Our continuing professional development (CPD) articles are designed to assist with your nursing skills and practice.
Why you should read this article • To understand the difference between normative ethics and teleological ethics, and how they are applied in everyday care situations • To enhance your knowledge on ethics derived from the principles of person-centred care • 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) Nurses working across community and primary care settings face a number of ethical issues in their everyday work. Ethical principles underpin optimal practice. There are two main approaches to ethical reasoning: normative ethics, based on the rights and obligations of an individual; and teleological ethics, based on anticipating the consequences of an action. Issues can arise when ethical principles based on the obligations of the nurse or an analysis of the possible consequences of an action are applied to care. Nurses have to manage patients’ expectations, service protocols and economic constraints, as well as proceed in a person-centred and ethical way. This article explains the two main approaches to ethical reasoning, before identifying their limits and proposing some person-centred principles of care negotiation that will enable nurses to provide care that is principled and practical.
In healthcare clearly formulated arguments can mean nurses’ efforts are directed effectively
Nurses involved in travel health should be aware of the signs of dengue fever and what to do
Risks associated with tracheostomy cannot be eliminated, but they can be addressed
This article summarises the diagnosis, treatment and long-term consequences of lymphoma
Varicella zoster virus (VZV) is a common illness that causes varicella (chickenpox) and shingles. It is prevalent mostly during childhood but there are additional co-morbidities from this disease for a woman and her fetus, if she contracts it during pregnancy. Many developed countries vaccinate children who have not acquired immunity to prevent their developing complicated varicella as adults. Countries that have implemented widespread vaccination have fewer hospital admissions for such complications. The UK does not have a national VZV vaccination programme and there is no strategy for reporting and documenting the incidence of the illness, so it is difficult to determine the potential prevalence of gestational VZV and its associated outcomes. The aim of this article is to provide an understanding of the aetiology of VZV and the potential health risks to unimmune women who may contact it during pregnancy, to advise them about their healthcare choices.
Long-acting, reversible contraception is a safe and effective way to control fertility, enabling women to have the sex life they want without the risk of pregnancy. Nurses working in primary care are important in providing contraception and promoting long-acting methods. Actively reviewing staff’s knowledge about the accessibility and availability of all contraceptive methods and identifying any gaps informs decisions concerning investment in their training and development. Sexual health and the provision of contraception, as well as the promotion of long-acting contraception, can be achieved by embracing social media and technology, not only with the practice population but with staff accessing e-learning and training pathways.
This article is aimed at primary care nurses and covers the presentation of migraine across the whole lifespan. It reminds the reader that migraine is a genetic condition, and gives an overview of presentation, phases of migraine attacks, triggers, treatment strategies and situations that may be seen in primary care. It discusses the differences between migraine with and without aura and the importance of accurate diagnosis. Issues pertinent to pregnancy, breastfeeding, contraception, perimenopause and children are discussed, as well as when to scan and when to refer patients with headaches. The article is intended to provide insights into the effects of this diagnosis on adults and children. It also highlights the causes and solutions of the common problem of medication overuse headache.
Multimorbidity is becoming an increasing problem with more patients having two or more long-term conditions. This is putting an additional burden on healthcare resources while having a detrimental effect on the quality of patients’ lives. Clinicians need to consider how they can treat this cohort of patients better. This article will discuss the issues and challenges of dealing with multimorbidity and suggest how these patients can best be managed.
Irritable bowel syndrome is a common disorder of gastrointestinal function with symptoms that can include abdominal pain, constipation and/or diarrhoea. Many patients report that diet affects symptoms and guidelines identify first- and second-line dietary treatments to improve symptoms. This article discusses recent improvements in standards of care for patients, with an emphasis on diet, and suggests a new approach to treating patients that is clinically effective and reduces costs.
This article outlines the issues involved in assessing and managing people who present with skin infections. Inflammatory skin conditions such as eczema, psoriasis and skin lesions are the commonest reason for referral to a specialist, whereas skin infections are commonly seen by generalists ( Schofield et al 2009 ). If the skin’s integrity is damaged, it can become vulnerable to microorganisms, resulting in an infection. Skin infections are common and are often upsetting for people and their families because of the stigma surrounding them – the perception being that the infections are the result of poor hygiene and the person being dirty. As a result, many people with dermatology problems experience negative reactions from others. This article will provide an overview of skin infections commonly seen by nurses working in primary care. It will look at examples of bacterial, viral and fungal infections, focusing on their aetiology, history, clinical findings, diagnosis, treatment and management.
Spirometry is the most widely used pulmonary function test. It is useful for identifying obstructive and restrictive ventilatory patterns, and plays an important part in supporting the diagnosis of respiratory conditions such as asthma and chronic obstructive pulmonary disease. This article focuses on the importance of accurate interpretation of spirometry to improve a diagnosis, and the process of identifying the correct patient, assuring the quality of the spirometry, reporting the results and relating this back to the patient and the clinical history taken.