Supporting the transition from nursing student to newly qualified children's nurse

BACKGROUND

The transition from nursing student to newly qualified nurse is known to be challenging but research on the transition to children's nurse is limited.

AIM

To examine the experience of primary and secondary transitions among newly qualified children's nurses and to identify effective support strategies for this staff group.

METHOD

The study was supported by a literature review and conducted in a children's hospital in Ireland in 2017. A descriptive survey methodology was used. Data were collected using a validated survey tool. The purposive sample encompassed 81 nurses who had qualified as children's nurses from 2011 onwards.

FINDINGS

The transition to children's nurse was found to be a complex but generally positive experience and to require robust support. Transition lasted beyond the first year of practice and the transition experience was similar for all participants, irrespective of whether they had undergone primary or secondary transition. Preceptorship, transition and orientation programmes were reported to be beneficial support strategies.

CONCLUSION

Challenges are to be expected during transition and effective support strategies for new children's nurses are needed, as is further research in this area.

Using video consultations to support family carers of people living with dementia

Established in 2019, the Lincolnshire Admiral Nurse Service supports family carers of people living with dementia through psychosocial interventions. Before the coronavirus disease 2019 (COVID-19) pandemic, the team provided home visits as standard, but the fact that Lincolnshire is a large rural county affected the team's ability to provide timely support to all the carers who needed it. In 2019-20, a practice development project underpinned by participatory action research was undertaken to trial the use of video consultations with carers. However, carers' uptake of video consultations was low and the project was affected by the COVID-19 pandemic. This article describes the project and discusses the findings of its evaluation. The Admiral Nurse team had mixed experiences and felt that, overall, its support was more effective when delivered face to face. The project provides insights into the challenges and benefits of video consultations for delivering psychosocial interventions to carers of people living with dementia.

Introducing a digital portal that enables patients to access their health records

People manage many aspects of their lives online through digital devices such as smartphones. However, the ability for people to manage their healthcare digitally has not yet been fully realised. Patient portals are secure online links that offer patients convenient and constant access to their personal health records. Evidence has suggested that patient portals can enhance patients' engagement in their own care and support them to manage any long-term conditions. This article describes the introduction of a patient portal at Cambridge University Hospitals NHS Foundation Trust. The article outlines the process of implementation and discusses the lessons learned, which may be of value to other organisations.

Educational requirements of nurses providing care to children with complex needs in the community

BACKGROUND

The number of children with complex care needs has increased in recent decades and many of them are cared for in the community. Nurses may require additional training and education to provide optimal care to these children.

AIM

To establish whether nurses providing care to children with complex needs in the community feel prepared for their role and whether they require additional education and/or training, and to identify the essential skills and knowledge required to provide care to children with complex needs in the community.

METHOD

A quantitative descriptive study was conducted with nurses employed by private providers to care for children with complex needs in the community across the Republic of Ireland. The study used an existing online survey validated through a literature review, an expert panel review and a pilot study.

FINDINGS

A total of 62 nurses responded, 53% of them (n=33) stating that their current education met their requirements when caring for children with complex needs in the community. There was a small positive correlation between the number of years of nursing experience and whether respondents thought their educational requirements were being met. More experienced respondents identified a need for continuing education and less experienced respondents identified a need for community placements during preregistration education. Assisted ventilation, non-invasive ventilation and tracheostomy care were the three top subject areas in terms of the usefulness of their inclusion in an educational programme designed to enhance the knowledge and skills of nurses providing care to children with complex needs in the community.

CONCLUSION

The findings reinforce the need for specific training and continuing education for specialist nurses caring for children with complex needs and their families in the community.

Supporting the well-being of nurses working during COVID-19

On 11 March 2020, the World Health Organization declared that the coronavirus disease 2019 (COVID-19) was a pandemic. As the COVID-19 pandemic has developed there have been many parallels made with other pandemics and epidemics, such as the 1918 influenza A (H1N1) pandemic and the 2003 severe acute respiratory syndrome (SARS) epidemic. This article discusses the challenges experienced by healthcare staff working during COVID-19, and the lessons that can be learned, such as the enhanced support required for staff.

