Nursing Path

CARING is the essence of NURSING. -Jean Watson

Nursing Path

Knowing is not enough, we must APPLY. Willing is not enough, we must DO. -Bruce Lee

Nursing Path

Treat the patient as a whole, not just the hole in the patient.

Nursing Path

Success is not final. Failure is not fatal. It is the courage to continue that counts. -Winston Churchill

Nursing Path

A problem is a chance for you to do your best. -Duke Ellington

Nurse appointed chief executive of Bristol hospitals trust

Eugine Yafele, who is a nurse by background, has been appointed as chief executive for University Hospitals Bristol and Western NHS Foundation Trust (UHBW). He will take over the role for Robert Woolley who is retiring at the end of March 2022, and who led…

The post Nurse appointed chief executive of Bristol hospitals trust appeared first on Nursing Times.



Concern over ‘consistent net loss’ of nursing students in South of England

Too few student nurses are choosing to study in the South of England, where cost of living is typically more expensive than other regions and university offerings are more sparse, analysis has shown. Data from the Universities and Colleges Admissions Service (UCAS), seen by Nursing…

The post Concern over ‘consistent net loss’ of nursing students in South of England appeared first on Nursing Times.



Nurses celebrate recognition of Filipino as standalone ethnic group

Filipino nurses in the UK have welcomed the fact they can now have their ethnicity properly recorded and recognised on NHS and Nursing and Midwifery Council (NMC) databases. The update was celebrated by many on social media including the Filipino Nurses Association UK (FNA). "We’ve…

The post Nurses celebrate recognition of Filipino as standalone ethnic group appeared first on Nursing Times.



Mandatory Covid-19 vaccines for NHS and social care staff ‘could be scrapped’

The government is reportedly expected to perform a U-turn on its mandatory Covid-19 vaccination policy for NHS and social care staff in England. It comes after the health and social care secretary announced last week that he was “reflecting” on the plans in wake of…

The post Mandatory Covid-19 vaccines for NHS and social care staff ‘could be scrapped’ appeared first on Nursing Times.



Parliamentary debate spotlights nursing workforce challenges

Key issues facing the nursing workforce, including retention, recruitment and staff wellbeing, were at the centre of a House of Lords debate this week. Lords, baronesses and a former chief nursing officer for England were among those who pressed for answers on what the government…

The post Parliamentary debate spotlights nursing workforce challenges appeared first on Nursing Times.



Primary care nurses under pressure as GP appointment figures soar

Latest GP appointment figures reveal an increased workload in general practice that is putting unsustainable pressure on general practice nurses, contributing to the existing staffing crisis. The general practice appointment figures for England show that there were more than 29 million GP appointments in December…

The post Primary care nurses under pressure as GP appointment figures soar appeared first on Nursing Times.



RCN urges caution amid emergence of Omicron subvariant in UK

The Royal College of Nursing has urged the government to re-evaluate making face coverings voluntary amid the emergence of the new BA.2 variant. From 27 January all Plan B measures are lifted meaning face coverings are no longer mandatory at indoor venues, although the rules…

The post RCN urges caution amid emergence of Omicron subvariant in UK appeared first on Nursing Times.



Leading nurse urges government to reconsider mandatory vaccination policy

An influential nurse has written to the health and social care secretary urging him to reconsider the incoming mandatory Covid-19 vaccination policy for health and care staff – raising concerns about its impact on an already burnt-out and depleted nursing workforce. While supportive of vaccination,…

The post Leading nurse urges government to reconsider mandatory vaccination policy appeared first on Nursing Times.



Nurse working environment ‘affects surgical patient outcomes’

Investments to improve the working environment of nurses could reduce the number of patients undergoing surgery who then require intensive care, leading to fewer deaths, a US study has found. The research published in the journal Advanced Critical Care, includes data from 453 hospitals in…

The post Nurse working environment ‘affects surgical patient outcomes’ appeared first on Nursing Times.



