CPD articles

Our continuing professional development (CPD) articles are designed to assist with your nursing skills and practice.

Breaking bad news to patients in the emergency department

Breaking bad news to patients in the emergency department

Why you should read this article: • To identify the importance of preparation for autonomous practitioners when breaking bad news in the emergency department (ED) • To consider further training to improve autonomous practitioners’ expertise and skill in breaking bad news in the ED • To count towards revalidation as part of your 35 hours of CPD, or you may wish to write a reflective account (UK readers) • To contribute towards your professional development and local registration renewal requirements (non-UK readers) Breaking the news of potentially serious and new diagnoses to patients in the emergency department (ED) is a common but challenging aspect of the autonomous practitioner’s role. It is a complex process, requiring expertise and skill. If the news is delivered appropriately there is evidence to suggest a beneficial effect on the patient’s ability to cope, yet there is little formal training available and literature focused on the ED setting is limited. This article aims to guide and prepare autonomous practitioners in the ED to break bad news to patients, including during remote consultations introduced due to the coronavirus disease 2019 pandemic. It identifies the importance of preparation; different approaches to breaking bad news, namely the six-stage SPIKES framework and a case study exploring its application in practice; the range of potential patient reactions and how these can be managed, including the provision of support; and how to involve and communicate with other members of the multidisciplinary team. Suggestions for further training are outlined.

Health promotion in emergency care: rationale, strategies and activities

Health promotion in emergency care: rationale, strategies and activities

Concept of health promotion and its relevance to nurses working in the emergency department

Managing violence and aggression in the emergency department

Managing violence and aggression in the emergency department

Featuring a successful small-scale trial of body-worn cameras at an East London ED

How to get care right for people with learning disabilities in the emergency department

To get care and treatment right it is essential to ‘ask and engage’ people

Meeting the needs of homeless people attending the emergency department

Meeting the needs of homeless people attending the emergency department

The care needs of homeless people attending EDs are frequently misunderstood

Mallet finger injuries: the signs, symptoms, diagnosis and management

Mallet finger injuries: the signs, symptoms, diagnosis and management

CPD article on the pathophysiology, signs, symptoms, diagnosis and management of mallet finger injuries

Sepsis: an overview of the signs, symptoms, diagnosis, treatment and pathophysiology

Sepsis: an overview of the signs, symptoms, diagnosis, treatment and pathophysiology

Sepsis is a medical emergency that should always be considered in acutely unwell patients

Nursing patients with acute aortic dissection in emergency departments

Nursing patients with acute aortic dissection in emergency departments

This article aims to increase emergency nurses’ knowledge of acute aortic dissection

Asthma

Nursing management of paediatric asthma in emergency departments

Childhood asthma is a complex disease which may be resistant to treatment and varies in its clinical presentation. The number of children admitted to emergency departments (EDs) with acute exacerbation of asthma is high and many are managed solely in the department. The correct assessment of the severity of an exacerbation can be achieved through competent history taking, examination and accurate recording of observations. Nurses working in EDs should be able to recognise the clinical signs and symptoms of acute asthma, assess severity and advise on appropriate management. Nurses should have some knowledge of first-line management and how and when to help deliver these therapies. They should also be able to guide patients in discharge and follow-up care, develop a rapport with families and educate them on topics such as trigger avoidance. The assessment and management of these patients as outlined in this article is based on the British Thoracic Society/Scottish Intercollegiate Network guidelines ( BTS/SIGN) (2016) .

Lyme disease: recognition and management for emergency nurses

Lyme disease: recognition and management for emergency nurses

Over the past ten years there has been a significant rise in the number of people who present to emergency departments with Lyme disease. Although some patients remain asymptomatic many present with a rash around a previous tick bite and others may present with a range of debilitating symptoms that can be problematic if left untreated. Due to the growing prevalence of Lyme disease in the UK and the US this article gives an overview of the vector-borne condition and provides emergency nurses with information about the pathophysiology, prevention, presenting signs and symptoms and management.

Burns

Emergency management of burns: part 2

Infrequent presentation of this patient group to emergency departments can cause stress and anxiety to front-line clinicians when they are faced with patients with a traumatic burn injury. Assessment relies on accurate evaluation of burn aetiology, size and depth, and initial management is directly responsible for patients’ outcomes and quality of life. This is the second article in a two-part series that gives an overview of the minimum standard of care in burns first aid, and highlights the likely challenges in assessment of burn depth and size. The aim of the two articles is to enhance emergency clinicians’ knowledge and confidence in burn management, and to build awareness of the life-changing implications of the initial clinical interventions in burn care.

Burns

Emergency management of burns: part 1

Caring for patients with burn injuries can be traumatic for staff. Non-specialist clinicians in emergency departments are often the first point of contact for patients with burn injuries and their families. Lack of burns education, exacerbated by infrequent presentations, can add to front-line clinicians’ stress and anxiety. Assessment relies on accurate evaluation of burn aetiology, and the size and depth of the injuries, and initial management is directly responsible for patients’ outcomes and quality of life. This is the first article in a two-part series that highlights the criteria and process of referral to a specialist burn service and gives an overview of the challenges posed by the burn mechanism and subsequent unique treatment considerations. The aim of the two articles is to enhance emergency clinicians’ knowledge and confidence in burn management, and to build awareness of the clinical guidance and support available via the specialist burn service providers.

Concussion in sport: the importance of accurate and reliable discharge advice

Concussion in sport is a common presentation in urgent and emergency care settings, so it is...

Nursing management of childhood chickenpox infection

Chickenpox is an extremely contagious infectious disease caused by varicella zoster virus (...

Parkinson’s disease: nursing care in emergency settings

In the UK 127,000 people are diagnosed with Parkinson’s disease, many of whom are frequently...

Prevention and management of skin tears in older people

Skin tears are frequently encountered in emergency and unscheduled care, and are prevalent...

The Glasgow Coma Scale in adults: doing it right

After 40 years, the Glasgow Coma Scale (GCS) is the resource of choice for assessing the...

Assessment and management of pain in children following traumatic limb injury

Children with acute musculoskeletal pain caused by traumatic injury often present to...

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