British journal of nursing (Mark Allen Publishing)
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The Scope of Professional Practice (UKCC, 1994a) now offers nurses, midwives and health visitors new opportunities to develop their clinical role. Role expansion is at the centre of debate in the health service. In the spirit of Scope, trusts and regional health authorities have been experimenting with new roles that combine medical and nursing practice in order to promote a holistic approach to health care. ⋯ New roles must be evaluated before they are allowed to develop and there is an urgent need for national evaluation of the initiatives underpinning Scope. This article examines the changing role of practitioners in specialist practice. The ethical, professional and legal issues surrounding these changes will also be considered.
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There is a vast amount of research available relating to postoperative nausea and vomiting (PONV). This research has been analyzed and summarized in a series of two articles which draw out the main factors influencing the incidence and affecting the treatment of the condition. This, the first article, will describe the physiological processes that result in PONV. ⋯ These factors include personal, preoperative, intraoperative and postoperative variables which affect differing neurotransmitter centres in the chemoreceptor trigger zone (CTZ) which is situated in the brainstem. These variables will then be related to the appropriate neurotransmitter centre allowing a greater understanding of the most likely physiological pathways involved in specific cases of PONV. The second article will explore the management and treatment of PONV.
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This article presents an empirical study of nurses' and patients' assessment of patients' pain following surgery. The study aimed to replicate and extend previous research which indicated that nurses tend to underestimate patients' pain. The independent variables were type of operation, patient gender, time since surgery and nurses' experience. ⋯ Not surprisingly, pain ratings were lower on day four than on day one. The data failed to confirm previous findings that the more junior the nurses the greater pain they infer in their patients. The main conclusion of this research is that nurses continue to underestimate the severity of pain suffered by patients postoperatively.
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The team approach to trauma care has demonstrated benefits for patients in terms of both quality of care and outcome. This article examines the current management and organizational strategies of trauma care and the effect these have on patient outcome. ⋯ However, 81% of these nurses may be responsible for the care of patients with multiple injuries at least once a week (Hamilton, 1991). Although medical staff have a vital role to play within the trauma team, this article will focus predominantly on the role of the nurse.
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This study examines critical care patients' perspectives of hope. It focuses on the patients' expression of their experience of hope while being critically ill on a coronary care unit. ⋯ The researcher believes that hope is of great therapeutic benefit for these critically ill individuals, and that the nurse's role is pivotal in inspiring this hope. Furthermore, due to the often subtle, unobtrusive nature of hope inspiration, these interventions may enhance the more visible, tangible nursing interventions.