Nursing Times - Practice team blog When was the last time you really talked about suicide? If anyone ever needed irrefutable evidence that depression doesn’t discriminate, the death of Robin Williams is surely it. 18 August, 2014 In healthcare, local doesn’t always mean best Whenever NHS services are reorganised to offer specialist services in centres of excellence there tends to be a public outcry about the loss of local services, with accusations that the reorganisation is an attempt to cut spending. Local MPs vociferously defend those on their patch – often when the reorganisation is the result of their own party’s policies. 8 August, 2014 'We can't all set off to Sierra Leone or Liberia to look after people with ebola' I can’t imagine what it is like to look after someone with ebola but I got an insight last week when BBC news interviewed a nurse who had just seem a baby die from the virus. 1 August, 2014 Are you ready for a cardiac arrest? Inevitably nurses in some areas such as cardiac care and casualty are more ready than others. Are you ready for such an event?  28 July, 2014 Nurses don’t grow on trees: will NICE’s new safe staffing guidelines improve safety? The second I walked onto the ward I knew something was wrong. 21 July, 2014 Should we charge for GP appointments? A few weeks ago nurses at RCN congress hotly debated a controversial resolution to introduce a standard charge for GP appointments. Thankfully it was overwhelmingly rejected. 4 July, 2014 Can Morecambe Bay lead the way in raising concerns? As a board member of a trust put into special measures after a series of high-profile problems including patient deaths, a director of nursing’s first instinct might be to stay below the media parapet – even if the problems didn’t happen on her watch. However, Sue Smith of University Hospitals of Morecambe Bay Foundation Trust has come out fighting to change perceptions of her trust and in particular its nurses and midwives in an exclusive ... 4 July, 2014 Health promotion needs to be of this planet to be effective A suggestion by doctors on how to prevent teenagers smoking was made for a different utopia than the one we live in 27 June, 2014 Do politicians play on the fact many nurses would feel striking is "abandoning" their patients? When we asked this question last week on twitter, we were stunned by the unanimous “yes!” we received from nurses and other healthcare professionals. 20 June, 2014 Why do we need to know about legal highs? I have two teenage children who have been through a school system that claims to educate them about the dangers of drug and alcohol misuse. In year five of primary school they both graduated from the Drug Abuse Resistance Education programme and have regular PHSE classes at secondary school. 12 June, 2014 Are you a nurse because your dad didn’t wash up? What makes people want to go into nursing? 6 June, 2014 Lack of community nurses is policy madness The policy message has been transmitted and understood. Delivery of care needs to shift from the hospital setting into the community. Where possible, it is best for patients to be cared for in their own home. Shorter stays in hospital, delivering what patients want, enhances recovery, reduces risk of hospital-acquired infection. 2 June, 2014 Is a “Masterchef-style”’ competition the answer to poor nutrition in hospitals? How many of us watched Jamie Oliver taking on school lunches and wished he’d do the same for hospitals? 23 May, 2014 Let’s face it, there is no additional money As part of my job I get out to conferences and meet nurses who have taken some time out to learn and network with others. I also spend too much time looking at Twitter, which gives the impression that everyone who works in the NHS spends most of their time at conferences. 7 May, 2014 How can we move care into the community if there are no nurses to provide it? If it feels like governments have been discussing the shift towards providing a greater proportion of healthcare outside of hospitals for years, that’s because they have. 7 May, 2014 Do we need a ‘health atlas’? I must admit, when I first saw the headlines about the health atlas – a map showing which areas are most affected by certain illnesses and conditions – I was intrigued. 25 April, 2014 How can you recover if you are tired? One night you can manage but after a few nights short of sleep you feel jaded and don’t think and respond as well as you would like. 16 April, 2014 Listening is harder than you think After Mr Benn’s death was announced a few weeks ago I thought about that conversation and was struck by how my experience compared to so many others. Mr Benn had an amazing ability to listen, ask relevant questions and appear genuinely interested in my answers. When he got off the train I realised that he had said very little about himself and why he was on a train to Leicester but he had found out a lot about me. 16 April, 2014 Morals should not affect decisions on who receives treatment News that heavy drinkers are to be considered for liver transplants led to a predictable flurry of comments on national press websites. Many were along the lines of “it’s a waste of a liver”, “why should I fund surgery that just lets them carry on drinking”, or “the NHS shouldn’t offer this to people who have brought it on themselves”. 4 April, 2014 How can we show our appreciation of student nurses? Not wanting to miss out on the excitement, I took my laptop to reception and based myself there to meet our shortlist. 