Journal of advanced nursing
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A variable proportion of hospital in-patients were deemed 'not for resuscitation'. Using a qualitative methodology, this phenomenon was investigated, placing particular emphasis upon the effect on nursing care. A total of 71 student nurses from two district general hospitals were interviewed and from transcriptions of tape recordings of the interviews, utilizing a grounded theory approach, the following conceptual categories were identified: the patients; decision making; changes in nursing care? are patients and/or their relatives consulted? the unsuccessful resuscitation; the right to die; and dying and death. ⋯ Informants felt that subjecting patients to cardiopulmonary resuscitation was incompatible with a dignified death. Senior members of the nursing staff were felt to be unfeeling in dealing with the distress of their juniors when laying out deceased patients. More discussion and joint decision making between health care professionals would alleviate some of the student nurses' distress concerning patients who are 'not for resuscitation'.
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This study was carried out to investigate the effect of triage on attenders' waiting times in an accident and emergency (A & E) department. The A & E department comprised three separate areas: the A & E unit, dressing clinic and review clinic. Data on all A & E attenders were collected by the nursing staff over a period of 1 week using a data collection form. ⋯ This latter finding is a cause for concern, since the receptionist is the main triage assessor at night. However, the time the attender spent waiting to be clinically assessed by a health care professional (nurse) was shorter in 1988 than when performed by a health care professional (doctor) in 1986. This indicated that nurse triage enabled a shorter waiting time between arrival and assessment of the A & E unit attender.
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Comparative Study
The costing of nursing care: a study of 65 colorectal cancer patients.
Nursing care is a major factor in the cost of most medical treatments. This paper reports on two alternative techniques for estimating the costs of nursing care, in the context of colorectal cancer treatment on a surgical ward in the University Hospital, Nottingham. The simpler, but cruder, technique is based on average patient costs, whilst the other is patient-specific and incorporates the use of nursing dependency data. Results from the two estimation methods are compared and the implications for the proper costing of nursing care are discussed.
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Ethical debate abounds in the literature relative to treatment decisions for the high risk neonate in the intensive care nursery. A systematic examination of the parents' perspective is missing. ⋯ This concept evolved through the parents' reflection on conflict naming, content of decision-making, context of decision-making, information sharing and perception of infant status. These concerns differ profoundly from those of health professionals, philosophers, theologians and others active in this debate who cite lower limits of viability, iatrogenic effects of treatment, use of multiple invasive procedures, and the role of paternalism as ethical issues.
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Adequate pain relief during the postoperative period has long been recognized as difficult to accomplish. The reasons for this are mentioned in a brief review of methods of pain control, and an overview of the detrimental effects of acute pain is given. ⋯ It was also noted that only 30-35% of the maximum doses of analgesics prescribed were actually given within the immediate postoperative period. The possible reasons for these findings are discussed.