Behind the Rituals
This is part of the first ever national workforce plan for the NHS, which aims to recruit and retain more nurses to prevent staffing levels dropping dangerously low.
This could result in 2017 seeing the largest number of qualified nurses ever produced, according to HEE.
What do you think?
- How far will this go to solving the staffing crisis?
- Will universities, placement and mentors be able to adapt to increasing numbers of student nurses?
- Should more be done to persuade former nurses to return to the profession?
- Why are nurse numbers dropping?
Relatives and nurses sometimes express concerns about colluding with patients who have dementia and the ethics of doing so. Others argue that correcting misunderstandings causes unnecessary distress.
This raised the question of when it is acceptable to lie to patients.
What do you think?
In latest guidance NICE warned that as many as one in five patients on IV fluids and electrolytes suffer complications or even die due to their inappropriate administration.
It said a lack of formal training was a “major concern” that was putting lives at risk. It is calling on nurses and doctors in England and Wales to become better educated in how to safely care for patients given IV fluid therapy.
NICE has recommended measures to improve education and training, including practical steps to make decision-making clearer, simpler and safer.
The guideline highlights that IV fluid therapy should always be given as part of a protocol and includes a one-page, step-by-step guide on assessing whether patients need a n IV and if they do, what fluids should be given and how long for.
Have you had training to manage IV infusions?
Has your competency been assessed?
Do you think formal training is needed?
Figures obtained by the Daily Telegraph showed that 1,158 care home residents suffered dehydration-related deaths from 2003 to 2012. According to the newspaper, dehydration was noted on death certificates as either the main cause of death or a contributory factor.
How do you assess whether a patient is dehydrated?
Why do nurses fail to spot the signs of dehydration?
What tips can you offer readers to improve patients’ fluid intake?
Are fluid balance charts a reliable record of input and output in your clinical area?
More information about fluid balance and managing dehydration is available in our archive:
More information is available in our nutrition and hydration zone
NHS hospitals should ban smoking on their premises and staff should be told not to help patients who want to smoke, according to new guidance according to new NICE guidance.
Trusts should ensure “there are no designated smoking areas, no exceptions for particular groups and no staff-supervised or staff-facilitated smoking breaks for people using secondary care services”.
Patients should be encouraged to stop smoking before planned admissions to hospital, while stop-smoking drugs should be available to help people stop.
Professor Mike Kelly, director of the Centre for Public Health Excellence at NICE, said: “We need to end the terrible spectacle of people on drips in hospital gowns smoking outside hospital entrances. This guidance can help make that contradiction a thing of the past by supporting hospital smoke-free policies to make NHS secondary care an exemplar for promoting healthy behaviour.”
Is it possible to achieve a total smoking ban on hospital premises?
Will it lead to covert smoking?
Have you had training to support patients who smoke?
More information about smoking cessation is available in our archive:
Data obtained by the RCN via a freedom of information request found five hospitals from 18 trusts in the east of England had wards with only one registered nurse on duty. This was compared with their establishment of two registered nurses and one healthcare assistant.
The RCN report said having only one nurse on duty would “result in delays for patients receiving pain relief and intravenous fluids” and outcomes for patients on such wards should have been recorded as “near-miss clinical incidents”.
Their investigation was sparked by anecdotal evidence from members of the public who said nurses in some hospitals “were looking after wards single-handedly with only a healthcare assistant in support” and “covering at night to support inexperienced junior doctors” because there was not enough senior-level supervision.
What are your thoughts on this story?
I was talking to a nurse last week about workload on wards. She suggested that initiatives such as restrictive visiting and protected mealtimes prevent families from participating in the delivery of care and pointed to other countries where families are expected to provide care and food in hospital.
What do you think?
- Do you think families should be more involved in providing physical care?
- How does this affect the role of the nurse?
- What can we learn from community services about family involvement in care?
Silicon Valley investor Vinod Khosla suggested that machines could replace 80% of doctors. He describes an average consultation with a GP as “a routine diagnosis with a standard treatment … something a computer algorithm could do if the treatment involved no harm, or at least do as well as the median doctor”.
Is this prediction a threat or an opportunity for nurses?
What elements of nursing practice could be replaced by algorithms?
What impact does technology currently have on practice?
What technology would help you provide patient care?
A research review published this week looking at patients’ experience of living with a catheter has described the effect these devices have on patients’ quality of live and intimate relationships and highlights the need to involve patients in decisions about their care.
- What do you consider when you select a urinary catheter?
- Do you involve patients in your decision making?
- Do you consider alternatives to indwelling catheter such as intermittent catheterisation?
- Would you know how to find answers to their questions?
- Do you know where to get accurate information?
- Do you feel anxious talking about a cancer diagnosis?
We’re going to be discussing these questions and any others you may have during a webchat with experts from Macmillan on Thursday 31 October. Just go to http://www.nursingtimes.net/opinion/webchats/ at 1pm to watch the discussion live or to join in