Professional Nursing Today - Volume 12, Issue 3, 2008
Volume 12, Issue 3, 2008
Author Vicki Pinkney-AtkinsonSource: Professional Nursing Today 12 (2008)More Less
My grandmother Gladys was a dinosaur. Not a real one, of course. She passed her professional sell by date long before she was really ready. Granny Glad was a midwife who did home deliveries in England in the early part of the last century. The final event that put her into professional extinction was the registration of midwives. She had a choice to register or get a golden handshake. She took the latter.
Author J. SlomeSource: Professional Nursing Today 12, pp 4 –5 (2008)More Less
Historically nursing has been perceived in religious terms as a charitable, self-sacrificing, devotional, altruistic and silent profession. These perceptions have gone a long way to undermining the true value and clinical expertise that nurses bring to the forefront of modern health care. It has thus become imperative that nurses themselves become the voice and agency of the profession, developing clinical narratives to explain to the public the important work that they do.
Author S. ArmstrongSource: Professional Nursing Today 12, pp 6 –8 (2008)More Less
Mr Brown, a 76 year old man, was admitted to a medical ward in a district hospital with diarrhoea. He was discharged from the ward after three days but his next of kin could not be traced. He was therefore moved to a step down facility while the social worker tried to find his relatives or make alternative arrangements for him. The fourth day he was in the step down facility; he climbed out of a window and fell to his death.
Source: Professional Nursing Today 12, pp 10 –14 (2008)More Less
Nurses work with patients daily, and see so many ill and suffering patients that they sometimes start to accept that there is little that can be done to speed up treatment delivery for patients. Often, the patient waits until he or she is very ill before they present at a hospital for treatment because of factors such as financial or transport problems. If treatment is delayed too long, the time required for antimicrobials or surgery to act is prolonged. Therefore the nurse must be able to identify infections as soon as possible. The best way is by identifying and interpreting clinical signs and symptoms, and analysing a microbiology report as soon as it arrives from the laboratory.
Author D. RegensbergSource: Professional Nursing Today 12, pp 17 –18 (2008)More Less
What is the alternative - Mother-to-be and the midwife sit down to discuss the next option: A hospital based birth with discharge as soon as possible - no different to our Midwife Obstetric Unit model. Here we encounter our next hurdle. Does the midwife have privileges at the local hospital? Is the mother-to-be happy with the choice of backup medical practitioner? If the regular attending obstetrician does not work at the hospital where the midwife has privileges the backup obstetrician will not be of the mother-to-be's choosing.
Source: Professional Nursing Today 12, pp 28 –31 (2008)More Less
Against the background of increased demands for health care and quality in a resources constrained environment, nurses and midwives have the responsibility to practice in an evidence-based manner. Evidence-based practice (EBP) is crucial in promoting excellence in nursing and midwifery and provides a systematic approach to decision-making that supports best practice and accountability. When the best available evidence is considered critically, the chances of doing the right thing at the right time for the right patient improves. EBP entails the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. EBP further requires integrating individual clinical expertise with the best available external evidence from systematic research, available resources and patient preferences. The crux of EBP is to continuously consider the link between patient care and outcomes (mortality, morbidity, clinical, functional and economic) and best evidence to improve the quality of health care and the care individual patients receive. To convince the community that nurses and midwives care with their hearts and minds, each one of us continuously needs to reflect on our practice: To what extent is my practice evidence-based? How can I improve the evidence-based quality of my practice? The aim of this paper is to clarify the concept of EBP. The 5-step process of evidence-based practice is illustrated using a scenario. Finally, the implementation of EBP is described and some sources nurses and midwives can use are given.
Author I. TruterSource: Professional Nursing Today 12, pp 32 –36 (2008)More Less
The definitions used in the literature are currently inconsistent and confusing. Regardless of frequency or severity, heartburn is often loosely considered to be gastro-oesophageal reflux disease (GORD) and vice versa. Heartburn is, however, only a symptom of GORD. Recurrent heartburn is widely recognised as the main indicator of GORD and the symptomatic severity of GORD is rated on this symptom (the spectrum of GORD spans from mild symptoms, not requiring treatment to severe erosive reflux oesophagitis requiring intensive aggressive investigation and treatment).
Source: Professional Nursing Today 12, pp 37 –42 (2008)More Less
Author P.M. JeenaSource: Professional Nursing Today 12, pp 44 –48 (2008)More Less
Respiratory distress (RD), a term utilised to summate a conglomeration of clinical features, including tachypnoea, use of accessory muscles of respiratory, lower chest wall indrawing, grunting, hypoxaemia and cyanosis, is useful in determining severity of illness in childhood. While these features commonly reflect pathology in the respiratory system, a condition accounting for the vast majority of the 10.8 million under-five childhood deaths occurring globally each year, dysfunction in other organ systems may also present with features of respiratory distress. The World Health Organization (WHO) has utilised some of these clinical findings to classify the severity of pneumonia and to advocate management under its programme of integrated management of childhood illness. The WHO has identified the following three essential steps that would help reduce mortality from pneumonia: (1) recognition of a sick child, (2) appropriate seeking of care, and (3) management of the underlying condition. Despite the WHO's acknowledgement that appropriate implementation of these steps would have a significant impact on reaching the target of Millennium Development Goal 4 (a two-thirds reduction in the global under-five mortality rates between 1990 and 2015), only about one in five health caregivers knows the danger signs of severe respiratory distress, inappropriate behaviour in seeking care is often seen in the impoverished, poorly educated communities, and effective interventions are inconsistently applied.