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Don’t keep your opinion or views to yourself, send us a letter

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We must back learning disability nurses
The recent article ‘Does learning disability nursing have a future?’ rang worryingly familiar alarm bells with me (NT Analysis, 11 December, p11)

For some years now, Unison has been highlighting the threat to registered learning disability (LD) nurses from many national initiatives and an apparent lack of recognition within government circles of the valuable role that LD nurses can make.
That is why my own Unison branch is sending a motion on LD nursing to next year’s Unison conference.
There is a perception that LD nurses cannot work within a social care setting and will somehow sabotage innovation.
This is nonsense. Oppressive care can happen in any setting and it is insulting to point the finger of blame at LD nurses.
What is really required is a reinvigoration of LD nurse training with more locally based courses being made available. We also need an expansion of the secondment programme to allow support workers to step up to the registered role.
But above all, we need recognition that people with a learning disability often have a number of complex and inter-related needs that an LD nurse is ideally placed to deal with.
Peter Atkinson
Vice chairperson, Unison National Nursing Committee

Queen’s Nurses improve patient care
I am delighted that Drew Payne has drawn attention to the Queen’s Nurse (QN) title (NT Opinion, 11 December, p12) but I would like to correct some misunderstandings.
There are not just 13 QNs: 25 nurses have achieved the title in the first nine months, more nurses are applying for the title all the time, and there are rolling submission dates publicised on our website (www.qni.org.uk).
Of the first 25 QNs, only two are not working directly with patients. Instead, they are both working in roles that directly influence quality of care.
QNs choose to apply for the title via a process that includes feedback from their patients, as a way of showing commitment to community practice.
QNs identify ways to improve care, and to lead and encourage others to do so. I think all nurses would agree that this is ‘the way nursing should be going’.
Rosemary Cook
Director, The Queen’s Nursing Institute

Don’t knock the NHS – it beats US healthcare
Which US did Sean Morton mean when he wrote how much better it is than the UK (NT Letters, 27 November, p16)?
My sister, an RGN/RMN, works in the US. On her last visit home, she told me about a depressed woman who was discharged from a private mental health facility as her health insurance only allowed ‘45 days of inpatient mental health care in her lifetime’.
So, regardless of her suicidal ideation, she was discharged home and was found dead by her mother just one week later.
I’m sad the NHS is criticised when at least patients are not refused care on the basis of how much they earn.
Angela Narbey
East London

Suppositories must be inserted correctly
In his article on administering a suppository (NT Clinical, 20 November, p26), Dan Higgins states there is insufficient evidence about which end a suppository should be inserted, but then fails to offer any practical advice on this.
The illustration shows the suppository being inserted blunt end first but this contradicts advice given by Angela Bradshaw in an article published in the Journal of Clinical Nursing.
She concludes that, until there is sufficient evidence otherwise, we should continue with the commonsense approach of inserting the pointed end first for local effect to promote defecation, while for systemic action the suppository should be inserted blunt end foremost.
The suppository should also be aligned against the bowel wall so it can dissolve with body heat.
Gaye Kyle
Senior lecturer, Thames Valley University

Views from the forum on care pathways at the end of life
 I am a nursing student on an elderly ward where the local care pathway is established. A patient had a high temperature (40.4ºC) so I enquired whether a dose of paracetomol could be given and was told it could not. But treating the high temperature would have given the person more comfort at the end of life. sharond

 The idea of the Liverpool Care Pathway is to preserve dignity in the last days/weeks of life. Should a patient have a problem such as above then to keep them comfortable they can be given drugs and it is then recorded on the variance section. sjc

 I would have taken off excess bedlinen, put the fan on, maybe opened the window a bit and given the patient paracetomol. Putting a cool flannel on the patient’s forehead and wiping their face and hands with cool water may have also helped. nloup

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