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Florence Nightingale would turn in her grave

I have read with disdain about washing, Clostridium difficile and units closed due to flies. I thought we were in the 21st century. Florence Nightingale would turn in her grave to see what has happened to healthcare in the UK.

If the NHS did its job properly there would be no need for the Healthcare Commission.

I have just returned from the US to be closer to family. The US is leaps and bounds ahead of the UK. Infection and poor customer service is just not acceptable. Why does it seem the NHS is going backwards?

In the US I also had many opportunities as a nurse, with career progression, including time in management and university professorships. I even had a master’s degree paid for.

Sean Morton
via email


Basic continence care needs a higher priority

Why is basic continence care seldom addressed?

Although the NMC’s Essential Skill Clusters is excellent in other areas, it does not address bladder and bowel incontinence.

Nursing students receive around one day on continence care in their three years’ training. So it not surprising that it is often abysmal.

Continence courses for nurses are very poorly attended and some universities have stopped running them. This would never happen with ICU or A&E courses, would it? Or have the 400 cumulative years we have been practising made us cynical?

Many patients say that incontinence is their worst symptom. While we would not suggest a return to the use of the ‘back trolley’, we would recommend that more emphasis is placed on fundamental care.

National Continence Clinical Supervision Group


Job applicants need to show some respect too

While employers should be more respectful to job applicants, there is a flip side to the coin (NT Opinion, 6 November, p12).

I am amazed at how many people use the same application without tailoring it to a post.
One applicant told me how much she wanted to be a district nurse – which was a pity as the post was as far removed from a district nurse as it could be.

A number of people simply do not turn up for interview. We had shortlisted eight nurses (nearly all newly qualified), none had confirmed that they were attending, so we called them and left messages asking them to let us know if they were going to attend. No one returned the call and only two turned up.

While I agree employers should be more considerate, so should potential employees.

Angela Knight
Assistant director of nursing (commissioning)
West Kent PCT


Good points on finding the right literature

As a health librarian, I would agree with most of Lori Havard’s approach, especially the advice to contact library staff (NT Clinical, 6 November, p32).

I have to admit to some pitfalls early in my career, including using ‘nurs*’ in a search.

The number of results was huge, causing the search engine to stop as it was looking for nurse, nurses, nursed, nursing and lots of compound terms.

You need to be more specific by, for example: combining words such as ‘nurse* NEAR wash’ (to find articles where the terms are within five words of each other); limiting the search to the title and abstract; or using the database’s thesaurus.

I find that it helps to sit with the person who is doing the search so you can improvise as you go along.

When you encounter a good reference, check the terms used to index it and adopt them if they look useful.

For those without easy access to a healthcare library, there are online tutorials and checklists.

The Thames Valley Health Libraries Network literature search protocol is at management/Page.aspx? pagename= RZHOME.

Gill McGlashan
Assistant librarian
Heatherwood Hospital library

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