28 March, 2014 Would you value a week away with your team? As we know nursing is a 24-hour job. Patients that need care require  it just as much at two o’clock in the morning as they do at three in the afternoon. And they need it as much at weekends as they do during the week. 24 March, 2014 Why is it so difficult to give a patient a drink? How difficult can it be to take a glass of water, put it to a patient’s lips and get them to drink? 17 March, 2014 The academic integrity of the nursing degree must be protected Last week’s announcement that an apprenticeship route into nursing is to be developed has caused quite a stir. 10 March, 2014 Wishing I was a student nurse now I spent a day last week experiencing the adult student nurse programme at City University in London. The student nurses on that programme will be spending time on placement on the same wards that I trained on 35 years ago. Without a doubt I know who is getting a better deal – the patients now. 3 March, 2014 Does ‘Bedpans and Bandages’ give nurses and student nurses the respect they deserve? Last week ITV aired the first of its new series looking into the lives of student nurses. The producers say ‘Student Nurses: Bedpans and Bandages’ will offer “insight into what it takes to become a nurse in the 21st century”. 19 February, 2014 Is removing RCN indemnity insurance really a small change? I was shocked last week by the RCN’s decision to remove indemnity insurance from most nurses. 14 February, 2014 Why won’t trusts pledge to support staff who raise concerns? A year on from publication of the Francis report, The Nuffield Trust has published a report on how NHS trusts have responded to Francis’ shocking findings and wide-ranging recommendations. So how much progress has been made? 7 February, 2014 Recognise night nursing as a specialty During the hours when most of us are asleep, in hospitals and care homes across the country, night nurses are striving to ensure the care and recovery of patients. 31 January, 2014 Why are antipsychotics so regularly given to people with dementia? When reading about the background to the upcoming NICE guideline on medication use in residential homes (due March 2014), I was surprised to find that, despite the fact that the majority are not licensed for use in people with dementia, this is a widespread practice. 24 January, 2014 Trusts must resist the temptation of a 'quick fix' It is nearly a year on from the Francis report and the launch of our Speak Out Safely campaign to ensure staff will be supported when they raise concerns about care. It was disappointing, therefore, to read the recent CQC inspection of Barts Health Trust. 17 January, 2014 Speak up about revalidation, or forever hold your peace Only a couple of decades ago you could, in theory, qualify as a nurse and spend 40 years in the profession without undertaking any form of study or updating. And while examples of nurses who did that may be few and far between I’m long enough in the tooth to remember the introduction of PREP in the 1990s, and I know a few did exist. 10 January, 2014 How many smokers can you help to quit this year? New Year is traditionally a time when we evaluate our lives and make resolutions to change or improve things. To reflect on the past year and make a fresh start for the one coming. 18 December, 2013 Will universities protect students who speak out about poor care? Two weeks ago, the first of hopefully many schools of nursing signed up to Speak out Safely. 13 December, 2013 What do you wish for Christmas? This Christmas a close friend of mine will be dividing her time between her family and caring for her mother with dementia. 16 December, 2013 Practice nurses deserve investment from their employers There were some great speakers at the Chief Nursing Officer’s Summit a couple of weeks ago, and delegates left with plenty of food for thought, advice on how to tackle NHS priorities, and new networks of mutual support developed over the two days. Even in the best conferences, often the most valuable aspect for delegates is the opportunity to meet peers, share experiences and ideas and mull over the latest challenges. 16 December, 2013 When did you last fill out a Yellow Card? Nurses are in the best position to observe if a patient has a reaction or a suspected reaction to a medicine they are taking. The good news is that more and more nurses are filling out Yellow Cards – more than hospital doctors but not as many as GPs. 9 December, 2013 Pick a gender When the announcement came that the three acute mental health wards in the unit I worked were to become single-sex, there was uproar. 29 November, 2013 Have you defined your personal privacy settings? Student Nursing Times has been having an interesting debate on how much information about themselves nurses should share. 22 November, 2013 Government misses opportunity to redefine ward sister role The government’s failure to make mandatory the recommendation by Robert Francis to get ward sisters out of the office and back with patients and staff is a missed opportunity. 19 November, 2013 Have you defined your personal privacy settings? Student Nursing Times has been having an interesting debate on how much information about themselves nurses should share. 15 November, 2013 A dog could be someone's only friend Pets are an increasingly important part of our lives and especially so for many older people. For some, their dog is the most important being in their lives with a strong attachment bond that gives them companionship and helps to get them through tough times. For those who have few friends and family they can be almost like next of kin. 11 November, 2013 Prince Charles can be a powerful ally for the profession I was lucky enough to be one of the Nursing Times team who went to Clarence House last week to a reception for finalists of the Nursing Times Awards, which was hosted by HRH the Prince of Wales – who has also written of his support in Nursing Times. It was a lovely ... 