Journal of clinical nursing
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This paper describes the participation of critical care nurses in ward rounds, and explores the power relations associated with the ways in which nurses interact with doctors during this oral forum of communication. The study comprised a critical ethnographic study of six registered nurses working in a critical care unit. ⋯ Nurses experienced enormous barriers to participating in decision-making activities during ward round discussions. By challenging the different points of view that doctors and nurses might hold about the ward round process, the opportunity exists for enhanced participation by nurses.
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Patient safety and comfort during general anaesthesia and surgery are to a considerable extent dependent on the capability of anaesthesia personnel to interpret directly monitored as well as indirect clinical signs of pain and/or depth of anaesthesia. The aim of the present study was to evaluate how nurse anaesthetists in their clinical routine work assess and interpret intra-operative responses evoked by pain stimuli and/or insufficient depth of anaesthesia. A questionnaire was designed to assess the perceived relevance and validity of cardiovascular, respiratory, mucocutaneous, eye-associated, and muscular responses for routine assessment of intra-operative pain and/or insufficient depth of anaesthesia in patients undergoing surgery under general anaesthesia. ⋯ Changes in breathing rate/volume, central haemodynamics (BP, HR), lacrimation, and presence of moist and sticky skin were given higher score values as indicators of pain than as indicators of depth of anaesthesia. Occurrence of grimaces, attempted movements, and presence of non-centred pupils were variables considered more indicative of insufficient depth of anaesthesia than intra-operative pain. In conclusion, it is obvious from the present data that indirect physiological signs of intra-operative pain and depth of anaesthesia are still considered of importance by Swedish anaesthesia nurses in the anaesthetic management of surgical patients.
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Family members do not give up their involvement in the life of their older relatives when they move to an institution. Relatives feel that it is they who take the initiative to establish a working relationship with the staff at the nursing home. ⋯ Staff behaviour and activities towards residents and relatives are a source of many feelings for relatives. Relatives' understandings of the challenges faced by staff are not communicated to staff, nor are positive or negative experiences explicitly passed on to staff.
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The aim of this project was to re-introduce post-operative epidural analgesi on to two orthopaedic wards using an evidence-based practice approach. This was achieved through the provision of appropriate staff education and information, assessment of staff competence, and provision of relevant and appropriate staff support. An education programme was developed which included study days, ward-based teaching and the assessment of competence. ⋯ The results of the questionnaire demonstrated significant improvements in knowledge following the education programme. Participants commented on the importance of the ward-based teaching. They also felt that pain was controlled more effectively using this method of analgesia.
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This study was designed to identify the feelings and experiences of critical care nurses who have been involved in nursing brain dead patients prior to organ donation. The purpose of the study was to generate knowledge which informs the discipline of nursing. ⋯ The interpretative analysis in this study has revealed a range of meanings articulated by the nurses involved. However, the primary focus of care--as identified by the participating nurses--was the donor family.