British journal of community nursing
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There are persistent calls from Government, health regulators and even the Parliamentary health select committee for health professionals to report poor practice. The Government argues that district nurses who blow the whistle on substandard care will be protected by changes to the NHS Constitution for England. However, a recent decision of the Court of Appeal shows that whistleblowers who are subject to bullying and recriminations from colleagues are not protected by the law and cannot claim compensation. In this article Richard Griffith and Cassam Tengnah review the law protecting whistleblowers, and discusses ways in which district nurses who have concerns can safely report poor practice.
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Decision-making capacity has been described as the 'key to autonomy'. A person who is capable of making a decision about their health care must have that decision respected by a district nurse, as to proceed against the person's wishes would amount to the tort of trespass to the person and, in some cases, a criminal assault. It is essential, therefore, that district nurses are able to assess the decision-making capacity of their patients.
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Although district nurses provide care and treatment to adults, they also have children on their caseloads from time-to-time. Obtaining consent for the examination and treatment of children is a complex process, where parental responsibility and the developmental concept of Gillick competence become increasingly intertwined as the child matures to adulthood. In this article, the authors consider the requirements for Gillick competence, and highlight the factors district nurses must consider when determining whether a child is competent to give consent to treatment.
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Br J Community Nurs · Feb 2012
Managing constipation: a focus on care and treatment in the palliative setting.
Constipation can cause unnecessary discomfort and suffering for patients, and there appears to be a lack of awareness among nurses and doctors about its cause, impact and management. A large proportion of the evidence for the assessment and management of constipation in the context of palliative care is derived from the perspective of advanced cancer and from guidelines developed at a European level. Although constipation remains a problem for palliative care patients, early intervention combined with continuous and impeccable assessment can assist in its management and improve patient comfort at the end of life.