1 November, 2013 'Sometimes you have to take the clinic to the person' Driving home today from a visit to a homeless service, I was reminded of the quote, “you can judge a society by the way it treats its prisoners, its minorities, the poor and the infirm”. 24 October, 2013 The first time: Being a real-life nurse No matter how good your training is, and even if you are starting your nursing career on a ward where you’ve had a placement, everyone experiences that wave of anxiety when they feel the weight of The Keys in their hand for the first time. 18 October, 2013 Ask yourself what you achieved today, not what you failed to do We recently published an article about the use of cognitive behavioural therapy to help depression and low self esteem in post natal mothers. The project was successful in alleviating their symptoms and helping them cope. 14 October, 2013 Why hasn't every NHS organisation embraced Speak out Safely? When we started inviting NHS organisations to declare their support for Speak out Safely, I naively thought it would be fairly easy. Send an email to all the CEOs and they’ll review their whistleblowing policies, making a public commitment to support and protect their staff if they raise concerns about patient care or safety. 3 October, 2013 ASDA has shown us how little progress has been made This morning I heard a radio interviewer ask: 26 September, 2013 Care and compassion must begin at board level Governments around the world have been committed to ensuring their healthcare systems provide safe and high-quality care for over a decade (which begs the question, what were they committed to before?). 20 September, 2013 What one piece of advice would you give a new student nurse? If you could just say one thing to a new student starting out what would it be? If you look back and remember your student days, what advice or information would have been helpful to have known as you started? Or if you are fully immersed in your course now as a second or third year nurse, I imagine you would have some ideas about what you would say to someone starting out if you had the opportunity. 13 September, 2013 Social media blurs the boundaries of our work and private life The NMC’s decision to suspend Allison Marie Hopton for comments she posted on Facebook will make sobering reading for some nurses. As one person commented on the story “I know of several people who are sailing close to the wind with this kind of thing even though my trust recently gave out written info about ... 9 September, 2013 Students who are committed and enthusiastic are always welcomed with open arms Last week, our online editor Nadine and I sat around a phone calling student nurse after student nurse. We had to find four new student editors for Student Nursing Times (one for each branch) and had decided to dedicate an entire day to phone interviews. That morning we each downed a strong coffee and braced ourselves for a very long day. 30 August, 2013 Let’s see some action on nursing numbers In the past few years we have seen a plethora of critical reports about NHS care, and in the vast majority nurses came in for a kicking. There have, of course, been examples of poor practice, some of which have led to criminal prosecutions. However, there is a general acceptance both within the profession and from independent commentators that the vast majority of poor practice can be linked to low ratios of registered nurses. 23 August, 2013 When is an adult an adult? I recently had an interesting chat with a young man who had just spent a week in hospital. He’s nearly 18 and was admitted to an adult medical ward. It was both a challenging and at points frightening experience for him. 15 August, 2013 How can we improve patient experience of early discharge? A friend of mine recently had very major surgery and will require months of follow-up. Discharged after five days he came home feeling tired, unwell and unable to cope. He had concerns about pain, his wound, how much he should do and how quickly. After three days he was a nervous wreck and began phoning the hospital for support. His wife was equally anxious, bearing the burden of his worries and also her own concerns about his condition. For the first two weeks she felt she had taken ... 9 August, 2013 No nurse wants to leave patients in need of care Nurse staffing numbers are in the news again following publication of a study suggesting that the worse patient outcomes associated with lower nurse staffing levels result from the omission of necessary nursing care. Put simply, short-staffed nursing teams don’t have the time to do everything their patients need them to do. 1 August, 2013 Could you offer a convicted sex offender non-judgmental care? I was fascinated to see in an NT news story quote: “In my theatre, I had a guy who was blown up with an IED, and the guy on the next table was supposed to be the guy who detonated the IED. That’s really difficult. But… you treat them no different.” 25 July, 2013 Saying bonjour really makes a difference I recently had to attend an outpatient’s appointment at my local hospital. As I went through the front door, the reception staff gave me a cheery wave as I headed down the corridor towards the clinic. Two people that I passed in the corridor, who were in uniform of different kinds, said good morning to me and, at the entrance to outpatients, I was greeted enthusiastically by someone directing the traffic of patients. 18 July, 2013 Can 10 minutes ever be long enough to do more than change a dressing? “You have to understand GP practices are businesses, and have to operate in that way as making money is one of their priorities.” 