Journal of clinical nursing
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Structured interviews were carried out with a sample of 96 patients to identify the sources of anxiety for patients in the accident and emergency (A & E) department. Only two patients reported that they were not at all anxious about any aspect of being in A & E. The average number of anxieties reported was 6.9. ⋯ The findings indicate that patients were as concerned with psychological and social aspects associated with admission as they were about physical factors. The authors suggest that it is essential for nurses in A & E to assess patients holistically and consider their psychological state and social circumstances as well as their physical condition. There is also a need for closer links to be developed between accident and emergency departments and other community health agencies and for more emphasis to be placed on referral to other bodies.
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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.
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Review
The experience of dementia: a review of the literature and implications for nursing practice.
This paper explores the early experience of dementia when the veil of uncertainty that surrounds the diagnosis of this condition is lifted. Consideration will also be given to the impact of dementia on carers and the service demands that are created. In the UK alone there are estimated to be 636,000 people living with dementia, with this figure rising to just under 900,000 by the year 2021. ⋯ Current services and interventions focus predominantly on the later stages of dementia, when a meaningful perspective of the person with dementia is difficult to obtain. Nursing has a relatively long history of caring for people with dementia and their family carers. The paper will also consider the contribution of nursing and nursing research to the field and explore additional avenues for service intervention and education.