Journal of clinical nursing
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The introduction of telephone triage in many accident and emergency (A&E) departments is seen as a way to give clients information immediately on demand, to assess and prioritize the need for treatment and to direct the client to the most appropriate service available. This article aims to examine the medico-legal aspects of telephone triage and the nurse's responsibility to the caller and themselves. It will involve looking at triage as a nursing function and how the nurse may minimize the threat of liability by beginning to understand the legal implications of giving advice by telephone. The article will also discuss the use of detailed documentation and communication skills and will aim to show how important these are in the protection of nurses in a court of law.
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Chest drains are routinely inserted during thoracic surgery and to conservatively manage spontaneous pneumothorax. An extensive search of the literature revealed only a small number of highly prescriptive articles to advise the nurse on the specific care needs of this patient group. ⋯ Most of the patients also experienced short-lasting but intense pain when the chest drain was removed. Patients appeared ill-prepared for their experiences despite opportunities to obtain verbal and written information from staff.
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This study uses a qualitative approach to explore patients' expectations and experiences of pain, factors contributing to the effective/ineffective management of their pain and strategies patients reported as helpful when experiencing pain. Ten patients on a mixed surgical ward at a District General Hospital in the south of England participated in the study. Pain scores, using a visual analogue scale, were obtained for 'expected' pain preoperatively and 'worst pain experienced'. ⋯ Patients expected pain after surgery but the intensity of the pain they experienced was often significantly greater than anticipated. Lack of information, inadequate pain assessment and ineffective pain control contributed to this finding. It is suggested that new pain technology, such as epidural and patient-controlled analgesia, may not change the prevalence and incidence of pain unless the systems these technologies are placed within also change.