Perceptions and beliefs about the regulation of advanced nurse practitioners

BACKGROUND

The role of the advanced nurse practitioner (ANP) is not regulated in the UK, which has led to wide variation in the skills, competencies and academic qualifications of nurses using this title. Urgent treatment centres (UTCs) require a broad and experienced knowledge base to meet the demand of patients presenting with undifferentiated illnesses and injuries, which can be stressful and challenging.

AIM

To examine the perceptions and beliefs about ANP regulation, and to explore and discuss any ideas about proposed regulation.

METHOD

The author used interpretative phenomenological analysis to uncover valuable insights into the experiences of two ANPs working in an UTC, and their beliefs around regulation of the ANP role.

RESULTS

Both ANPs had different backgrounds and qualifications yet still had similar perceptions and beliefs regarding the regulation of ANPs. Five main themes were developed from the interview transcripts.

CONCLUSION

This study identified the need to consider the importance of ANPs' identity and the complex regulatory process required to standardise the role.

BMUS journal club on Twitter: An analysis of the first #BMUS_JC discussions

INTRODUCTION

Journal clubs have evolved over recent years within healthcare to encourage continuing professional development. More recently, there has been a move from face-to-face group meetings to virtual groups utilising social media platforms. This article aims to explore the discussions and narrative following the inaugural BMUS journal club, highlighting the key discussions and themes from the participants and to provide a narrative for the future of ultrasound continuing professional development.

METHODS

The August 2020 journal club chat was focussed on the article featured in Ultrasound: "Sonographers' level of autonomy in communication in Australian obstetric settings: Does it affect their professional identity?" by Thomas et al. Data consisting of Twitter correspondence were extracted and analysed from the advanced search function on Twitter using #BMUS_JC thread. An initial review ensured related content was included. A second review and semantic thematic analysis was then conducted on the 123 tweets.

RESULTS

In total, seven overall themes were identified between the three sub-threads within the journal club discussions. Those participating in the Twitter discussion recognised the limitations and barriers for communicating results to patients, acknowledging that training, support and regulatory involvement is required for sonographers to change practice locally and internationally.

CONCLUSION

The group discussions on Twitter highlight the ongoing issues for sonographers' professional identity worldwide. Furthermore, our analysis echo other contemporary studies which indicate that Twitter journal clubs act as a fruitful and dynamic source of continuing professional development, particularly in an era where social distancing is encouraged. The outcomes of the first BMUS journal club support the wider evidence that online journal clubs can provide a successful platform for professional discussion and debate.

Investigating organisational justice and job satisfaction as perceived by nurses, and its relationship to organizational citizenship behaviour

BACKGROUND

Organisational justice refers to the extent to which employees perceive workplace procedures, interactions, and outcomes to be fair in nature. Previous research has found that organisational justice has been associated with an employee's commitment to their organisation, job satisfaction, and intention to leave their role. Organisational justice has also been linked to organisational citizenship behaviours, and the likelihood of these behaviours being demonstrated by employees.

AIM

To investigate staff nurses' perceptions of organisational justice and job satisfaction and its relationship to their levels of organisational citizenship behaviour.

METHOD

Perceived levels of organisational justice, job satisfaction, and levels of organisational citizenship behaviour were evaluated among 175 nurses working in two hospitals in Egypt. Analysis was undertaken to ascertain whether a correlation existed between organisational justice or job satisfaction and levels of organisational citizenship behaviour.

RESULTS

The majority of nurses in this study were found to perceive moderate levels of organisational justice. Organisational justice was positively correlated with levels of organisational citizenship behaviour, as was job satisfaction.

CONCLUSION

This study found that nurses in two hospitals in Egypt perceived moderate levels of organisational justice in their place of work. Nurse managers should pay extra attention to strategies that promote organisational justice among nurses.