9 July, 2013 Are negative stereotypes about older people bad for their health? We’re all accustomed to hearing how memory problems are common – or even inevitable – in older people. And if you’re anything like me, each time you enter a room and forget what you came for you’ll think it’s a “senior moment”, a sign of things to come. 3 July, 2013 What do Mick Jagger’s gyrating hips tell us about the future of healthcare? The sight of Mick Jagger jumping around on the Glastonbury stage just a few days short of his 70th birthday was a clear demonstration of the changing demography in the UK. The Stones’ drummer was even older at 72 but he, of course, was sitting down. 2 July, 2013 Please Mr Hunt, invest in nurses first It’s another day and there is a new initiative for you to implement. In a bid to improve patient safety and make lines of accountability clear, the health secretary Jeremy Hunt has come up with the idea of putting the name of an accountable nurse above every patient’s bed. 25 June, 2013 How do you get hospital staff to walk in the shoes of people with dementia? Yesterday I went to see a play Inside out of Mind. Based on a dementia admissions ward it told the story of staff and patients. It captured the chaos, noise and unpredictability of the ward as well as the emotional and physical demands of caring for people with dementia. 18 June, 2013 'Let’s stop pointing the finger of blame and address the real problems' Since the government aimed its Francis report response firmly at nurses, with many of its promises focusing on “improving” nursing care, I have felt a sense of injustice that the wrong group is being targeted. 6 June, 2013 ‘Why treat a problem when you can throw a pad at it?’ In the NHS some patients are more equal than others. 30 May, 2013 'Older people aren't to blame for NHS problems' The Telegraph’s website the other day carried the headline “Minister: NHS will collapse if elderly bed-blocking continues”. 24 May, 2013 Every week needs to be dementia aware for nurses This is Dementia Awareness week which is a good way to call attention to this common condition. But in reality every week needs to be dementia aware for nurses. And it’s not just for nurses working in care of the older persons and in nursing homes. All nurses will come into contact with patients with dementia – on surgical wards, in  A&E, outpatients, GP surgeries and out in the community. 20 May, 2013 Are nurses too quick to use rapid tranquillisation? Rapid tranquillisation on mental health wards is much-debated. 13 May, 2013 'How do we close the research-practice gap?' There is an old man who occasionally catches the same bus as me to the station. When he arrives at the bus stop there is an odour which in the confined space of the bus gets worse. 7 May, 2013 Resources for community clinics must match those of the hospital A friend recently tried to have a Doppler scan and tissue viability assessment in the community rather than in the hospital. 26 April, 2013 Challenging behaviour is often a symptom, not a personal attack Throughout university we’d been taught that patients with this diagnosis can exhibit “challenging” behaviour, that they can divide teams and we should reflect on how we feel to avoid burnout. 19 April, 2013 Would you accept payment from the drugs industry? Last week the ABPI released figures suggesting that doctors, nurses and other health professionals in the UK received £40m last year from pharmaceutical companies. The money pays for medical education events, training and development, and fees for services such as speaking engagements and participation in advisory boards. 12 April, 2013 'No other profession has faced the implication that it has been accepting the wrong people' Over the years I have seen the nursing profession deal with some enormous challenges, including seismic changes in nurse education, the eradication of an entire level of the profession and countless media storms – both justified and not. 5 April, 2013 'Does the government response support frontline nursing?' The Francis report was clear that nursing was not working and made a series of recommendations broadly welcomed by the profession. Although it was damming about some nurses and the care they did not give it gave hope for the future. But this response to the detail and consideration in the Francis report feels a bit too much of a sideways swerve, a dodge even. 26 March, 2013 'Can you manage nurses if you don't actually nurse?' Years ago I worked with a nurse manager who was happy to tell her staff that their standards were too high. She rarely ventured onto the wards where standards of care were a problem. Wearing a suit and managing with extremely long arms from an office several floors away from her wards meant she rarely saw a patient let alone what was happening behind the curtains. 21 March, 2013 'We want to make it safe for health professionals to speak up about patient care and safety issues' We often receive calls from people with random queries or requests that we simply can’t help with. 18 March, 2013 ‘Babies have fluid levels?’ Six months ago I received my second favourite text to date. A picture of an eight week ultrasound and the words “You’re going to be an aunty!” 11 March, 2013 What will Francis do to address lack of resources? Many nurses feel like they are working in a war zone even though they are actually working in a NHS district general hospital in a town or in the outskirts of a city. They don’t have enough staff, enough equipment and feel stretched to their limits. They feel concerned they are failing their patients and not supporting families. 