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Using the STARTER model to talk about sex in mental health nursing practice
People with mental illness are more likely to contract sexually transmitted infections and blood-borne viruses than the general population. They are also at higher risk of becoming victims of domestic or sexual violence and of having an unplanned pregnancy. Despite this, the sexual health of people with mental illness is often overlooked in the healthcare environment. This has an adverse effect not only on morbidity and mortality but also on quality of life and recovery outcomes.This article introduces a systematic approach for including sexual health enquiry and promotion in holistic mental health nursing practice. It is relevant for staff who work in inpatient and community settings.The STARTER model is a step-by-step tool that has been designed by the author for mental health nurses to encourage conversations about sexual health. It considers that mental health nurses may be limited by lack of training, and by personal or organisational barriers, but encourages them to look at how these can be overcome, as well as when it is necessary to refer to external agencies that can provide support and services that may be more appropriate for the individual patient.
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Enhancing the care of transgender and non-binary patients through effective communication
There is increasing evidence to suggest that transgender (trans) and non-binary people encounter significant societal discrimination, stereotypical and misleading representation in the media, and frequent misgendering. They may also experience several barriers to accessing healthcare, as well as discrimination from staff and other patients. This article explores how and why trans and non-binary people experience discrimination, and discusses how healthcare professionals, including nurses, can enhance the care experience for these patients, with a particular emphasis on language and communication.
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Managing the effects of cancer and cancer treatments on patients’ nutritional status
Adequate nutrition is a basic requirement of the human body, supporting cell growth and optimal organ function. The nutritional requirements of patients with cancer can increase due to systemic inflammatory responses caused by cancer and cancer treatments. Nurses have an important role in providing nutritional interventions to patients undergoing treatment for cancer, through education and person-centred nutritional care. This article examines which nutritional interventions provided by nurses can relieve symptoms and side effects, improve nutritional status and enhance quality of life in patients with cancer.
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Recognising the importance of language in effective pain assessment
Pain is a highly personal experience that can be challenging to define. In addition, evidence has indicated that the assessment of pain by healthcare professionals is often suboptimal and its severity often underestimated. In clinical practice, the use of language can be a significant influencing factor in the effective management of pain, with terms such as pain, discomfort and comfort used interchangeably. This article explores how language can both act as a barrier to, and assist, nurses to understand the patient’s pain experience.
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Understanding the causes, symptoms and effects of young-onset dementia
Young-onset dementia refers to dementia that develops before the age of 65 years. It can present with a wide variety of symptoms including cognitive, behavioural, neurological and systemic symptoms, which reflects the wide range of possible causes. Young-onset dementia profoundly affects all aspects of people’s lives, including relationships, employment and finances, and it will also profoundly affect relatives and carers. This article outlines the causes, symptoms and effects of young-onset dementia and describes the role of nurses in providing care and support to people with this progressive condition.
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Management of haemorrhage and haemorrhagic shock
Haemorrhage is defined as the acute loss of blood from the circulating volume, while haemorrhagic shock is characterised by suboptimal perfusion caused by bleeding. Their prompt recognition and management is vital to ensure optimal outcomes. This article discusses the assessment and management of patients experiencing haemorrhage and developing haemorrhagic shock. It also outlines how these conditions are classified, and explains their pathophysiology. The article emphasises the importance of a thorough ABCDE (airway, breathing, circulation, disability, exposure) assessment and prompt identification of the source of bleeding, along with the initial management of a patient who is bleeding.
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Care of patients undergoing the removal of an indwelling urinary catheter
An indwelling urinary (Foley) catheter may be used in the management of various urological conditions, such as intractable incontinence and urinary retention, or as part of treatment regimens such as chemotherapy. Although some catheters may be required for long-term use, healthcare practitioners should regularly assess whether the device is still necessary and if it can be removed. This is because urinary catheters are a highly invasive intervention and their use is associated with a range of potential complications, including healthcare-associated infection and trauma to the neck of the bladder. This article outlines the procedure for the safe removal of a urinary catheter, including the patient care and monitoring required before, during and after this procedure. It also explains the complications that are associated with catheter removal and how these can be prevented and managed.
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Respiratory assessment: undertaking a physical examination of the chest in adults
Nurses frequently encounter patients in respiratory distress or with respiratory complications, whether from acute disease or a long-term condition. A physical examination of the chest should be conducted as part of a comprehensive respiratory assessment of the patient, and should follow a systematic approach that includes inspection, palpation, percussion and auscultation. Nurses undertaking these hands-on components of respiratory assessments need to have adequate knowledge of the procedures involved, as well as practical skills that need to be practised under supervision. This article outlines how to undertake a physical examination of the chest in adults.
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Understanding the elements of a holistic wound assessment
Wounds have become a significant public health challenge and consume a large amount of healthcare resources. Wounds can have severe negative effects on patients’ quality of life, causing psychological and social distress, and may lead to significant periods of lost employment, resulting in financial loss. For nurses to manage wounds effectively, they need to be competent in undertaking holistic wound assessments. This article supports nurses’ understanding by providing information on various types of wounds and their differing aetiologies. It also outlines the elements of a wound assessment and discusses some of the challenges that may be encountered during this process.
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Understanding the basic assessment and treatment of lower urinary tract symptoms in older women
Lower urinary tract symptoms (LUTS) are prevalent in older women. These symptoms are often under-reported due to the potentially embarrassing nature of the symptoms and a belief that they are an inevitable consequence of ageing. LUTS such as urinary incontinence have a significant negative effect on people’s quality of life; however, with the appropriate assessment and management, improvements can be achieved. This article reviews the different types of LUTS and their causes, assessment and treatment, focusing on older women. It aims to provide nurses with an understanding of LUTS so that they can identify appropriate interventions.
