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Behind the Rituals

Why do you do the things you do? How much of nursing practice is based on ritual and myth and how much on sound evidence? If you have a ritual you’d like to discuss here, email

Is the focus on compassion a red herring?

Posted by Eileen ShepherdMon, 30 Sep 2013

An emphasis on compassion could actually be dangerous to the NHS, according to a medical ethics expert.

Can you identify the signs of sepsis?

Posted by Eileen ShepherdMon, 23 Sep 2013

A study by the Health Service Ombudsman found shortcomings in initial assessment and delay in emergency treatment which have led to missed opportunities to save lives.

Do nurses need to be taught to introduce themselves?

Posted by Eileen ShepherdMon, 16 Sep 2013

Nurses and other frontline NHS staff are being asked to tell their patients their name, as part of a campaign launched by a terminally ill doctor on Twitter.

Can your patient wash their hands before eating?

Posted by Eileen ShepherdMon, 9 Sep 2013

Most of us were taught to wash our hands before a meal but how many patients confined to their bedside are given the opportunity to wash their hands before eating?Do you offer patients a hand wipe or bowl to clean their hands?Do you have time?

Do you ever sit on patients' beds?

Posted by Eileen ShepherdMon, 2 Sep 2013

I recently spoke to an experienced nurse who was reprimanded for sitting on a patient’s bed. She was looking after a person with dementia who was crying and sat on the bed so she could give her a hug.Is this a distraction from the real issue of ensuring staff clean their hands?

Do we meet the sexual health needs of people with learning disabilities?

Posted by Eileen ShepherdMon, 26 Aug 2013

The man already had a son but the judge ruled that a vasectomy could take place after hearing that another child could cause the man “psychological harm”.

When should you use Deprivation of Liberty Safeguards?

Posted by Eileen ShepherdMon, 19 Aug 2013

Dols aim to make sure that people in care homes and hospitals are looked after in a way that does not inappropriately restrict their freedom.

Should the Berwick report have suggested a minimum staff:patient ratio?

Posted by Fran EntwistleMon, 12 Aug 2013

Earlier this week, the Berwick report was unveiled amidst much speculation that it would recommend minimum staffing levels. However, the report did not give a specific number and instead recommended providers should “ensure they have sufficient staff to meet the NHS’s needs now and in the future”. The review also added support to Robert Francis’ recommendation that NICE develop evidence to enable minimum staffing tools to be devised.

Are low numbers of staff “early warning signs” of poor patient care?

Posted by Fran EntwistleMon, 5 Aug 2013

Sir Bruce Keogh’s review, published earlier this month, into the high mortality rates at 14 trusts found that all these trusts were understaffed.

Is nursing a low-status profession?

Posted by Eileen ShepherdMon, 29 Jul 2013

A news story last week highlighted that nurse leadership is ahead of the rest of the NHS in reflecting the gender of its workforce, but concerns remain that nursing’s perception as a “female” profession means it does not get the attention it deserves.

Is a certificate for HCAs a move to bring back SENs?

Posted by Eileen ShepherdMon, 22 Jul 2013

Last week Camilla Cavendish recommended all support workers in health and social care should complete a “certificate of fundamental care” before being allowed to work unsupervised.

Is it appropriate to use your mobile phone at work?

Posted by Eileen ShepherdMon, 15 Jul 2013

Nurses are increasingly using their personal mobile phones at work to access the internet and check information.What do you think?Is it appropriate for nurses to use their personal phones in front of patients?Is it necessary to have immediate access to the internet in a clinical situation?Should nurses be able to access social media sites at work?

Is there a skills deficit in student nurse education?

Posted by Eileen ShepherdMon, 8 Jul 2013

A recently Student Nursing Times Twitter chat discussed this issue. This transcript gives their views on whether their education equips them for practice. Have you identified a skills deficit in newly qualified nurses?Is it a skills rather than ...

Has risk assessment replaced clinical judgement?

Posted by Eileen ShepherdMon, 1 Jul 2013

The term cookbook medicine is used to describe decision making that is based on rigid adherence to guidelines, pathways and mandatory risk assessment.Let’s discuss…Have audits and dashboards used to measure adherence to pathways, guidelines and risk assessment undermined clinical judgement? Are routine risk assessment carried out on all patients regardless of their condition, completed to meet the requirement of the organisation rather than the ...

Is physical restraint over-used?

Posted by Fran EntwistleMon, 24 Jun 2013

Nearly 40,000 incidents of physical restraint on mental health patients in England were recorded in one year - with more than 3,000 in the “dangerous” face-down position - according to figures released by Mind.

Should falls be a “never event”? Or are some falls inevitable?

Posted by Eileen ShepherdMon, 17 Jun 2013

All hospital patients aged over 65 should be considered to be at high risk of falling and have an appropriate care plan drawn up, according to guidance from the National Institute for Health and Care Excellence.

Does current nurse education reflect government aims to provide more care in the community?

Posted by Fran EntwistleMon, 10 Jun 2013

They have warned of “widespread and significant” concerns over the number of district nurses currently being educated, stating that there simply are not enough coming through to replace those who are retiring.

Do patients receive less care at the weekends?

Posted by Eileen ShepherdMon, 3 Jun 2013

New research has shown that patients who have elective surgery later in the week and at the weekend have a greater risk of dying. Previous studies have found there to be a significantly higher risk of death if patients are admitted as an emergency over the weekend compared with a weekday.

What training do you need to manage an intravenous infusion?

Posted by Eileen ShepherdMon, 27 May 2013

Article: NICE launches draft guidance on IV fluids for clinicians

Should nurses be on hand to help police in dealing with mental health offenders?

Posted by Fran EntwistleMon, 20 May 2013

Article: Nurses to aid police with mental health offenders