1 March, 2013 ‘Two in a bed’ As a mental health nurse working on an acute ward, I found that all too frequently the handover I was given contained the dreaded words “two in a bed”. We didn’t physically have two patients sharing a bed, although a glance at the list of patients might make you think we were. This phrase referred to one patient being on leave and another patient being admitted in their absence. So a 20-bedded ward could technically be accommodating 21, 22 or more patients. Often, this meant the leave ... 26 February, 2013 'Sorry, not my patient' No patient’s care should ever be reduced to a job list. Yet nurses have resorted to task-based care in NHS organisations that have failed to put patients first. 14 February, 2013 'To leave the Francis report gathering dust would be an insult'   11 February, 2013 'It is hard to hear criticism of the nursing profession' For those of you out there who are striving every day to deliver compassionate and high-quality care to your patients within the current resource and staffing constraints of the current NHS, this is an even more difficult day than usual. It is hard to hear criticism of the profession. 6 February, 2013 'She was terrified of the very people who should have been there to care for her' Isabella Bailey was admitted to mid Stafford hospital with a hiatus hernia. During her hospital stay her family became so concerned about standards of care on ward 11 they decided to keep watch over her 24 hours a day. 5 February, 2013 'Punitive financial penalties won't produce the results that patients deserve' Pressure ulcer reduction is one of the latest targets directed at nurses, as reported by Nursing Times last week. New rules linking them to trust funding mean you will face increased pressure to hit targets on reducing pressure ulcers this year. 24 January, 2013 Do you remember your first week in nursing? It’s freshers’ week and all over the country student nurses will be starting out on a training  that will contain experiences and challenges that will be with them for the rest of their life. Nurse training changes your life – not just in career terms but also personally. 17 January, 2013 Nursing must not carry the can for Mid Staffs While there can be few groups within the NHS looking forward to the Francis report into Mid Staffordshire Trust, the nursing profession appears to have most to fear. Large swathes of the general media already seem to assume that the largest proportion of blame rests with nurses. 10 January, 2013 Are nurses born or made? Everyone has an opinion on what makes a good nurse. Words such as kind, caring, empathetic, patient, efficient, compassionate, organised, giving and thoughtful trip off the tongue – and then there are the thorny question of cleverness and vocation. 3 January, 2013 What are your New Year resolutions at work? It seems that my resolutions have a five to one hit rate – that is of five resolutions only one will come good. But nevertheless I am thinking now about my list of do more/do less and hoping that some of them will stick. 18 December, 2012 When making a difference makes it all worth it One of my oldest and dearest friends reappeared in my life late last year, over 20 years after disappearing. She had spent the intervening years battling severe mental health problems that made her assume her friends and family wanted nothing to do with her. These have not gone away, but she has felt able to get back in contact with people. 13 December, 2012 Why should you buy your manager a Christmas present? I was idling my time away on twitter a few weeks ago and came across a blog by Dean Royles, the director of the NHS Employers. 13 December, 2012 The care gap that cheats nurses and patients alike As the news focuses again on the dangers of going into hospital and the pressure I wonder if we are missing something fundamental. 6 December, 2012 Six-step dementia care approach must be given a chance Alzheimer’s disease and other forms of dementia are devastating both for those unlucky enough to develop them, but also their families. 30 November, 2012 Is interdisciplinary the new multidisciplinary? It was when I was editing one of this week’s articles on stroke that I was struck by the reference to interdisciplinary working and how it was benefiting patients.    22 November, 2012 Why people living with bipolar deserve better For 35 years my mother lived with bipolar disorder. It is difficult to imagine what it must have been like for her not to sleep for days on end and at other times just sit and cry and cry and cry. It was hard enough watching it. 15 November, 2012 'The LCP is only as good as the people who use it' One of the worst examples in recent history was the hysteria whipped up about the MMR jab, on the basis of highly questionable evidence from a tiny sample of children. This evidence has now been utterly discredited, but not before vaccination rates dropped to dangerous levels. 9 November, 2012 'Beeping is hindering patient recovery' A recent US study has revealed that overnight noise levels in intensive care units often exceed levels recommended by the World Health Organization. The assumptions seems to be that if patients are asleep, sedated and even unconscious they won’t be affected by the beeping and noises of machines. 1 November, 2012 Making informed choices on healthy eating Levels of obesity in the UK are rising at alarming rates in all age groups, and its knock-on effects will be seen in terms of ill health for the individuals concerned and costs to health and social care providers. High fat and sugar intakes are also contributing to rising incidence of other long-term conditions such as heart disease and diabetes. 