Covid-19 restrictions to be eased across England’s care homes

Visiting restrictions and self-isolation periods for residents across care homes in England will be “eased” under latest coronavirus measures announced by the government. From Monday 31 January, residents will once again be able to have unlimited visits, while self-isolation periods will move in line with…

The post Covid-19 restrictions to be eased across England’s care homes appeared first on Nursing Times.



Former district nurse selected as Labour candidate for by-election

Paulette Hamilton, a local councillor for Birmingham City Council and a former nurse, has been chosen as the Labour candidate for the Birmingham Erdington by-election. Following the announcement, Ms Hamilton thanked the Erdington Labour members as well as the people of Erdington. She said: "I’m…

The post Former district nurse selected as Labour candidate for by-election appeared first on Nursing Times.



Nurse leader to host international conference on race and health inequality

Influential nurse leader Yvonne Coghill will co-host the NHS Race and Health Observatory’s inaugural conference on 7 and 8 July 2022. The conference titled Race, Racism and Health will be hosted by Ms Coghill and by Professor David Williams, who specialises in public health at…

The post Nurse leader to host international conference on race and health inequality appeared first on Nursing Times.



T-level health training rolled out for school leavers at Devon hospital

A new educational qualification that gives hands-on hospital experience is now available to 16 year olds in Exeter with an interest in nursing or other healthcare professions. The health T-level is a two-year full-time educational programme available to students post-GCSE that includes a minimum of…

The post T-level health training rolled out for school leavers at Devon hospital appeared first on Nursing Times.



England’s NHS workforce education budgets delayed by merger

The budget used for educating and training NHS staff, including nurses, in England has not yet been set for the year ahead, an influencial committee of MPs has heard, sparking questions about the future of the workforce. Health and social care secretary Sajid Javid confirmed…

The post England’s NHS workforce education budgets delayed by merger appeared first on Nursing Times.



Hospice hosts own recruitment fair in bid to find nursing staff

Staff shortages and increasing demand have sparked a hospice to hold its own recruitment fair this week for registered nurses, allied health professionals and support workers from primary and secondary care. St Clare Hospice, based in Hastingwood, said there had been a rise in demand…

The post Hospice hosts own recruitment fair in bid to find nursing staff appeared first on Nursing Times.



Charity asks nurses about ‘financial resilience’ in new survey

Nursing and midwifery staff are being asked to complete a survey about their money problems, with a chance of winning £200 worth of shopping vouchers in a prize draw. The survey is being run by Cavell Nurses’ Trust, a charity that provides financial support to…

The post Charity asks nurses about ‘financial resilience’ in new survey appeared first on Nursing Times.



Welsh hospices set to receive government funding boost

Hospices in Wales are set to receive a share of an additional £2.2m starting in April this year, minister have announced. This money is on top of £13.8m emergency funding allocated to hospices by the Welsh Government earlier in the pandemic, in order to try…

The post Welsh hospices set to receive government funding boost appeared first on Nursing Times.



Health secretary ‘reflecting’ on Covid-19 vaccine mandate

The UK government is “reflecting” on its incoming policy on mandatory Covid-19 vaccination for NHS staff in wake of the Omicron variant, the health and social care secretary has told MPs. During a Health and Social Care Committee (HSCC) meeting on Tuesday, Sajid Javid said…

The post Health secretary ‘reflecting’ on Covid-19 vaccine mandate appeared first on Nursing Times.



Pilot leadership programme for student nurses and midwives

A pilot student leadership programme has been launched this week by a nursing charity in collaboration with a north London hospital trust, with the aim of amplifying the voice of student nurses and midwives. Nine student nurses and midwives have been selected to take part…

The post Pilot leadership programme for student nurses and midwives appeared first on Nursing Times.



