Nursing standard (Royal College of Nursing (Great Britain) : 1987)最新文献

The demand for high-quality end of life care services for lesbian, gay, bisexual, transgender or trans, queer and other sexual or gender minority (LGBTQ+) people will continue to increase alongside that of the wider population. However, there does not appear to be the expected, representative numbers of LGBTQ+ patients within such services. In this article, the author examines some of the challenges experienced by LGBTQ+ people in accessing long-term and end of life care services, and discusses issues related to the concealment and disclosure of sexual orientation and gender identity. The author also explores some of the ways in which nurses, educators and healthcare organisations might improve the representation and inclusion of LGBTQ+ people in end of life care services.

The concept of planetary health explains how human health and the health of the planet are intrinsically linked. As such, nurses have an important role in caring for the environment. Nurse leaders who consider the health of the planet alongside providing patient care can ensure that they offer effective leadership in a world threatened by growing environmental concerns. This article provides an overview of the concept of planetary health and examines the practical, ethical and relational dimensions of planetary health leadership in relation to nursing practice. The author also makes the case for broader action from healthcare organisations and leaders to contribute to the preservation of planetary health.

Evidence suggests that opioids are no longer appropriate for long-term use in chronic non-malignant pain, due to lack of efficacy and risks to patients such as increasing tolerance and dependency, multiple physical side effects, mental health issues or even death from accidental overdose. This article considers the evidence on the appropriate use of opioids, and ways to safely implement and manage their long-term use. The author details best practice for nurses on subjects such as the use of opioids in the treatment of various types of pain, the principles of opioid stewardship, optimising the effects of opioids, and the risk of tolerance, dependency and dose escalation.

Portal hypertension is a condition that describes increased pressure within the portal vein, an important structure that drains blood from the gastrointestinal tract and conveys it to the liver. This article describes the normal structure of the liver and its circulation. It also explains how cirrhosis leads to the development of portal hypertension and varices, and considers the latest evidence and guidance for safe clinical management. As liver disease is a leading cause of morbidity and mortality, nurses commonly encounter patients experiencing the effects of portal hypertension in practice, and professional bodies have highlighted a need for increased foundational nursing knowledge to enable informed care and optimise patient outcomes. Therefore, this article aims to enhance nurses' knowledge of the underlying pathophysiology, clinical manifestations and recommended management of portal hypertension and varices in the context of end-stage liver disease, with specific consideration of the nurse's role.

Professional identity, which reflects an individual's self-concept as a nurse, is a defining aspect of nursing. The development of professional identity in nursing students is shaped by their educational preparation, clinical experiences and relationships with the wider multidisciplinary team and patients. This article discusses the process of professional identity formation in nursing students and considers various factors that can influence its ongoing development as they progress and transition to newly registered nurses. The authors consider how nurses and educators can foster a sense of belonging in nursing students, provide them with consistent supervision and create supportive learning environments to help them establish resilient and authentic professional identities.

Nurses in all settings are frequently in contact with bereaved people, which places them in a unique position to offer emotional and practical support. However, nurses may feel unprepared to provide meaningful support to, or lack the confidence to initiate conversations with, bereaved people. This article describes theoretical models of grief and practical strategies that can inform and support effective and compassionate bereavement care. Applying these models and strategies can assist nurses in providing meaningful support to bereaved people and recognise when they may need additional, formal interventions from specialist services. The article also underscores the importance of organisational support and self-care to sustain the well-being of nurses delivering bereavement care.

The term neurodivergence encompasses conditions such as attention deficit hyperactivity disorder (ADHD), autism, developmental language disorder, dyscalculia, dyspraxia, dyslexia and Tourette syndrome. In recent years, there has been an increase in the reported numbers of neurodivergent nursing students. The Equality Act 2010 promotes inclusivity by placing a duty on organisations, including education providers, to make reasonable adjustments aimed at removing or reducing the disadvantages faced by people with disabilities. However, there are several barriers to making reasonable adjustments for neurodivergent students in placement settings. This article explores how to provide personalised support to neurodivergent students that is tailored to their needs and enables them to thrive during placements. It discusses the role of practice education facilitators, practice supervisors and practice assessors in promoting inclusion for these students, and describes a proposed flexible package of support developed by one of the authors in collaboration with a neurodivergent student.

Rationale and key points: Sepsis is a serious, life-threatening condition in which a dysregulated host response to infection causes organ dysfunction, potentially leading to death. It is a time-critical condition, so early recognition of deterioration potentially due to sepsis, escalation to a senior clinician and rapid initial treatment are key for improving outcomes and saving lives. Nurses screening patients for sepsis must have the knowledge and skills required to do so effectively, working within their level of competence. • Sepsis is a life-threatening and time-critical condition that requires prompt recognition and treatment. • To ensure comprehensive and accurate screening, it is recommended to use an early warning score observation chart and a sepsis screening tool. • The 'sepsis six' is a bundle of six activities that must be carried out to improve patient outcomes when sepsis is suspected. 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: • How this article might improve your practice when screening and providing rapid initial treatment for sepsis in adults. • How you could use this information to educate nursing students or colleagues about screening and providing rapid initial treatment for sepsis in adults.

While resilience is often promoted by healthcare organisations as a personal coping strategy, this approach risks overlooking systemic issues and structural inequalities that significantly affect staff well-being. This article critically explores the growing emphasis on resilience as a strategy for managing the stresses and demands experienced by nurses. It also examines how an overreliance on resilience can shift responsibility from organisations to individuals, potentially distorting perceptions of harm and internalising blame. Although the authors acknowledge the value of resilience, they advocate for a more balanced and integrated approach that combines individual resilience with organisational accountability and collective action to support the nursing workforce more effectively.

Psychological safety refers to the belief that one will not be punished or humiliated for speaking up with ideas, questions, concerns or mistakes. It comprises elements such as open communication, candour and honesty, interpersonal risk-taking and a learning culture. This article discusses the importance of fostering psychological safety as part of effective leadership. It also explores the benefits of leading in a psychologically safe way, highlighting research and evidence on how this can enhance patient care and team performance. The author places psychological safety in context by explaining the links and overlaps between this concept and various leadership styles.