25 October, 2012 Have you ever made a drug error? The dose was ten times larger than had been prescribed and the baby died. A registrar had prescribed 5ml of sodium chloride but the baby was wrongly given 50ml. 18 October, 2012 Is resilience more useful in healthcare than wellbeing? I have been hearing the term resilience used more and more in healthcare and have thinking that it works well in the place of the term wellbeing which is now so over used it is almost without meaning.  10 October, 2012 Are you up to date with bowel management? Bowel care is part and parcel of nurses work and it is worth reading this personal reflection to get a sense of how long term problems effect relationships, work and self esteem. 3 October, 2012 Do nurses know enough about wound care? We were responding to an international, multidisciplinary study which highlighted the need for all health professionals to receive a basic level of education about wounds in undergraduate and postgraduate education programmes. 21 September, 2012 'Let's hope the RCN's campaign reassures the public that nursing hasn't lost its way' For the past two years nursing has been hit by a barrage of reports into devastating failures in care. 17 September, 2012 Let's not make a habit of neglecting certain diseases Unfortunately it is often the same group of patients - allergy is one example, patients with lymphoedema another. Patients with stroke was a particularly desperate example until the launch of the stroke strategy and accompanying investment finally made a difference. Another is chronic fatigue syndrome with a report out this week detailing the continuing failure of services to patients with this condition. 7 September, 2012 Why are we facing one of the biggest outbreaks of measles in decades? My children were due their MMR vaccinations when the debate about the safety of the vaccine was at its peak. I remember vividly the hysteria that accompanied the publication of Andrew Wakefield’s paper in 1998. Parents talked about herd immunity, believing it would protect their child but not understanding they had to be part of the herd to make it work. Messing about with single vaccines resulted in many of my friends’ children never getting the full two doses. And there was a strongly ... 31 August, 2012 Time for the NHS to hit back against fraudulent claims? She mentioned how she had been subpoenaed to appear in court as a witness in a false claim for work-related injury brought by a nurse on her ward. 24 August, 2012 Maybe it's time for Cinderella to go to the ball It’s a long time since I worked as a care assistant in a home for older women with dementia, and back then older people’s nursing (or geriatric nursing as it was known) was called the Cinderella service. It was seen as a backwater where nurses went if they had either no talent or no aspirations. 17 August, 2012 Does anyone remember when patients made the hot drinks? When I was a student we used to ask patients to do the milky drinks rounds in the evenings. 10 August, 2012 'Patients who put nurses before themselves need putting straight' An elderly woman said to me recently that she wore incontinence pads because it was easier for the nurses. 3 August, 2012 'Nothing in nursing is really simple; comprehension of its complexity is vital' Like many of you who commented on the story on this website, I question whether the staff had grasped the significance of their patient’s diagnosis. 27 July, 2012 'The time that students offer to patients can be invaluable' In this time of stretched resources and staff cuts, student nurses can provide an extra element of care for patients. 23 July, 2012 'Whistleblowers need a supportive stance to be reflected in UK law' The recent news that pharmaceutical giant GlaxoSmithKline had received a record-breaking fine for fraud grabbed my attention. 13 July, 2012 'It can be hard for acute units to change their mindset to care for the dying' A report has found that relatives and carers are less satisfied with the experience of having a loved one be cared for in an acute hospital setting than in a hospice or at home. 9 July, 2012 'When I first heard about the family and friends test I was sceptical' Last week my new neighbour asked if I could recommend my GP practice. 3 July, 2012 'We all make assumptions about our patients and their relationships' Many years ago I nursed a man, Jim (not his real name) who was a widower. 26 June, 2012 Why are nurses still afraid of opioids? Nurses’ understanding of pain treatment is essential for its effective management. Yet effective pain control often eludes those who most need it particularly when opioid analgesics are involved. 20 June, 2012 'When we see a patient’s condition deteriorating, the instinct to save usually kicks in' The only way health professionals can be sure of spotting it is if initial assessment on admission is thorough, and is repeated at appropriate intervals. It is also important that all members of the healthcare team are clear about what treatments or interventions are appropriate. 8 June, 2012 'It's too easy to forget the simple things that make a big difference' Looking out of my window at the garden on a lovely sunny day reminds me of my Dad. He loved the summer, sitting in the back garden with my Mum. 28 May, 2012 'Hiving off important responsibilities devalues nurses' skills' News that a West Midlands trust is to extend a scheme whereby unemployed people deliver patient care makes me deeply uncomfortable. 22 May, 2012 'We need more health visitors AND more district nurses' The recent report on community nursing released at RCN Congress highlights the pressure that community nursing is currently under. 