Nurses key to successful digital comms roll-out at Yorkshire hospital

High uptake by nurses of a clinical communications app rolled out at Sheffield Children’s Hospital is helping make handovers quicker and safer, according to those behind the project. The CareFlow Connect app, provided by System C Healthcare, is designed to give staff easy and secure…

The post Nurses key to successful digital comms roll-out at Yorkshire hospital appeared first on Nursing Times.



RCN Scotland survey suggests 60% of nurses considering quitting job

Six out of 10 nurses are considering leaving or actively planning to leave their current role, according to a survey by the Royal College of Nursing in Scotland. RCN Scotland has today released results from the union’s latest employment survey, which was carried out before…

The post RCN Scotland survey suggests 60% of nurses considering quitting job appeared first on Nursing Times.



Nurses facing the sack protest mandatory Covid-19 vaccine rules

Nurses and midwives were among thousands who protested over the weekend against mandatory Covid-19 vaccination for NHS and care staff, as they face potential dismissal in the coming weeks. Staff and members of the public marched throughout different cities across England to object to upcoming…

The post Nurses facing the sack protest mandatory Covid-19 vaccine rules appeared first on Nursing Times.



Only one paediatric intensive care unit operating with enough nurses

Results from an annual paediatric intensive care report have revealed a shortage of specialist nurses in the UK and Ireland, and found that frequently healthcare assistants were making up the difference. The report by the Paediatric Intensive Care Audit Network found that only one paediatric…

The post Only one paediatric intensive care unit operating with enough nurses appeared first on Nursing Times.



Deliveroo and RCN charity to partner on nurse training programme

Deliveroo and the Royal College of Nursing (RCN) Foundation have announced a partnership to deliver a training programme for NHS nursing and midwifery staff across the UK. The food delivery company said it had raised £300,000 through customer and partner donations from its Supporting the…

The post Deliveroo and RCN charity to partner on nurse training programme appeared first on Nursing Times.



Nurse joins board of Black Country mental health provider

A nurse with a “wealth of experience” and a “passion for local health services” in the East Midlands has been appointed to a position on the board of a mental health provider. Dr Janet Bailey, who has over 40 years’ experience as a registered nurse,…

The post Nurse joins board of Black Country mental health provider appeared first on Nursing Times.



Student nurses urged to have Covid-19 jab or risk ability to join register

Nursing students who have not been double vaccinated against Covid-19 by April will not be able to undertake clinical placements, risking their ability to complete their studies and join the register. New guidance published by Health Education England (HEE) on 21 January offers answers to…

The post Student nurses urged to have Covid-19 jab or risk ability to join register appeared first on Nursing Times.



Unions demand ‘decent wage boost’ for NHS staff in evidence to pay body

A total of 14 unions have called on the government to produce an NHS pay award large enough to stop more nurses and other health staff from quitting and to attract new recruits. If this is not done, unions warned in evidence to the NHS…

The post Unions demand ‘decent wage boost’ for NHS staff in evidence to pay body appeared first on Nursing Times.



Paediatrics study finds nurses ‘especially’ impacted by pandemic

A study looking at the effects of the pandemic on paediatric oncology services around the world has found that nurses especially faced tougher conditions. The study, Impact of the Covid-19 pandemic on pediatric oncology providers globally: A mixed-methods study, was published by Wiley online in…

The post Paediatrics study finds nurses ‘especially’ impacted by pandemic appeared first on Nursing Times.



Post-Covid-19 global nursing workforce challenges ‘too big to be ignored’

Calls have been made for a long-term action plan to address global nursing shortages amid serious concerns over the impact the coronavirus pandemic has had on the recruitment and retention of nurses across the world. A new report published today by global nursing leaders provides…

The post Post-Covid-19 global nursing workforce challenges ‘too big to be ignored’ appeared first on Nursing Times.



Green Party peer says improving nurse pay a ‘matter of justice’

Improving the pay of nurses is a "matter of justice", the former leader of the Green Party has urged, noting that some nurses were having to go to foodbanks to feed their families. In a powerful speech in the House of Lords yesterday, Natalie Bennett,…

The post Green Party peer says improving nurse pay a ‘matter of justice’ appeared first on Nursing Times.