Compassion in nursing: exploring the perceptions of students and academics

BACKGROUND

Compassion is integral to effective nursing practice, yet there is limited empirical research exploring this concept, particularly from a professional perspective. Aim To advance understanding of compassion from a professional perspective, specifically through the perceptions of students and academics from the fields of adult, child, learning disability and mental health nursing.

METHOD

A constructivist grounded theory study was undertaken, and a theoretical sampling strategy was used to guide the selection of appropriate participants. A total of 12 nursing students and eight nurse academics were interviewed to explore their perceptions of compassion in nursing between January and August 2018. The interview transcripts were analysed using grounded theory techniques.

FINDINGS

Four categories were identified from the interview data: character for compassion, competence for compassion, culture for compassion, and connections for compassion. These categories were interlinked, with each having the potential to influence the implementation of humanising approaches to care, which participants perceived to be fundamental to compassion.

CONCLUSION

Compassion is a complex concept that can be influenced by biological, psychological and socio-contextual factors. Further consideration of these factors is required to support nurses to facilitate compassion through humanising approaches to care. The findings of this study advance the existing evidence to inform future policy, practice, education and research.

Reimagining care homes: can the COVID-19 pandemic act as a catalyst for enhancing staff status and education?

During the first wave of the coronavirus disease 2019 (COVID-19) pandemic, older people were discharged from hospitals to care homes to release NHS beds. This influx of new residents whose COVID-19 status was largely unknown added to the many challenges already experienced by care homes, with serious consequences including an increased number of deaths among residents. The social care sector has been fragile for several years and the pandemic has brought the challenges experienced by care homes to the forefront, prompting renewed calls for improved funding and reform. This article describes the ongoing challenges and additional challenges caused by the pandemic in the care home sector. The authors argue for urgent reform to enhance the status and education of care home staff, move towards registration of the social care workforce in England, and achieve integration of health and social care services for older people.

Examining the effects of COVID-19 on mental health services, service users and nurses

The coronavirus disease 2019 (COVID-19) was declared a pandemic by the World Health Organization in March 2020. This article examines the effects of the pandemic on mental health services, service users and healthcare staff, including nurses in the UK. It explores how the pandemic has led to increased demand for mental health services, alongside a concomitant increase in the severity of cases. The authors also consider how the effects of COVID-19 on healthcare staff and service users can be managed, for example by providing mental health services to front-line staff, and by implementing innovative solutions such as increased remote working and digital therapy.

Continuing professional development: evaluating a masterclass for band 5 children's nurses

BACKGROUND

Continuing professional development (CPD) is an important factor in being able to recruit and retain staff. However, it is recognised that budget constraints make offering CPD difficult, and it often falls to local NHS organisations and higher education providers to develop CPD initiatives that are fit for purpose.

AIM

To evaluate the impact of a CPD masterclass on band 5 children's nurses.

METHOD

Fourteen band 5 children's nurses attended a CPD masterclass delivered as a series of workshops over one day. Participants completed questionnaires before, at the end of, and three months after the masterclass. The pre-masterclass and three-month follow-up questionnaires included the short version of the Occupational Self-Efficacy Scale.

FINDINGS

After the masterclass, all participants had a plan (or a partial plan) for their career development, compared with 79% before it. Participants felt more confident at handling challenging situations at work after the masterclass. Participants appreciated the opportunity to focus on their CPD needs and discuss them with colleagues.

CONCLUSION

Time for CPD, career development opportunities, workplace culture, learning and development, and confidence are all important factors to consider when developing CPD opportunities for band 5 children's nurses.

Nurses must have moral courage to call upon our nation's leaders to reduce the effects of firearms

President Biden's inauguration and the subsequent convening of a democratically controlled Congress signals a real opportunity to make progress on legislation to reduce the devastating effects firearms are causing in the United States. Nurses need to seize this opportunity and call upon our nation's leaders to prioritize legislation that would allow the United States to end the epidemic caused by firearms.

