British journal of community nursing
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Br J Community Nurs · Sep 2006
Compensation for psychiatric injury: evolution of a law of nervous shock.
District nurses will be well aware that if a person receives an injury because of someone else's negligence they are entitled to compensation for the harm that has been caused. However, where the injury is in the form of psychiatric harm the law has traditionally imposed rules that set out the conditions to be met before a successful claim for damages can be made. Even in today's enlightened society the law still does not always treat a psychiatric injury in the same way as a physical injury. In this article Richard Griffith outlines the development of the law in relation to psychiatric injury--historically called "nervous shock"--and considers the current approach to claims for damages where a person suffers psychiatric harm because of another's negligent act.
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Breathlessness is one of the commonest symptoms experienced by people receiving palliative care. However, misunderstanding of the nature of palliative care may hinder assessment, management and evaluation of care and may contribute to the fear associated with living with breathlessness in the community. ⋯ Pharmacological interventions have their place, but the focus of nursing care should be on systematic holistic assessment. Using this, nurses should adopt a proactive role in supporting and helping patients to adapt to change by maximizing coping strategies.
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Br J Community Nurs · Sep 2005
Review Comparative StudyHyoscine vs glycopyrronium for drying respiratory secretions in dying patients.
The 'death rattle' is a common symptom among dying people, and causes a great deal of anxiety and upset to relatives and carers, including nurses. A mini-review was carried out to evaluate the effectiveness of two drugs--hyoscine hydrobromide and glycopyrronium--in drying up respiratory secretions in terminally ill patients. Searches were made of the Cochrane Library, Medline, Embase, Cinahl and Pharmline. ⋯ One paper demonstrated that hyoscine hydrobromide was the more effective drug; the other favoured glycopyrronium. There is no clear evidence to support the choice of one drug over the other, based on the clinical outcome selected for this review. Although clinical trials are difficult to conduct in this vulnerable patient group, more research is needed to facilitate the best management of this distressing symptom and allow clinical guidelines to be produced.
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Nurses are required to deliver care based on current evidence, best practice and, where it is available, validated research. A senior staff nurse in an 18-bed community hospital in North Bradford primary care trust identified a gap whereby there were no defined processes to address the lack of evidence-based material, look at new evidence or provide a forum to discuss new ideas. ⋯ Various approaches were undertaken to increase attendance, and although the purpose of establishing a journal club within a community setting was clear, the reality was very different. A new approach was eventually found to be successful, and is described here so that it may help other people in similar settings develop and run a journal club.