Practice team blog
All posts from: September 2012
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.
On Twitter, nurses expressed concern about their knowledge and it is clear that there is a lack of confidence in dealing with the complexity of wound care.
Access to education for students was patchy and there was a telling comment about post registration education.
@CathyLamputt said “After doing the tissue viability module I was left thinking that no one should touch a wound that hadn’t done the course”.
Concerns were also raised about management of complex wounds.
@littlenurse1 commented “I wasn’t confident enough to make those decisions alone unless it was a basic wound, there were so many complex ones”.
In response to these concerns nursingtimes.net hosted a Clinical Chat on 27 September at 1pm to help answer your questions about chronic wound management. If you missed it you can reread the transcript here.
Participating in NT Clinical Chats can contribute to you CPD. How to get the most out of Clinical Chats:
- Look at the topic in advance of the chat and plan questions you would like to ask
- Participate in the chat by posting questions or comments
- Download the transcript after the chat as evidence of your participation. This will be available here after the webchat
- Write a reflection on what you have learned and how you could use this information in clinical practice, to store in your portfolio.
For the past two years nursing has been hit by a barrage of reports into devastating failures in care.
It is little wonder that many of the general public believe the profession has lost its way.
Of course the reports are shocking, and what they reveal should never have been allowed to happen. Poor practice should have been addressed before it turned into abuse and neglect. However, these examples do not reflect the reality of most patients’ experiences. Most nurses deliver technically excellent and compassionate care – often in trying circumstances, and their work should be celebrated rather than tarnished by the actions of a few people who bring the profession into disrepute.
Not too long ago the image of the teaching profession was at an all-time low. The knock-on effect was a rush of excellent but demoralised teachers leaving the profession. Universities found it impossible to attract high-calibre students to enter the profession to replace them, and it seemed to be on a downward spiral that could only get worse.
The situation was turned round, however, and a significant factor in this was a government-funded advertising campaign highlighting the best aspects of a career in teaching. The fact that it was accompanied by improved pay and conditions also helped, and once again the profession began to attract the sort of people it needed.
In today’s climate of austerity the government would no doubt argue that it cannot afford to spend money on a similar campaign for nursing – although some might argue that it can’t afford not to.
But the RCN has now stepped into the breach, launching a huge advertising campaign to show the public the other side of nursing – the side experienced by the vast majority of patients.
The campaign celebrates caring, compassionate, skilled and innovative nurses – in other words, ordinary nurses. Let’s hope the campaign reassures the public that the profession has not lost its way, that they can feel safe in its hands – and that it shows what a rewarding career nursing can be.
A career fit for the brightest and the best.
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.
The report By Action for ME found that one in four PCTs do not even commission services for this group. Rightly the charity describes the lack of change or impetus as ‘depressing’ despite repeated assurances from successive governments that the needs of patients with chronic fatigue would be met.
It is frustrating that this condition remains unrecognised and therefore untreated. Patients do not receive the help they need for their condition and have to struggle on, often for many years, with this difficult and debilitating condition. And as research shows that the sooner the condition is addressed the better the outcome, this delay in care is short termism at its worst. Relatively simple measures can make a big difference - this is not a condition that is treated with expensive drugs but is managed by a programme of symptom control, for example managing sleep problems and relieving pain. Chronic fatigue or ME affects each patient differently and to varying degrees so individualised care is important.
It seems sometimes as if there is an acceptance that a certain disease group will be neglected. Does this allow commissioners to ignore it? I hope that this is not the case and this report will shame those areas that are not offering proper services to these patients into making it more of a priority.
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 held belief that measles, mumps and rubella were not dangerous - after all most of us had had them in childhood.
Why did a small-scale research study in the Lancet manage to have such a long-lasting detrimental impact on public confidence? Andrew Wakefield was heavily criticised at the time, and was finally struck off the GMC register in 2010, but the impact on public health was led entirely by the mainstream media.
They were happy to dedicate pages of news and opinion fanning the fears of vulnerable parents struggling to make the right decision for their children - because parents’ fears sell papers. From 1998 to 2004 when the Lancet eventually withdrew the paper, commentators were happy to give space to opinion writers describing their anxieties about MMR and raising suspicions about its safety to new groups of parents facing the vaccination question.
The outcome is that while vaccination rates are now back to a pre-Wakefield level of 93% the Health Protection Agency says there are still enough people unprotected to allow outbreaks to occur. This leaves some of our most vulnerable children, who do not access health services, at risk. There also remains an underlying suspicion about vaccination among some parents.
I watched with interest the media coverage of Wakefield’s downfall. Perhaps I was naive to think there would be a retraction by the popular press of the coverage that has undermined an essential element of our public health policy. So while we consider standards of press in public life perhaps there should be some discussion about standards in their reporting of medical research.
The real story about MMR is that infectious diseases can have devastating consequences and we should be grateful that we have the ability to prevent them. Public confidence is fragile and reporting of medical research has to be based on fact not opinion.