A forgotten need: paediatric resuscitation training

This article highlights the fact that there are currently no real official recommendations regarding the provision of paediatric resuscitation training in the UK. All too often, this teaching features as no more than an ‘add on’ to adult resuscitation sessions. This is a thoroughly inadequate situation as the relatively infrequent occurrence and different aetiology of paediatric arrests necessitates specific training, based on standard guidelines, and adapted to meet the needs of the various groups who have contact with children. A three-tiered package of training is recommended, starting with nationwide paediatric Basic Life Support (BLS) training for the general public. In addition to BLS, healthcare personnel need to be trained in appropriate use of airway adjuncts. Paediatric Advanced Life Support (ALS) is also essential for all medical, nursing and paramedical staff who come into contact with acutely-ill children. In an attempt to address the need for ALS, the PALS (Paediatric Advanced Life Support) course, has been implemented in the UK. Adapted from the American PALS course, it aims to provide appropriate personnel with a systematic, research-based approach to acutely-ill children in emergency situations.     

The Lautenbach method for chronic osteomyelitis: nursing roles, responsibilities and challenges

Osteomyelitis is serious for both the orthopaedic surgeon and the patient. Bone infection is very difficult to treat and if not eradicated has long-term effects for the patient. The current techniques available have a low success rate and sometimes the only alternative is amputation.This article discusses:

• What is bone infection and how it effects a person's life

• Existing methods of treatment and compares them with the Lautenbach method

• Pre, peri and post-operative care of patients undergoing the Lautenbach method of treatment

• A case study to illustrate how the method was used to successfully treat a patient.

Passivity vs. militancy: a Q methodological study of nurses' industrial relations on Merseyside (England)

This paper describes a Q methodological study of accounts of nurses' industrial relations expressed by a sample of nurses (n = 60) drawn from the geographical area of Merseyside, United Kingdom (UK). The participants completed a 65-item Q sort made up of statements which could be ranked in terms of their relevance to an understanding of their industrial relations situation. Of interest was the importance of the narrative accounts which nurses draw upon in making sense of their employment relations, having the potential to underpin or delimit their actions. The notion of industrial action was an important focus of this research. Q methodology was chosen to allow the meaningful investigation of such subjectivity, with interesting tensions between differing notions of professionalism and militancy apparent from the analysis. Six accounts of industrial relations, which are available to be drawn on by nurses, are described and interpreted within a social constructionist framework. Some implications for the conduct of nurses' industrial relations in the UK are contemplated.     

The search for meanings in nursing: could Facet Theory be a way forward?

This paper examines some of the underlying tenets of Benner & Wrubel's Primacy of Caring, and suggests the use of Facet Theory as a possible route to overcome criticisms of the lack of systematic data collection and analysis in this approach to nursing research Some of the steps undertaken in Facet Theory are described, and its use in wider nursing research discussed It is proposed that Facet Theory offers a method of studying the multidimensional nature of nursing, which has the potential for a scientific approach without losing the essential ontological data     

Reflection and critical incident analysis: ethical and moral implications of their use within nursing and midwifery education

Despite the dearth of rigorous empirical investigation, reflection and reflective practice have become buzz words in nursing and midwifery education Reflection and critical incident analysis may be tools which can facilitate the integration of theory and practice It is proposed that in the absence of explicit and thorough preparation of lecturers and students, together with very careful curriculum planning, these activities may be counter-productive or even harmful In the absence of structure, reflection and associated critical incident analysis may lead to student disaffection or, worse, the potential for actual psychological disturbance Empirical studies on the use of identified models of reflection and critical incident analysis are urgently needed to assist nursing and midwifery lecturers and students to achieve predictable learning outcomes for this potentially valuable activity     

Assessing mental competence of patients and relatives

This paper presents a discussion on the assessment of mental competence of patients and relatives in the health care setting Their decision-making ability is explored with particular reference to the giving of consent for nursing intervention and medical treatment It is suggested that, in addition to obvious psychological or neurological disorders, decision-making ability will be influenced by psychological stress and the ability to communicate effectively It highlights the ambiguity of mental competence assessment and concludes that such assessments will, to a greater or lesser extent, be subject to value-laden judgement     

Impact of the palliative care clinical nurse specialist on patients and relatives: a stakeholder evaluation

Within the last decade, there has been a rapid expansion in the United Kingdom of clinical nurse specialists (CNSs), yet there has been limited evidence of their effectiveness. The clinical area of palliative care has one of the largest numbers of CNSs which has particularly started to escalate in the acute hospital setting. Following the Calman-Hine Report and the more recent NHS Cancer Plan, it is anticipated that the number of CNSs in palliative and cancer care is likely to grow. In light of the current policy emphasis of Clinical Governance and Clinical Effectiveness, there is an urgent need to demonstrate the contribution that CNSs make. This paper presents the qualitative findings of an evaluation study on the impact of the CNS within a palliative care team in a large acute hospital in the North-West of England. A stakeholder evaluation that encompassed tape-recorded semi-structured interviews to explore how the stakeholders saw the impact of the CNS within palliative care was performed. Twenty-seven interviews were conducted with stakeholders across the hospital setting including senior nurses, consultants, junior doctors and nurses representing the different grades. Data were analysed for emerging themes utilizing a case and cross-case analysis. The results indicated that the CNSs within palliative care in an acute hospital are seen to be potentially beneficial for both patients and relatives. This paper will focus on exploring these perceived benefits, which included symptom control, psychological care and being an advocate for patients and relatives.