Linking nursing education to practice in India

Governed by central and state nursing Acts that are dated and disconnected, and numbers below global norms, nursing education and practice function within caste- and gender-based prejudices in India. Nursing education is fragmented and siloed, and nursing practice is delinked from education. The study strategically relooks at the Acts and highlights pathways that can strengthen, sustain, or weaken nursing education and practice, and suggests how nursing education can be linked to practice.

Understanding nurses' responsibilities in promoting equality and diversity

Nurses have a duty to promote the values of equality and diversity during their interactions with patients and their families and carers, as well as peers and colleagues. This article defines the terms equality, diversity and inclusion, and explains the importance of the Equality Act 2010 and the Human Rights Act 1998 in protecting people from various types of discrimination. It also outlines nurses' responsibilities in promoting equality and diversity by treating all patients and colleagues with respect and dignity, providing compassionate leadership, and practising in accordance with the ethical principle of justice. The article encourages and empowers nurses to recognise and challenge discrimination wherever they see it, thereby delivering high-quality care to all patients.

Managing volunteers who support patients with dementia or cognitive impairment on acute hospital wards: the NURTURe model

Volunteers are widely used to support patients with dementia or cognitive impairment on acute hospital wards. However, it appears that traditional volunteer management models do not fully address the challenges posed by managing volunteers in that setting. In a study of the use of volunteers in the care of people with dementia and cognitive impairment on acute hospital wards, interviews with a range of stakeholders revealed challenges regarding the environment, role and image of volunteers. Based on the study findings, an alternative model for managing volunteers on acute hospital wards was developed. This article describes the study and discusses the development of this alternative approach, the NURTURe model.

Managing capability in specialist nursing practice

Raising concerns over another nurse's clinical practice and capability presents significant challenges, particularly in specialist clinical nursing roles. However, the support provided to nurses who raise such concerns is not always optimal. While compassionate leadership in healthcare has been stated as a priority to develop safer workplaces for staff, it must be balanced against the need to manage staff undergoing capability management processes. This article discusses how enhanced training and support for both line managers and staff can improve the capability management processes.

How to undertake effective record-keeping and documentation

RATIONALE AND KEY POINTS

Effective record-keeping and documentation is an essential element of all healthcare professionals' roles, including nurses, and can support the provision of safe, high-quality patient care. This article explains the importance of record-keeping and documentation in nursing and healthcare, and outlines the principles for maintaining clear and accurate patient records. REFLECTIVE ACTIVITY: 'How to' articles can help to update your practice and ensure it remains evidence-based. Apply this article to your practice. Reflect on and write a short account of.

Nursing-sensitive indicators: a concept analysis

Nursing-sensitive indicators (NSIs) are the criteria for changes in a person's health status that nursing care can directly affect, and they form the foundation for monitoring the quality of nursing care. For example, they can assist in establishing a common ground for benchmarking and in providing evidence of the cost-effectiveness of nursing care. However, despite the considerable influence of nursing interventions on the quality of healthcare, measuring the quality of nursing care and its effects on patient outcomes and healthcare systems remains challenging. There is also little consensus on what constitutes an NSI, resulting in inconsistent conceptualisations for measuring the quality of nursing care and the use of several different terms to describe indicators that are sensitive to nursing interventions. This article describes a literature review and concept analysis, which enabled the authors to develop a concept model for NSIs, with the intention of improving the concept of NSIs.

Moving from face-to-face to telephone assessments with patients during the COVID-19 pandemic

The coronavirus 2019 (COVID-19) pandemic has led to an increase in the number of healthcare consultations being undertaken remotely rather than face to face, including telephone assessments with patients. When undertaking telephone assessments, the communication and clinical skills used in face-to-face consultations must be adapted to compensate for the loss of visual contact between the patient and the nurse. Specific techniques such as visualisation and managing silence can enable the nurse to develop trust and rapport with the patient, and contribute to effective telephone assessments.

