malignant and benign brain tumours often cause long-term, debilitating neurological effects, and if they recur can be fatal.This article outlines the updated World Health Organization classification of adult primary brain tumours, as well as their treatment and predicted outcomes. It also identifies the role of cancer specialist nurses in supporting patients and their families.
