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- Herausgeber: John Wiley & Sons
- Kategorie: Fachliteratur
- Serie: Student Survival Skills
- Sprache: Englisch
Survive clinical skills training with this essential guide for all student nurses.
Providing words of wisdom and advice from real-life student nurses, Care Skills for Nurses is an easy-to-read, quick-reference guide to all the key care skills you need to know – boosting your confidence and competence both in the clinical skills lab and on your clinical placements.
Special features:
- Developed by students, for students
- Clear, straightforward, and jargon-free
- Ties in with the NMC standards for pre-registration education and the Essential Skills Clusters
- Examples and questions based on real life nursing and healthcare situations
- Available in a range of digital formats
Sie lesen das E-Book in den Legimi-Apps auf:
Seitenzahl: 199
Veröffentlichungsjahr: 2013
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Contents
Cover
Half Title page
Series
Title Page
Copyright
Preface
Introduction
Acknowledgements
Chapter 1: Care and Compassion in Nursing
TEST YOUR KNOWLEDGE
BIBLIOGRAPHY
Chapter 2: Basic Infection Control and Aseptic Technique
VIRUSES
BACTERIA
HAND WASHING
APRONS
PERSONAL PROTECTIVE EQUIPMENT
UNIFORMS
ASEPTIC TECHNIQUE
TEST YOUR KNOWLEDGE
BIBLIOGRAPHY
WEBSITE
Chapter 3: Performing Personal Care
SKIN CARE
THE SKIN AND THE AGEING PROCESS
CARING FOR BABIES AND INFANTS S KIN
BED BATHING
COMPRESSION STOCKINGS
MOUTH CARE
EAR, EYE AND NOSE CARE
NAIL CARE
TEST YOUR KNOWLEDGE
BIBLIOGRAPHY
Chapter 4: Continence Care
URINE
FLUIDS
FAECES
TEST YOUR KNOWLEDGE
BIBLIOGRAPHY
WEBSITE
Chapter 5: Pressure Ulcer Care
PRESSURE ULCER ASSESSMENT
A CROSS-SECTION OF THE SKIN
WHAT IS A PRESSURE ULCER?
HOW TO RECOGNISE A PRESSURE ULCER
TESTING FOR SIGNS OF A PRESSURE ULCER
COMMON AREAS FOR PRESSURE AREA FORMATION
CHANGING POSITION
SKIN CARE
NUTRITION
EPUAP CLASSIFICATION SYSTEM
PRESSURE ULCER RISK ASSESSMENT TOOL
TEST YOUR KNOWLEDGE
BIBLIOGRAPHY
WEBSITE
Chapter 6: Patient Safety
SAFETY BRIEFINGS
PATIENT SAFETY
FALLS PREVENTION
FALLS AT HOME
IN-PATIENT FALLS
REDUCING PATIENT FALLS
FOOTWEAR
IN VERY HIGH-RISK PATIENTS
THE MULTIDISCIPLINARY TEAM
FALLS AND DELIRIUM
FALLS RISK ASSESSMENT
BEDRAILS
USING AN ULTRA-LOW BED
VERY HIGH-RISK PATIENTS
WHAT TO DO IF A PATIENT FALLS
TEST YOUR KNOWLEDGE
BIBLIOGRAPHY
Chapter 7: Stoma Care
THE DIGESTIVE SYSTEM
THE RENAL SYSTEM
WHAT IS A STOMA?
STOMAL APPEARANCE
REASONS FOR STOMA SURGERY
DRAINAGE DEVICES
SKIN CONDITION
BODY IMAGE
CHANGING A STOMA BAG
DISPOSAL OF THE STOMA BAG
ISSUES TO CONSIDER
TEST YOUR KNOWLEDGE
BIBLIOGRAPHY
WEBSITE
Chapter 8: Peri-operative Care
WHAT IS PERI-OPERATIVE CARE?
