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Putting it into practice

All posts from: October 2012

Is group reading of benefit to people with mental health problems?

29 October, 2012 Posted by: -

  • Article: McLauglin S, Colbourn S (2012) A reading group in acute mental healthcare. Nursing Times; 108: 44, 14-15.

Key points

  • The Reader Organisation works in healthcare to share great literature with patients and staff
  • One trust has piloted readings of stories and poems to patients with acute mental health problems
  • The 90-minute “read aloud” sessions encourage patients to interrupt and share life experiences
  • Participants in the sessions engaged with the content of the text and with each other
  • The sessions were a good example of collaborative working between healthcare and the third sector

Let’s discuss

  • Think about what you get from reading. Outline why you read and what you gain from the process.
  • What are the benefits of group reading for people with mental health problems?
  • If you were going to set up a group reading scheme how would you advertise it to patients?
  • How would you measure its effectiveness?
  • Could the principles of group reading but used in other clinical specialties? Give examples.

You can email questions to Eileen.shepherd@emap.com or tweet @eileenshepherd

Participating in NT Clinical Chats can contribute to you CPD. Here is 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.

Comments (2)

Why is it that nurses sometimes ask the wrong questions?

22 October, 2012 Posted by: -

  • Article: Mee S (2012) Why do nurses sometimes ask the wrong questions? Nursing Times; 108: 43, 16-18.

Key points

  • The case of Kane Gorny is one of many instances that have come to light in recent years where a patient’s needs have been neglected
  • When a patient is aggressive, a nurse can either seek a reason for it and act on this, or respond to the aggression directly
  • Nurses should always ask “Why is this person behaving like this?”
  • Nurses can improve their responses to “difficult” patients by becoming aware of their deeper cognitive processes
  • When nurses see patients as “others”, they are less likely to meet their actual needs

Let’s discuss

In this article Steve Mee summarised the case of Kane Gorny as follows:

“A nurse chooses to respond to a man’s behaviour and ignore his life-threatening health needs. The health condition is known to cause aggressive behaviour if untreated. The man dies as a consequence.”

The author notes that a nurse had two choices in responding to aggressive behaviour; she can either actively seek a reason for it or respond to the aggression directly. What question should the nurses have asked about Mr Gorny?

After reading this article outline what we mean by attribution, schemas and social representation. How could you use these ideas to understand what happened to Mr Gorny?

What does the author mean by the term “othering”?

Look at this example of othering.

“Four people who have been resettled from a long-stay institution live in a house, with 24-hour support from a staff team. The staff are well organised. They keep a set of ‘staff cups’ in a high cupboard. In a lower cupboard there are ‘client cups’, which are cheaper and older than the ‘staff cups’. There is a dishwasher in the house and no one who lives there has a communicable disease.

Can nurses claim to value the people they support if they are not prepared to share the same crockery? Think about examples of othering in your own clinical area. How could you address these with your team?

You can email questions to Eileen.shepherd@emap.com or tweet @eileenshepherd

Participating in NT Clinical Chats can contribute to you CPD. Here is 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.

What can I do to aid the accuracy of X-rays in checking NG tube positioning?

15 October, 2012 Posted by: -

Key points

  1. The position of a nasogastric tube is vitally important as accidental administration of feed into the lungs can lead to fatal complications
  2. The gold standard method of detecting the position of nasogastric tubes is by X-ray, but this is not used routinely due to the risk of radiation exposure, cost and delay in feeding
  3. X-ray is indicated when the tube’s position cannot be confirmed by aspiration
  4. A recent National Patient Safety Agency (2011) alert drew attention to the risk of misinterpretation of X-rays used to confirm the position of a nasogastric tube
  5. All staff who may request or interpret X-ray images of nasogastric tube positions must be trained and assessed as competent

Let’s discuss

  • What are the risks associated with using a misplaced nasogastric tube?
  • What is the first line method, recommended in this article, for checking the position of a nasogastric tube?
  • When should x-rays be used to confirm the position of a nasogastric tube? What risks are associated with using x-ray?
  • The audit reported in this article found that 21% of nasogastric tubes were in the oesophagus.
  • What pH test result would you expect from aspirate obtained from the oesophagus? What method can you use to estimate the length of tube that should be inserted in order to reach the stomach?
  • Who should interpret X-ray results and what training is recommended?

You can email questions to Eileen.shepherd@emap.com or tweet @eileenshepherd

Participating in NT Clinical Chats can contribute to you CPD. Here is 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.

How can nurses aid management of chronic constipation in adults?

8 October, 2012 Posted by: -

Key points

  • Constipation is one of the most common forms of gastrointestinal disorders encountered by nurses
  • It is often trivialised but is a significant condition causing pain and distress and affecting quality of life
  • Chronic constipation is caused by multiple factors and requires an individualised approach
  • Constipation can be an indicator for serious underlying disease
  • There are new treatments available for prolonged intractable constipation

Let’s discuss

  • Describe the causes of constipation and the groups who are most at risk.
  • List the signs and symptoms of constipation.
  • What life style advice would you give a patient who presents with symptoms of constipation?
  • When you would refer a patient for further investigation?
  • Look at the suggested treatment algorithm in this article. How could you use this to explain the management of constipation to a student nurse?

If you sometimes feel uncertain when faced with a patient with constipation and have a question, join our Clinical Chat on constipation on 9 October at 1pm with clinical experts Wendy Ness, colorectal nurse specialist at Croydon University Hospital and Debra Ollerhead, continence lead at NHS Wirral Community Trust.

You can email questions to Eileen.shepherd@emap.com or tweet @eileenshepherd

You can learn more about constipation by taking our online learning unit: Advances in treatment of constipation.

Participating in NT Clinical Chats can contribute to you CPD. Here is 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.

Comments (2)

To what extent do you consider the humanisation of care in your practice?

1 October, 2012 Posted by: -

Key points

  • Focusing on what it is to be human will help us to reflect on our practice critically
  • The eight dimensions put the individual patient at the centre of care
  • Having a clear value framework helps to ensure the best quality of care
  • This approach helps us to focus on being with other human beings rather than doing tasks
  • This different way of caring is not focused on the professional group but on us as human beings

Let’s discuss

  • How would you define the words humanising and dehumanising?
  • Think about a patient you have nursed recently. What aspects of care would you consider humanising or dehumanising? Explain why.
  • Think about the area you work in. After reading this article how could you use the humanising/dehumanising continuum to explore your patients’ experience of their care?
  • How could you use it to evaluate the way care is organised in your clinical area?
  • Discuss whether task orientated care leads to dehumanisation?

Comments (7)

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