Supporting nurses' recovery during and following the COVID-19 pandemic

Research suggests that working during traumatic events can lead to deteriorating physical and mental health for nurses, a phenomenon that has been demonstrated during the coronavirus 2019 (COVID-19) pandemic. However, research has also shown that there are evidence-based strategies that can be used to assist nurses in their recovery from such events. Promoting awareness among individual nurses about the effects of COVID-19 enables them to adopt positive coping strategies, both on an individual and organisational level. This article details strategies including formal and informal debriefing, taking regular breaks, and using stress mitigation strategies during shifts. The article also discusses the potential for post-traumatic psychological growth. This acknowledges that while working in a healthcare environment during COVID-19 can be extremely challenging, it also enables nurses to experience personal growth such as the development of emotional intelligence. As nurses adapt to the 'new normal' of working during COVID-19, healthcare organisations should ensure that they provide nurses with the support that enables them to recover effectively.

Assessment and management of metastatic bone cancer in emergency departments

A cancer diagnosis in emergency departments (EDs) is often associated with advanced or metastatic cancer. Patients with bone metastases have a complex range of physical and psychological needs. Meeting the needs of patients with cancer is an important part of the role of emergency nurses, but evidence suggests that they often do not feel adequately prepared to provide effective care for this patient group. This article uses a case study of a patient who presented to an ED with metastatic cancer in his right lower limb, to provide an overview of bone metastases, including the relevant anatomy, pain management and psychological support. The article also outlines the signs and symptoms of bone metastases and discusses patient assessment, symptom management and available treatments.

Investigating the factors that influence Iranian nurses' workplace happiness

BACKGROUND

Employees who describe themselves as happy in their work are more likely to be motivated to fulfil their professional duties. Therefore, it is important that healthcare organisations and managers understand how to promote a sense of happiness among nurses.

AIM

To investigate the relationship between the concepts of psychological capital, interactional justice, supervisor support and workplace happiness, and how they are mediated by employees' trust in their supervisors.

METHOD

Self-report questionnaires were used to obtain data from nurses on the variables of trust in supervisor, psychological capital, interactional justice, supervisor support and happiness at work. The questionnaires were distributed to 250 nurses working in hospitals in the city of Hamedan, Iran, and a total of 200 respondents completed and returned them. The data were then applied to a proposed model for promoting employees' workplace happiness, which was evaluated using data analysis software.

RESULTS

The results showed that the model correctly identified a pathway for promoting workplace happiness in nurses. Moreover, it was found that psychological capital, interactional justice and supervisor support led to improved workplace satisfaction through the mediating role of nurses' trust in their supervisors.

CONCLUSION

The findings of this study indicate that paying attention to employees' psychological capital, interactional justice and supervisor support, as well maintaining employees' trust in their supervisors, could assist healthcare organisations and managers to achieve organisational targets such as increased job satisfaction.

Hand injury: investigating the accuracy of referrals to a specialist trauma centre

Hand injury is a common presentation in the emergency department (ED). The accurate assessment of hand injuries is essential to ensure optimal management, which may need to include referral to a tertiary trauma centre. However, hand injury assessment can be challenging, particularly in children. A better understanding of the accuracy of hand injury referrals to tertiary care can help improve clinical practice and clinician training. This article reports on a service improvement project that aimed to determine the accuracy of hand injury referrals from EDs and general practices to a tertiary trauma centre. The retrospective investigation found the accuracy of referrals to be high, but also identified areas where hand injury assessment required improvement, one of them being the training of clinicians referring complex cases to tertiary care.

Planning surgery for young people with learning disabilities

Surgery for spinal deformity is complex and preparation involves a wide multidisciplinary team. For young people with learning disabilities, especially those who have behaviour that challenges, there are further considerations to ensure that their hospital stay is a positive experience and all their additional needs are met. Staff and carers need to be well informed and there must be effective communication. Evaluation of one patient's journey through pre-assessment, surgery and rehabilitation has identified the need for more input from learning disability liaison nurses in acute children's services.