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Ensuring effective intercultural communication in the emergency department
Globalisation and migration trends are reflected in emergency departments (EDs), which increasingly care for patients and employ staff from diverse cultural and/or ethnic backgrounds. EDs are busy, pressured and unpredictable environments where effective communication with patients and families is challenging at the best of times. This is compounded by language and cultural barriers experienced by patients and families whose background differs from the prevailing culture. Cultural differences and language comprehension may also be a challenge for overseas nurses recruited to the ED, who may need support from colleagues and organisations. ED nurses therefore need to be competent in intercultural communication. This involves combining optimal interpersonal skills with cultural awareness, knowledge and sensitivity.
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Exploring the therapeutic relationship in nursing theory and practice
The therapeutic relationship is widely regarded as central to nursing practice, yet the concept is so familiar that it is easily taken for granted. However, like any relationship, a therapeutic relationship cannot be assumed, and to be therapeutic it requires investment from both nurse and service user. This article outlines the theoretical background and fundamental components of the therapeutic relationship, such as self-awareness, reflection and professionalism. The author also describes the skills required to develop therapeutic relationships with service users and introduces a new mnemonic – ATTACH – which encapsulates some of these qualities and skills.
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Improving the physical health of people with a mental illness: holistic nursing assessments
People with a mental illness are more susceptible to physical ill health than the general population, which leads to significantly higher mortality rates among this group. Reasons for this include lifestyle factors such as smoking, lack of exercise and poor diet. Inadequate knowledge and skills about physical health among mental health nurses can lead to uncoordinated care and inadequate access to physical health services for people with mental ill health. This article aims to guide nurses to make initial holistic assessments with specific focus on areas of greatest physical disparity: dental health, eye conditions, sexual and reproductive health, smoking, drugs and alcohol, and metabolic syndrome. Relevant screening tools and health resources are explored. If nurses carry out holistic assessments as a basis for care, make appropriate referrals and deliver timely health promotion, physical health outcomes for people with mental illness will improve.
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Biological basis of child health 14: understanding the immune system, vaccines, allergy and disease
This article, the 14th in a series on the biological basis of child health, focuses on the immune system. It provides an overview of pathogens to which the human body is susceptible, some of the milestones in the embryological development of the immune system, and some of the mechanisms of innate and acquired immunity. The article explains the importance of immunisations and provides examples of immune system dysfunctions and autoimmune conditions that children may experience. It is essential that children’s nurses have an understanding of how the immune system develops, how it is structured and how it functions, since such knowledge will be relevant in the care of a range of conditions where nurses need to explain infection, inflammation and immune processes to children and parents.
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Biological basis of child health 13: structure and functions of the skin, and common children’s skin conditions
This article, the 13th in a series on the biological basis of child health, focuses on the skin. The skin is the largest organ in the body and covers its whole outer surface, protecting it from external threats, assisting in retaining body fluids, eliminating waste products and regulating temperature. The skin also has a crucial role in wound healing and vitamin D synthesis. Skin conditions in children are often distressing for children and parents, and may significantly affect their everyday lives. This article explains how the skin develops in utero, describes the structure and functions of the skin, and explores the aetiology, manifestations and management of skin conditions commonly seen in children.
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Biological basis of child health 12: the endocrine system and common childhood endocrinopathies
This article, the 12th in a series on the biological basis of child health, focuses on the endocrine system. This system works alongside the nervous system to regulate the functioning of the human body using chemical mediators called hormones. It is composed of several glands secreting a wide range of hormones that act on target cells in organs and tissues. Various functions of the human body are controlled by the endocrine system, including growth, puberty, metabolism and bone health. This article explores the anatomy and pathophysiology of the endocrine system, the effects of hormonal excesses or deficiencies on the body, and the presentation and management of endocrinopathies commonly seen in children.
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Self-harm in young people: risk factors, assessment and treatment interventions
Self-harm, where an individual purposefully harms themselves with a non-fatal outcome, is common, especially among young people. A wide range of mental health issues are associated with self-harm and it increases the likelihood that the person will eventually die by suicide.This article explores the motivations for self-harming behaviours, risk and protective factors, the components of risk assessment and potential interventions. Self-harm can be associated with stigma and discrimination in society and in healthcare services. This article aims to support healthcare practitioners in providing non-judgemental, empathetic and respectful care to these young people and their families and carers.
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Focus on asthma 2: air pollution and its effects on children and young people
This article is the second in a series on asthma. The first article identified that the UK is experiencing an ‘epidemic’ of childhood asthma and one of the major culprits is air pollution. This article examines the main causes of air pollution and how they affect the lung health of children from before birth and onwards. It considers the contribution of indoor and outdoor air pollution, how these have changed over time and the unequal effect they may have on vulnerable populations. The nurse’s role is discussed, not only in terms of clinical care, but also as adviser to families and schools on what actions to take to limit their exposure and reduce their own emissions of pollutants.
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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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Dengue fever
Dengue fever is a viral infection transmitted by mosquitoes. It is endemic in tropical and subtropical regions of the world but is beginning to emerge in other regions, including Europe. Many dengue-endemic countries are popular tourist destinations, so nurses should be prepared to discuss the risks of dengue and strategies to avoid contracting it with patients who are preparing to travel.Rachael Fletcher, travel nurse adviser, National Travel Health Network and Centre, University College London Hospitals NHS Foundation Trust, London, England