PRE-ADMISSION ASSESSMENT
NURSING ASSESSMENT AND THE NURSING PROCESS
PRE-OPERATIVE PREPARATION
FASTING: ADULTS AND CHILDREN
MANAGEMENT OF MEDICATIONS
INTRA-OPERATIVE CARE
POST-OPERATIVE CARE
TEST YOUR KNOWLEDGE
BIBLIOGRAPHY
Chapter 9: Anaphylaxis
WHAT IS ANAPHYLAXIS?
WHAT IS AN ANAPHYLACTOID EVENT?
WHAT’S THE DIFFERENCE BETWEEN AN ANTIBODY AND AN ANTIGEN?
FOODS
INJECTED VENOM
DRUGS
LATEX
ROUTES
WHAT ARE THE SIGNS AND SYMPTOMS OF ANAPHYLAXIS?
Respiratory
MANAGEMENT
ADRENALINE
AFTERCARE
BIPHASIC RESPONSE
DOCUMENTATION
INVESTIGATIONS OF ANAPHYLAXIS
TEST YOUR KNOWLEDGE
BIBLIOGRAPHY
WEBSITE
Chapter 10: ECG Recording
HEART MONITORS
BASIC ANATOMY OF THE HEART
THE PROCEDURE
PERFORMING THE ECG
PLACEMENT OF THE LEADS
RECORDING
AFTERCARE
DOCUMENTATION
PROBLEMS WITH THE RECORDING
WHAT DOES IT ALL MEAN?
A NORMAL ECG
AC INTERFERENCE (ARTEFACT)
TEST YOUR KNOWLEDGE
BIBLIOGRAPHY
Chapter 11: Nutrition and Hydration Care
NUTRITION
PARENTERAL NUTRITION
KEY ASPECTS OF PROVIDING A CONDUCIVE EATING ENVIRONMENT
HYDRATION
CHILDREN
GOOD HYDRATION IN THE OLDER PATIENT
INTRACELLULAR AND EXTRACELLULAR FLUIDS AND ELECTROLYTES
FLUID REPLACEMENT
TEST YOUR KNOWLEDGE
BIBLIOGRAPHY
Chapter 12: Wound Care
WOUND CARE PREVENTION
THE SKIN
WOUNDS: CAUSES AND TYPES
CLASSIFICATION OF WOUNDS
WOUND COLOUR CODING
WOUND HEALING
OVERVIEW OF WOUND CARE PRODUCTS
SPECIALIST PRODUCTS
TEST YOUR KNOWLEDGE
BIBLIOGRAPHY
Answers to Activities, Questions and Test Your Knowledge
Appendix 1: The Components of Medical Words and Terms
Appendix 2: Weight Conversion Charts
KILOGRAMS TO POUNDS
STONES TO KILOGRAMS
POUNDS TO KILOGRAMS
Index
CARE SKILLS FOR NURSES
Student Survival Skills Series
Survive your nursing course with these essential guides for all student nurses:
Calculation Skills for Nurses Claire Boyd9781118448892
Medicine Management Skills for Nurses Claire Boyd9781118448854
Clinical Skills for Nurses Claire Boyd9781118448779
Care Skills for Nurses Claire Boyd9781118657386
This edition first published 2014 © 2014 by John Wiley & Sons, Ltd
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Library of Congress Cataloging-in-Publication Data
Boyd, Claire, author. Care skills for nurses / Claire Boyd. p. ; cm. – (Student survival skills series) Includes bibliographical references and index. ISBN 978-1-118-65738-6 (pbk.: alk. paper) – ISBN 978-1-118-65734-8 (mobi) – ISBN 978-1-118-65736-2 (epub) – ISBN 978-1-118-65737-9 (epdf) – ISBN 978-1-118-75738-3 – ISBN 978-1-118-75766-6 I. Title. II. Series: Student survival skills series. [DNLM: 1. Nursing Care–methods–Handbooks. WY 49] RT41 610.73–dc23
2013024791
A catalogue record for this book is available from the British Library.
