Journal of advanced nursing
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Review
Normal saline instillation with endotracheal suctioning: primum non nocere (first do no harm).
Normal saline instillation, in conjunction with endotracheal suctioning, is purported to be beneficial in removing thick and tenacious secretions for patients receiving mechanical ventilation. Guidelines for this routine procedure are inconsistent and its efficacy is unsupported by research-based evidence. This discussion paper highlights that the procedure produces no physiological benefits for the patient and, indeed, may have detrimental effects on the patient's psychological wellbeing. It is proposed that after 25 years of inconsistent practice in trying to remove thick and tenacious secretions, it is time to focus on techniques to prevent thick and tenacious secretions.
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Comparative Study
Non-verbal behaviour in nurse-elderly patient communication.
This study explores the occurrence of non-verbal communication in nurse-elderly patient interaction in two different care settings: home nursing and a home for the elderly. In a sample of 181 nursing encounters involving 47 nurses a study was made of videotaped nurse-patient communication. Six non-verbal behaviours were observed: patient-directed eye gaze, affirmative head nodding, smiling, forward leaning, affective touch and instrumental touch. ⋯ The results demonstrated that nurses use mainly eye gaze, head nodding and smiling to establish a good relation with their patients. The use of affective touch is mainly attributable to nurses' personal style. Compared to nurses in the community, nurses in the home for the elderly more often display non-verbal behaviours such as patient-directed gaze and affective touch.
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In the research reported, 298 patients were asked to describe their memories of the Royal Melbourne Hospital's intensive care unit (ICU). The data were collected by either self-reported questionnaires or structured interviews and examined from a bio-psycho-social perspective using both qualitative and quantitative methods. These recollections demonstrate that the close surveillance by both technological support and health care practitioners provide many patients and their families with a feeling of safety. ⋯ The data indicate that while patients found the presence of good communication in ICU both therapeutic and reassuring, they found the lack of good communication distressing. Poor communication not only caused anxiety while the patient was in ICU but also contributed to less than optimal recoveries after discharge. Finally, it will be argued that the provision of information from nurses not only diminished feelings of anxiety but also empowered patients to become involved in decisions about their care.
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This study measured the attitudes of Finnish paediatric nurses to children in pain and the connection between nurses' attitudes, nurses' attributes and nurses' own view of their knowledge and ability to take care of children in pain. The measurements were based on a purpose-designed instrument consisting of a 41-item Likert-type questionnaire and demographic data. The convenience sample consisted of paediatric nurses at all five university hospitals in Finland (n = 303). ⋯ The findings of this study indicate that although nurses' attitudes to pain management are mainly positive, there is much variation in how they feel they can actually provide quality care to control pain. More attention should be paid to training nurses and to providing knowledge about the treatment of pain in children. Future research should look at nurses' existing knowledge base as well as their activities in the assessment and management of pain.
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As a practice-orientated profession, nursing is clearly guided by theoretical concepts. Concept clarification attempts to show speakers and readers how they can liberate themselves from the judgement limitations imposed by rigid, unexamined beliefs, by exposing differences in the interpretation of language and how that interpretation creates meaning. Critical thinking is one way nurses apply the process of inquiry. ⋯ The purpose of this analysis is to illuminate the meaning and clarify the intent of critical thinking application to nursing practice. The paper begins by briefly outlining the historical aspects of critical social theory, suggesting that the foundational tenets of critical theory have influenced the development of critical thinking. The paper also critically compares the language used to describe critical thinking and that language that has traditionally defined nursing.