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Helping people live with chronic obstructive pulmonary disease
Chronic obstructive pulmonary disease (COPD) is a long-term condition characterised by persistent respiratory symptoms and airflow limitation. It is preventable and treatable, but still results in high levels of morbidity and mortality. This affects health service costs, but more importantly it affects the person with COPD, and their relatives and carers. If healthcare services continue to focus on managing the disease process rather than the person living with the disease itself, they may continue to produce the same outcomes and fail to substantially reduce the burden of the disease. Helping people live with COPD requires clinicians to communicate effectively with people, families and carers and share multidisciplinary team decisions with patients. Clinicians must consider the physical, psychological, social and spiritual implications of the disease. This article explores how nurses can have a positive effect on the lives of people with COPD and provides practical strategies and suggestions on giving them effective support.
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Assessment, diagnosis and management of constipation
Constipation is a common, treatable condition that can be experienced by all age groups. This article outlines the different types of constipation and explains how the condition is diagnosed. A comprehensive and person-centred assessment is fundamental to identifying constipation, and should include taking the patient’s clinical history and discussing any lifestyle factors that may be causing or contributing to the condition. This article also details the pharmacological and non-pharmacological interventions that nurses can employ in the management of constipation, including providing advice on lifestyle changes and the use of laxatives.
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Applying public health theory to practice in the context of the COVID-19 pandemic
Public health has a long history and a contested meaning. Furthermore, public health operates in a social context and its messages may be rejected by the public. Nurses who have a direct public health role, notably those working in the community and in primary care, need to be able to articulate and discuss public health theory and practice, particularly in the context of the coronavirus disease 2019 (COVID-19) pandemic. This article provides an overview of public health, including its meaning and historical development, and discusses six essential elements of public health theory and practice in the context of the COVID-19 pandemic. These six essential elements are related to public health interventions provided by nurses and to Platform 2 of the Nursing and Midwifery Council’s standards of proficiency for registered nurses, which is particularly applicable to public health. The aim of the article is to support nurses to gain a better understanding of their role in public health.
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Supporting older people experiencing anxiety through non-pharmacological interventions
Anxiety is a debilitating condition that adversely affects people’s quality of life. It is challenging to differentiate anxiety from other physical and mental health conditions in older people, particularly those with co-morbid dementia or depression. The coronavirus 2019 pandemic has compounded social isolation and loneliness in older people, causing increased levels of anxiety. Nurses need to be able to detect and assess anxiety in older people and offer short, low-intensity interventions to support older people’s mental health or refer them to specialist assessment and treatment. While research on anxiety in older people is lacking, cognitive behavioural therapy, mindfulness, yoga, music therapy and pleasant activities have shown potential as non-pharmacological interventions for alleviating anxiety in older people. This article explores the role of nurses in identifying when an older person may be experiencing anxiety and then choosing the optimal non-pharmacological intervention to support them.
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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.