Wiley also publishes its books in a variety of electronic formats. Some content that appears in print may not be available in electronic books.
Cover image courtesy of Visual Philosophy Chapter opener image: © iStockphoto.com/kokouu Cover design by Visual Philosophy
Preface
This book is designed to assist the student healthcare worker in 12 aspects of nursing that may be utilised in the hospital or community setting. It is designed to give a quick, snappy introduction to these skills in a non-threatening manner, allowing the reader to gain a brief understanding and overview. The aim is then to build on these skills.
Care and compassion are the two central themes running through this book, and due to their importance in the healthcare environment they are also the subject of the first chapter, which emphasises the importance of these key skills.
The book talks about ‘patients’ but often uses the community terminology of ‘service user’ as well. The paediatric nurse has not been forgotten, with information throughout incorporating this branch of nursing.
The book incorporates many exercises to check understanding, and is presented in a simple to follow step-by-step approach, ending with Test Your Knowledge exercises to relate learning to practice. The aim of this book is to start the individual on a journey through many healthcare-related exercises to help build confidence and competence: from day one to qualification, and beyond.
It has been compiled by quotes and tips from student nurses themselves: it is a book by students for students.
Claire Boyd
Bristol
May 2013
Introduction
Hello, my name is Claire and I am a Practice Development Trainer in a large NHS trust. I began my nurse training many years ago now, but still remember my first day ‘on the wards’ and how scary it felt. In my very first placement I was sent to the neighbouring ward for ‘a long stand’. Thinking this was some sort of medical equipment, I duly obliged. I asked for the long stand and then waited, and waited, and waited, before realising I had been ‘had’ and the brunt of my new co-worker’s joke. It seems that with increasing workloads many of us have lost our sense of humour, and according to recent press reports our ‘capacity to care’.
In my time as a nurse, if I was caring for a patient with a specific medical condition that I did not understand I would go to the university library to collect a book on the subject: no worldwide web at that time! Many of these books were informative, but they were too large and went into too much detail; in short, they were far too in-depth. I wanted a book I could carry around with me, to ‘dip into’, to gather the basic facts.
How I would have liked a small, snappy and clearly written book to help me to gain the information I needed, on the topics that I wanted to know about, enabling me to build my understanding. It is worth remembering, however, that although books can give the theory, the care aspect of nursing comes from within.
This book contains common nursing care activities that you may be required to perform, giving you the basics for use in your clinical placements. It treats those we are giving the care to – the patients and service users – in a holistic, compassionate and caring manner.
Some of these nursing care skills will require further training, supervision and/or proof of competence before being ‘let loose’. For example, taking an ECG recording will require training to use the ECG machine, and supervision will be required before conducting a bowel assessment.
You may be required to weigh your patient, on admission or as part of their ongoing care, so a weight conversion chart has been provided as Appendix 2 at the end of the book.
Lastly, you will come across many terms that may seem alien to you. Sitting through some handovers can feel like you are in a foreign language class! Many clinical placement areas have orientation packs for new staff, with a list of the most common terms used in that area. It is also always worth purchasing a nursing dictionary for understanding and never to be afraid to ask questions if you don’t know something. Many medical words and terms can be more readily understood if you become familiar with prefixes, suffixes and combining forms. With these components it is often possible to work out the meaning of new words. Appendix 1 lists some of these components and their meaning.
Good caring. Remember that it is our privilege to care for our patients and that it takes a remarkable personto be a nurse.
Acknowledgements
First acknowledgements go to the student nurses who have made this book possible with their hints and tips, which they have shared for those following in their footsteps.
Acknowledgements also go to North Bristol NHS Trust and specifically Jane Hadfield (Head of Learning and Development) and all my friends and colleagues in the Staff Development Department.
Thanks also to Magenta Styles (Executive Editor of Wiley Blackwell) for first approaching me about this exciting project, Madeleine Hurd (Associate Commissioning Editor), Catriona Cooper (Project Editor) and to freelance editor Nik Prowse for copy-editing the text for me.