14 May, 2012 'How can you revise if you don't have a plan?' Along with “What biology coursework is now on You Tube?” and “How can you revise when your physics book is downstairs?” Sadly my daily lecture on the benefits of a plan, to-do lists, colour pens and PostIt notes is greeted with, at best, rolling eyes and a “whatever”. 4 May, 2012 'We must recognise when medical intervention is inappropriate' One parent has cancer, and has been on the Liverpool Care Pathway for weeks. She and her family have received excellent care and support, which has focused on keeping her comfortable and offering emotional and practical support to her and her loved ones. 27 April, 2012 Trolleys as beds: how have we come to this? You realise what trouble we are in when policy advice is being given on whether it is best to look after patients on a trolley in A&E or on a trolley in a ward corridor. We seem to have got past the point where either of these situations are unacceptable and are now being seen as inevitable. 20 April, 2012 'Nurses have to knowingly carry out detrimental bed manoeuvres every day' Listening to recent news reports on discharge from hospital at night I wondered where were the nurses representing the needs of a 94-year-old man sent home at 1am in the morning. 16 April, 2012 'The battle for nurse representation on CCG boards isn't over' After all, who would ever assume the bulk of NHS care commissioning could be done effectively without the involvement of the largest group of health professionals. 2 April, 2012 'Our nurses are burnt out but still offering good care' It was probably not much of a surprise to nurses out there on the frontline that their experiences are nearer to those of nurses in Greece, a country facing economic meltdown, than nurses in countries we would feel more usually feel comparable with such as Holland. 2 April, 2012 'Is three years long enough to prepare our nurses for practice?' When I was a student there were very few options for dressing a wound; eusol and paraffin, paraffin gauze, hydrogen peroxide or a dry dressing. 26 March, 2012 'Many nurses would not wish to administer the drugs to end an intolerable life' The subject of assisted suicide, it seems, just won’t go away. 19 March, 2012 'There are not many days when you don’t meet a patient with diabetes' I was up in Glasgow for the Diabetes UK annual conference last week. 12 March, 2012 'Patients must retain the right to decide how they are referred to by health professionals' As a student nurse I was taught to address patients formally - Mr, Mrs, Miss, Ms - unless they requested otherwise. It was drummed into us that patients must never be labelled as bed numbers or by their diagnosis - “the stroke in bed 4” was deemed unacceptable as were terms of endearment such as “sweetheart”. 1 March, 2012 'Tackling drug use costs the UK eye-watering sums' Our Practice section contains two articles about the use of illegal drugs – one about the legal and ethical issues nurses face when their patients use cannabis for therapeutic reasons, and one discussing nurses’ attitudes to substance users, and whether drugs should be decriminalised. 27 February, 2012 'It's good news for practice nurses' News that a training course for practice nurse training is to be accredited by the Royal College of General Practitioners (RCGP) is significant. 20 February, 2012 'Being a student nurse makes you grow up fast' I was watching some student nurses deliver some sensitive and effective care on a ward last week. 14 February, 2012 'Ward sisters are the lynchpins that hold wards together' “It’s so bizarre how differently one is treated in a Sisters uniform…” @lopo485 2 February, 2012 Oppose the heath bill and be ignored The royal colleges - representing health professionals (whether these are medics, nurses or midwives) - are not natural rebels. 30 January, 2012 Ignore the politics and take a good look at intentional rounding The principles underlying the approach are sound. Any system that guides the organisation of care to build a therapeutic relationship between nurses and patients has to be welcomed. An article by Gregory Dix published in this week’s Nursing Times outlines how IR has had a positive effect on care on a medical admission unit in his trust. It enabled nurses to be proactive rather than reactive, anticipate patients’ needs and find out what works for them. I don’t think there is much to ... 13 January, 2012 Don't rush to judgement on Stepping Hill Now that a second nurse from Stepping Hill Hospital, Victorino Chua, l has been arrested for allegedly tampering with medication, I wonder whether those who attacked Rebecca Leighton so viciously will reflect on their actions. 9 January, 2012 Deciding to quit may not be enough A friend told me on New Year’s Eve that she was going to quit smoking. 3 January, 2012 'Many nurses have no part in decision-making processes that directly impact on patient care' Mary is a sister on a surgical ward. She was told a few months ago that theatres no longer have staff to escort patients back to the ward after 5pm, so ward nurses now have to collect them. Mary only has four staff on a late shift and queried how they will manage, but the business manager said there is no alternative. On the first evening of the new system two nurses went off on escort, buzzers started ringing and a patient complained about having to wait 15 minutes for a bedpan. A ... 15 December, 2011 'In their late sixties, how will nurses keep up with the demands of the job?' The debate about whether the country can afford to pay public sector pensions will, I’m sure, continue to rage long after the current dispute is resolved. And I doubt some sections of the media will ever stop referring to them as ‘gold-plated’. 