It starts off as something simple. Your patient is complaining of leg pain. Their right calf is swollen to twice the size of the left, and it is bright red. Whether your patient has had surgery, suffered trauma, or even has just come off of a long trip in the car, they may be at risk of venous thromboembolism, also known as deep vein thrombosis. It is important to constantly monitor the patient for signs and symptoms of venous thromboembolism and to know about measures for prevention. The prophylaxis for VTE has come a long way in recent years. Hospitals now have dedicated assessments in place to help prevent this sometimes silent condition from taking lives.
Tags: Vascular, Preventative health, Nursing
Published: November 30, 2011
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 Antibiotic adherence is an important issue in all patients, but specifically so in children. There are usually a number of factors influencing a doctor’s choice of antibiotic, however taste is not usually one of them. Research has indicated the importance of palatability when selecting drugs for paediatrics, so we are going to take a closer look at its influence, and what we can do to help.
Tags: Medicines, Paediatric Nusring, Nursing
Published: November 30, 2011
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 As a nurse, you may encounter parents who are against childhood vaccines. The debate over immunisations is a hot one, but the preponderance of the evidence suggests that vaccines are not only necessary, but they are the safest way to protect children from deadly diseases. Many studies have shown that the only way to protect children and the population from the diseases that these vaccines fight is to continue to inoculate children. You may encounter parents who want more information, or who have concerns that you don't know how to address. Here are some arguments in contrast to common concerns parents have about childhood vaccines.
Tags: Infection Control, Immunology, Minimising Risk
Published: November 26, 2011
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 A woman sits on the examination table in the middle of the emergency room. The curtain is drawn around her, but she seems to shrink from the sight. She has a large bruise forming over her eye, and you know that by morning, she'll have a shiner that everybody will see. She claims she fell down the stairs. You don't believe her. This is the third time this month she's been in here with a fall. When you confront her about her falls, she doesn't look at you, and she doesn't want to talk about it. You are certain she is a victim of domestic violence, but what can you do about it? As a nurse, you have the duty both ethically and legally to help her.
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 With the media so focused on diets and body size there can be little surprise that eating disorders are becoming more common and are affecting a wider variety of people. The Nurse Practitioner has recently published an article focusing on strategies the practising nurse can use to identify and manage individuals with eating disorders.
Eating disorders
Most people have heard of anorexia (nervosa) and bulimia (nervosa), both of which are complex psychiatric conditions believed to be on a disease continuum, where symptom overlap is common. Along with eating disorder not otherwise specified (EDNOS), these conditions result in altered body image and abnormal eating habits (starving, binging/purging) with the affected individual preoccupied with weight and body shape. Anorexia nervosa (AN) has one of the highest death rates of all psychiatric disorders, however early diagnosis is often uncommon.
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 Over the past month or so we have briefly examined how to undertake some basic research and pointers on how to perform a literature review. We are going to continue this theme by looking at how to appropriately critique a research article.
Why bother critiquing?
If you’ve managed to get your hands on peer reviewed articles then you may wonder why it’s necessary for you to perform your own article critique – surely the article will be of good quality if it has made it through the peer review process? Unfortunately this is not always the case. Publication bias can occur when editors only accept manuscripts that have a bearing on the direction of their own research, or reject manuscripts with negative findings. Additionally not all peer reviewers have expert knowledge of the subject matter, which can introduce bias and sometimes a conflict of interest. Performing your own critical analysis of an article allows you to consider its value to you and to your workplace. Critical evaluation is defined as “a systematic way of considering the truthfulness of a piece of research, the results and how relevant and applicable they are”.
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 Whether it is multiple patients, too many call bells, or the needs of co-workers, nurses deal with many different types of stress and have to know how to juggle all of these wildly different people and events clamouring for their attention - with ease.
Sometimes life outside of work can also test a nurse's sense of time management skills, so the skills a nurse learns to manage patients can often help make their home life flow more smoothly. To master how to navigate the stressful waters of nursing work and a hectic home life, a nurse needs to deftly organise the information coming at them, prioritise that information to handle the most important tasks first, and learn to roll with the inevitable interruptions.
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 You stand at the doorway and watch your patient's chest rise and fall. All around him, his family is crying. They are standing there, looking at you, waiting for you to tell them what the doctor said. You don't want to break their hearts, but you can feel your heart breaking inside of you. How many times has this patient come to this hospital? How many time have you had the opportunity – no, the honour – of taking care of him and his family for the day? You have looked at family pictures on the wall. You know all about his prized Pekinese at home that he hasn't seen in eight months because of his illness. You know it all, and now... now...
You are emotionally involved. That's what that lump in your throat means. You need to tell them the truth that the patient will likely not last the night, but you can't because you are having a hard time accepting the information yourself. You don't want it to be true. Tears burn at the corners of your eyes, but you cannot let them fall, not while you wear that uniform. How do you deal with a patient and his or her family when you have become emotionally involved?
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 All nurses have had family members yell at them at one time in their career. Whether it is the irate spouse who blows up in the middle of the ward because his wife is dying or the daughter who tears a nurse apart over some imagined oversight in her mother's care, nurses are often on the front lines of the emotional roller coaster that families experience in the hospital, long-term care, and home care settings.
Even if you work in a doctor's office, you can encounter angry relatives of patients who can become verbally abusive with you. Knowing how to diffuse these situations can sometimes mean the difference between a relative angrily walking out and that person coming to understand that the nurse is only trying to help.
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