I thank Dansac Limited for allowing the reproduction of the images of stoma products in Chapter 7, the Royal College of Nursing for permission to use the Principles of Nursing Practice in Chapter 1 and the Resuscitation Council (UK).
This book is dedicated to my loving family: my long-suffering husband Rob, my Rock (thanks also for the photographs), and Simon and Louise and David. Thank you for all your support.
Chapter 1
CARE AND COMPASSION IN NURSING
The reasons that individuals cite for wanting to work in the healthcare setting are numerous and varied. Personally, I went into nursing because I wanted to do some good: to help people. The biggest compliment I was ever paid in my nursing career was when a relative visiting her father told me that she wanted to go into nursing after watching me work on the ward and wanted to be ‘just like you – kind and caring’. However, visiting the wards in many different hospitals, and in community care homes, it seems that ‘kindness’ may often be in short supply.
It is true that nursing has been through many changes: not always all for the good. We have all seen the headlines citing lapses in basic care and how today’s nurses ‘have lost their compassion’. It seems that nursing is receiving a bad press at present and, although it shames me to say this, it is not always unjustified. This has prompted the Royal College of Nursing to launch a campaign, This is Nursing, to show the ‘skill and compassion’ of today’s nurses, as well as to explore the reasons behind failures in care (Royal College of Nursing 2012). This campaign, developed jointly by the Royal College of Nursing, the Nursing and Midwifery Council and the Department of Health, has produced the Principles of Nursing Practice (Royal College of Nursing 2010), which tell us what patients, colleagues, families and carers can expect from nursing. These principles are reproduced in Table 1.1.
Table 1.1 The Principles of Nursing Practice
ANurses and nursing staff treat everyone in their care with dignity and humanity – they understand their individual needs, show compassion and sensitivity, and provide care in a way that respects all people equally.BNurses and nursing staff take responsibility for the care they provide and answer for their own judgements and actions – they carry out these actions in a way that is agreed with their patients, and their families and carers of their patients, and in a way that meets the requirements of their professional bodies and the law.CNurses and nursing staff manage risk, are vigilant about risk, and help to keep everyone safe in the places they receive health care.DNurses and nursing staff provide and promote care that puts people at the centre, involves patients, service users, their families and their carers in decisions and helps them make informed choices about their treatment and care.ENurses and nursing staff are at the heart of the communication process: they assess, record and report on treatment and care, handle information sensitively and confidentially, deal with complaints effectively, and are conscientious in reporting the things they are concerned about.FNurses and nursing staff have an up-to-date knowledge and skills, and use these with intelligence, insight and understanding in line with the needs of each individual in their care.GNurses and nursing staff work closely with their own team and with other professionals, making sure patients’ care and treatment is co-ordinated, is of a high standard and has the best possible outcome.HNurses and nursing staff lead by example, develop themselves and other staff, and influence the way care is given in a manner that is open and responds to individual needs.Permission kindly agreed by Royal College of Nursing. From Royal College of Nursing (2010).
The Department of Health and the NHS Commissioning Board (2012) have developed a consultation/discussion paper entitled ‘Developing the culture of compassionate care: creating a new vision for nurses, midwives and care-givers’ to emphasise values and behaviours that apply in the NHS, public health and social care (Box 1.1).
Source: Department of Health and NHS Commissioning Board (2012).
In short, we need to pull our socks up and get back to the basics. Care and compassion are the two central themes of this book. Personally I do not believe that compassion can be taught, but there may be times when we should be reminded of this central ethos and the privileged position that we have when caring for others. I do believe firmly, however, that care and compassion still exist in the healthcare setting, but that they may need a bit of prompting to show themselves; hence the Department of Health, Royal College of Nursing and Nursing and Midwifery Council initiatives.