8 December, 2011 'Nothing happens at the weekend' Patients should be as safe in hospital at the weekend as they are during the week. And from a nursing point of view we need to avoid that ‘nothing happens at the weekend’ feeling that patients can get. 29 November, 2011 'Washing my patients' feet' Without even thinking I replied “washing patients’ feet!” Perhaps an odd answer but for me, somehow, it sums up what nursing is all about. 18 November, 2011 'The students’ situation could be a sign of worse things to come' How ironic that one in four student nurses who responded to our survey had difficulty in getting a flu jab. 10 November, 2011 Let's nap on nights: but not in the bath When one of my nursing friends was on nights she used to have a sleep in one of the ward baths during her break. 7 November, 2011 'The changed demands of healthcare require organisational commitment' The media storm following publication of the latest CQC report on hospital care of older people has abated has left health professionals – and particularly nurses – feeling bruised and battered. 31 October, 2011 'Every interaction with a patient is a therapeutic one' She described this as her survival technique on a ward where she knew she couldn’t be in three places at once. “When I realised I no longer felt their pain, I knew it was time to leave” she said. 17 October, 2011 Where do you find your patience? There are countless pressures and incidents that require your patience throughout the nursing shift. 10 October, 2011 'My top 10 suggestions for improving nursing' We have many problems and they all need to be addressed if we want to get nursing back on track. I don’t claim to be an expert but I have pulled together my top 10 suggestions. Please change, adapt, disagree as you see fit - I can take it. But let’s have a clinically focused conversation about what really matters to nurses and their patients. So, with a deep breath and in no particular order:My top 10Wards should have staffing levels and skill ... 3 October, 2011 'We've all had to insist our parents receive a fundamental aspect of care, quickly' Depending on how you want to look at it, our collective parents are either draining the NHS of vast proportions of its resources or keeping an awful lot of health professionals in gainful employment. 22 September, 2011 'Staff need to be clear about what constitutes theft' Most parents will have experienced that terrible moment when their first born child comes home from nursery school with a piece of logo or a Playmobile man tucked into a pocket. Did they put it there by accident or did they steal it? What do you do? 19 September, 2011 'It's a bit of a shame there are no men in the ward, she said' It all seemed pretty straightforward, the drive to have single sex wards and bays. 14 September, 2011 'It's a disservice to most nurses if we use poor care to define the profession' A Mail online article which criticised the use of tabards also talked about a crisis in nursing. Detailing a story of poor care the author said: ‘Talk to anyone who’s spent time in an NHS hospital recently and, nine times out of ten, you’ll get a similarly unhappy story.’ 2 September, 2011 'Do nurse badges have any relevance to nurses today?' Having a clear out at home a few weeks ago I came across an old jewellery box, a Christmas present from my parents some 35 years ago. 22 August, 2011 Evidence or instinct? Should you wake patients at 2am to measure vital signs? We posed this question last week in Behind the Rituals and the debate is still going on in Twitterland. 15 August, 2011 'A lot of research is barely seen by the nurses who could use it' One of the reasons I love my job is that it feels worthwhile. I and the rest of the practice team may not be actually delivering patient care, but we are helping you to do so. We do this by publishing double-blind peer reviewed articles, written in plain English by experts in their fields and focusing on the implications for nursing practice. 9 August, 2011 Nurses make the most awful patients Nurses are not always good at being patients. 2 August, 2011 What’s the matter with nursing? “What’s the matter with nursing?” cried a BMJ editorial a few weeks ago. Just about everyone seems to have a view, with many commentators looking for a scapegoat or a quick fix. Many of my friends know exactly what’s wrong. They don’t make nurses like they used to. In our day… 25 July, 2011 'Training to be a health visitor takes a leap of faith' Being a health visitor has characteristics that makes it different from many other nursing roles. You don’t wear a uniform, you manage your own caseload, you visit clients in their own homes and rarely carry out a nursing procedure. 18 July, 2011 You don’t have to be a prima ballerina to deserve a little dignity Like Eileen Shepherd, I was appalled at the story of Elaine McDonald, who lost a supreme court appeal against the London Borough of Kensington and Chelsea’s decision to withdraw the night-time care that enabled her to use the toilet. 11 July, 2011 'I went from mild discomfort, to anxiety then panic as I held onto a full bladder' I was driving on the motorway a couple of days ago counting the miles to the next services and regretting the second cup of tea I had before I set off. 8 July, 2011 Two hourly, three hourly turns, what we do just doesn’t work I have been really interested in your debate about the effectiveness of 30 degree tilts to reduce pressure ulcers. 6 July, 2011 Being a nurse changes everything We take our jobs home with us like our uniforms. 29 June, 2011