Journal of clinical nursing
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As a result of rapid developments in medical technology, health-care workers are increasingly faced with decisions regarding the prolongation of life and the withdrawal of treatment. Such decisions are often extremely complex and present a moral dilemma: they are further complicated by prevailing politico-economic, social and cultural influences. This article contrasts deontological and utilitarian philosophical perspectives, and discusses ethical principles which impinge on the decision making process. A knowledge and understanding of these philosophies and principles are essential to assist clinical practitioners in the examination of moral issues surrounding life and death.
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Review Case Reports
Preoperative hair removal: a case report with implications for nursing.
Preoperative hair removal has been a practice since the beginning of this century. Research in the 1970s and 1980s provide support for the contention that the procedure is unnecessary for wound asepsis and may increase the rate of surgical site infections (Seropian & Reynolds, 1971; Hamilton et al., 1977; Cruse & Foord, 1980; Court-Brown, 1981; Alexander et al., 1983; Winfield, 1986; Fairclough et al., 1987). However, some hospitals have continued routine preoperative hair removal long after dissemination of recommendations against it. ⋯ The court held the hospital liable for the nurse's negligent breach of its protocol. The case clearly supports findings in the literature that preoperative hair removal is potentially dangerous. It reinforces the importance of strict adherence to hospital protocols which have been put in place to protect patients' safety.
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This paper describes parents' experiences of participation in their hospitalized child's care on a general surgical paediatric ward. The findings indicate that parents chose to participate because of concern for the child's emotional welfare. ⋯ Parents were willing to adapt their parenting skills in order to be able to care for their child at home and were willing to perform more care provided it did not cause pain for the child, had the nurses' approval and increased their confidence and competence as carers. Lack of information, non-negotiation of roles, inadequate facilities, feelings of anxiety and loneliness were the difficulties parents experienced.
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Feelings engendered during 585 triage nursing assessments made by a total of 10 nurses were studied. Marked differences in nurses' feelings were demonstrated towards patients attending the accident and emergency (A&E) department with 'primary care' needs compared with those assessed as having 'A&E' needs. In particular, nurses demonstrated more negative feelings, in the form of less sympathy, more irritation and less motivation to help, towards patients with 'primary care' needs. ⋯ This work is part of a larger study into developing the primary care role of accident and emergency nurses. The culture of the A&E department is discussed, and the need to challenge and change this culture to ensure it becomes more responsive to individual patients' needs is advocated. This paper calls for development of triage training and education and further investigation into the effects of nurses' attitudes on patient assessment.
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The appropriateness of any set of criteria generated to measure the quality of a particular intervention is dependent upon a thorough, up-to-date assessment of the current state-of-the-art. Few areas in nursing have received as much research attention as that of pain control, particularly post-operative pain control. ⋯ This particular format was selected in order to help in the development of structure, process and outcome criteria on the topic of post-operative pain management. The section on measurement is to inform practitioners about pain-assessment charts and provide ideas about auditing this area.