Always remember: it could be us on the receiving end of care, or one of our loved ones. How would we like to be treated and how would we like our loved ones to be treated? I have been privileged to care for many wonderful people, ranging from those new to the world to those taking their very last breath. For all my patients and service users (people cared for in the community setting) I always strived to provide the very best care with kindness, care and compassion.
Now, let’s remove the rose-tinted glasses: some patients may be difficult to care for; they may be confused, frightened or aggressive due to their medical condition. They may be ‘under the influence’ of drugs or drink and not acting rationally. I’ve had chairs thrown at me due to ‘steroid-induced psychosis’ and there were times when I had to remember that my patient was ‘ill’. Some patients may just be naturally aggressive, but all patients must be treated with respect and dignity.
Let’s look at the case study in Activity 1.1. How much care and compassion has been shown to this patient?
In 2011 The Patients Association (a charitable organisation that aims to tackle poor care and its causes; www.patients-association.com) published a report entitled ‘We’ve been listening, have you been learning?’. It gave the most common complaints received by The Patients Association from patients.
It is true to say that reports of poor care seem to dominate the media at present, and in many cases care standards are not being met. However, it is also true that the overwhelming majority of staff working in the care system are skilled and hard-working. But we do need to learn from our mistakes in order to raise standards.
TEST YOUR KNOWLEDGE
Bibliography
Department of Health and NHS Commissioning Board (2012) Developing the Culture of Compassionate Care: Creating a New Vision for Nurses, Midwives and Care-givers. Consultation/discussion paper. Department of Health, London.
Dreaper, J. (2012) Campaign to Show ‘Skill and Compassion’ of Nurses. BBC News, Health, 17 September. www.news.live.bbc.co.uk/news/health-19602792.
Nursing and Midwifery Council (2010) Code of Conduct. NMC. London. www.nmc-uk.org
Patients Association, The (2011) We’ve Been Listening, Have You Been Learning? The Patients Association, Harrow.
Royal College of Nursing (2012) Thisis Nursing. http://thisisnursing.rcn.org.uk/.
Royal College of Nursing (2010) Principles of Nursing Practice. www.rcn.org.uk/nursingprinciples.
Chapter 2
BASIC INFECTION CONTROL AND ASEPTIC TECHNIQUE
Adhering to good practice in infection-control principles is a vital and integral part when undertaking any clinical skill in the healthcare environment. It has been estimated that approximately 800 NHS patients contract a hospital-acquired infection every single day while in the care of NHS. Patients also bring with them their own infections when coming into hospital from the community. Estimates are that approximately 5000 patients die, per annum, as a direct result of contracting one of these infections. Neonates, the elderly and immunocompromised patients are most at risk because their immune systems cannot fight infections as effectively as others.
As well as the human cost, there are also financial implications for poor hygiene in hosptial. Treatment costs amount to over £1 billion each year, which affects us all as taxpayers.
In the healthcare setting there are micro-organisms all around us that cannot be seen with the naked eye, but which are carried about on bits of dust, fluff, shed skin cells and anything else they can latch on to. Two of the main micro-organism groups are:
viruses, which are smaller than bacteria, e.g. norovirus, which is also known as ‘winter vomiting virus’ or ‘Norwalk virus’;bacteria, which include the ‘good bacteria’ found on the skin and in the digestive tract, and the ‘bad bacteria’ such as those responsible for causing Legionnaire’s disease, pimples and boils.VIRUSES
Viruses can be spread; that is why we need to stay off work for 48 hours following an illness, allowing the virus to pass through our system and to ‘burn out’. This means 48 hours after the last vomiting or faecal episode. This type of illness is often referred to as D&V, or diarrhoea and vomiting. Viruses can be spread by droplets when someone sneezes or even by indirect spread, such as being picked up from a hard surface by the hands. This is also known as transient spread. Viruses such as the swine flu virus can remain ‘live’ for 24 hours on hard surfaces and for 20 minutes on soft surfaces, with an incubation period of 2–5 days.
BACTERIA
Resident
