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Effective management of adult patients with asthma
Asthma is a chronic respiratory condition that can affect people of all ages. Globally, asthma is one of the most common non-communicable diseases and is associated with significant personal, financial and societal costs. In some cases, asthma can be fatal, although many fatalities would have been preventable with appropriate management. People with asthma often underestimate the effects of their symptoms, and nurses should develop their knowledge and skills so that they can provide appropriate management advice. This article outlines the causes of asthma and its symptoms. It also explains the interventions used in the management of this condition, including medicines, patient education, appropriate lifestyle changes and referral to specialist services.
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Improving nursing students’ experience of clinical placements
Clinical placements can present a significant challenge for nursing students, since the learning environment differs from that of the classroom, involving potential risks and complicated interpersonal and interprofessional relationships. The array of decisions required on clinical placements can be confusing for nursing students, which can cause them to doubt their skills and knowledge. This article describes the challenges involved in clinical placements, and discusses the importance of person-centred care and techniques such as reasoning and reflection that can improve nursing students’ learning in practice. It uses two case studies to illustrate how clinical supervisors and mentors can design clinical placements that enable nursing students to develop their skills, knowledge and self-confidence.
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Prevention and management of hyperglycaemic crisis
Hyperglycaemia is a defining feature of diabetes mellitus. It involves an elevated level of glucose in the blood, which develops as a result of the body’s inability to produce insulin or process insulin effectively. If left unchecked and untreated, patients with diabetes are at risk of short-term, potentially life-threatening hyperglycaemic crises such as diabetic ketoacidosis or hyperosmolar hyperglycaemic state. Nurses frequently care for patients diagnosed with diabetes in various clinical settings; therefore, it is essential that they have an awareness of the prevention and management of hyperglycaemia and hyperglycaemic crises. This article explains the causes and clinical manifestations of hyperglycaemic crises, and details the management of patients with these conditions, in accordance with national guidelines.
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Using a structured clinical assessment to identify the cause of chest pain
Chest pain is a common reason for patient presentation to emergency departments and visits to primary care settings. While most causes of chest pain are not life-threatening, a small proportion require urgent intervention, particularly cardiac conditions such as acute coronary syndrome. Therefore, it is essential for healthcare practitioners, including nurses, to identify the cause of chest pain in a safe, timely and effective manner. This article outlines the main causes of chest pain and describes the aspects of chest pain assessment, including patient history-taking, physical examination and clinical investigations. Assessing chest pain requires healthcare practitioners to have knowledge of its causes and pathophysiology, the use of structured assessment tools and the latest evidence-based guidelines.
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Effective approaches to health promotion in nursing practice
This article defines the concept of health promotion and explains why it is essential for nurses to embed health promotion aims and values in their practice. It discusses how health promotion contributes to the improvement and maintenance of population health and contemporary public health agendas in the UK and worldwide. Using several practical activities, this article aims to encourage nurses to identify their own approach to promoting health in their professional role, consider how they can implement ‘Making Every Contact Count’ with the patients they care for, and enhance the overall effectiveness of their practice.
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Enhancing the quality of clinical supervision in nursing practice
Clinical supervision has been an aspect of nursing practice in various forms for several years; however, it remains challenging to ensure its widespread implementation across healthcare organisations. There is an increasingly evident need for formalised support in nurses’ busy practice settings, so it is important to improve the quality of clinical supervision in healthcare. This will also assist nurses in providing evidence of their continuing professional development as part of revalidation. This article provides an overview of clinical supervision, outlining its features and functions in healthcare practice. It includes three case studies related to group clinical supervision, discussing how this was implemented in each case and the various methods of group-working that were used.
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Care of the critically ill patient with a tracheostomy
Tracheostomy insertion and management is increasingly common in critical care units and general wards. Therefore, it is important that nurses are equipped with the appropriate knowledge and skills to meet the individual needs of patients with a tracheostomy safely and competently. This article aims to enhance nurses’ understanding of the potential challenges that patients with a tracheostomy may experience, and to guide nurses in providing effective care and support to these patients. It outlines the care that should be provided for patients with a tracheostomy who are critically ill, including methods of humidification and endotracheal suctioning. This article also discusses the effects that a tracheostomy may have on a patient’s communication and psychological well-being, and explains the actions that nurses should take in an emergency and if complications occur.
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Managing challenging conversations by telephone with people living with cancer
Nurses working in cancer care can often find themselves engaged in challenging conversations with patients and their family members or carers. These conversations can cover a range of emotive subjects due to the negative effects of cancer on people and those close to them. Such conversations have become more challenging due to the coronavirus disease 2019 (COVID-19) pandemic because increasingly they have had to be conducted over the telephone.This article examines some of the psychological effects of cancer and considers some ways in which nurses can engage in challenging telephone conversations with patients with cancer, including the use of mnemonic frameworks. The article also explores the importance of nurses’ self-care and how this can underpin safe practice.
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Delivering personalised cancer care to enhance patients’ quality of life
Many people with cancer experience long-term physical and emotional challenges resulting from the disease and its treatment. Personalised care enables people to exercise choice and control over how their care is planned and delivered. The principles of personalised care are based on healthcare professionals focusing on what matters to people living with cancer. Personalised care enables people to use their individual strengths to ensure that they can have an active role in decisions about their care if they so choose. This article explores personalised nursing care in the context of people living with and beyond cancer. The author examines how nurses can adopt a personalised care model and how this supports improved quality of life and outcomes for patients with cancer. Additionally, the author explores how personalised care interventions have been affected by the coronavirus disease 2019 pandemic and how these might be delivered virtually.
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Results of recent RCN elections
View the results of recent national and regional RCN elections.