New category announced for the 2022 Student Nursing Times Awards

We are excited to announce a new Student Nursing Times Award category for 2022 which is now accepting entries – Student Nurse of the Year: Clinical Research. Thank you to the National Institute for Health Research, which is sponsoring the category and helped shape the…

The post New category announced for the 2022 Student Nursing Times Awards appeared first on Nursing Times.



Former CNO backs calls to delay mandatory Covid-19 vaccines

A former chief nursing officer (CNO) for England and now Bishop of London has joined calls to delay the implementation of mandatory Covid-19 vaccinations for NHS staff, citing concerns around the “harm” the move will have on the workforce. Dame Sarah Mullally made the comments…

The post Former CNO backs calls to delay mandatory Covid-19 vaccines appeared first on Nursing Times.



Study shows importance of nurse-patient connection in mental health care

The therapeutic relationship between a nurse and a young mental health patient is "crucial to good outcomes", a new study has found. However, results from the University of Manchester and Pennine Care NHS Foundation Trust research also said that sometimes nursing staff did not have…

The post Study shows importance of nurse-patient connection in mental health care appeared first on Nursing Times.



Northern Ireland’s nurses to receive additional one-off pay increase

Nurses in Northern Ireland are to receive an additional one-off pay increase backdated to April 2021, it has been announced. Health minister Robin Swann has today confirmed that after months of exploring funding budgets, he will invest a further £25m into the country’s health and…

The post Northern Ireland’s nurses to receive additional one-off pay increase appeared first on Nursing Times.



Ireland announces Covid-19 bank holiday and bonus for nurses

The Republic of Ireland is marking the work its health workers have done during the pandemic by giving them a bonus, while the country will also get a bank holiday to honour all Covid-19 victims and workers. Eligible frontline health workers, including nurses, midwives and…

The post Ireland announces Covid-19 bank holiday and bonus for nurses appeared first on Nursing Times.



Care home worker ‘fairly’ sacked over Covid-19 vaccine refusal

A care assistant who was sacked from the Sheffield care home where she worked because she refused the Covid-19 vaccine has lost an appeal against her dismissal. An employment tribunal determined that the care assistant, named in the report as Ms C Allette, but widely…

The post Care home worker ‘fairly’ sacked over Covid-19 vaccine refusal appeared first on Nursing Times.



Former CNO for Scotland appointed to drug deaths taskforce

Scotland's former chief nursing officer (CNO) has been appointed to the role of vice-chair of a taskforce that is trying to curb the rising number of drug-related deaths in the country. Professor Fiona McQueen was the CNO for Scotland between 2015 and 2021. "This work…

The post Former CNO for Scotland appointed to drug deaths taskforce appeared first on Nursing Times.



‘Capitalise’ on increased interest in nursing seen since Covid-19 – report

The supply of nurse training places in England needs to increase with demand in order to “capitalise on the growth in the popularity of nursing”, which has been largely driven by the coronavirus pandemic, a new report has urged. Today, the Universities and Colleges Admissions…

The post ‘Capitalise’ on increased interest in nursing seen since Covid-19 – report appeared first on Nursing Times.



New NICE proposals on self-harm welcomed by nursing organisations

New draft guidelines on supporting people who have self-harmed will save lives, the professional lead for mental health at the Royal College of Nursing has said. Stephen Jones said the proposed changes put forward by the National Institute for Health and Care Excellence (NICE) this…

The post New NICE proposals on self-harm welcomed by nursing organisations appeared first on Nursing Times.



Northern Ireland announces appointment of new CNO

The Northern Irish government has appointed a new chief nursing officer (CNO) for the country. Maria McIlgorm, who trained as both a nurse and a midwife and has worked in the NHS for nearly 30 years across Ireland, Scotland and England, will take up her…

The post Northern Ireland announces appointment of new CNO appeared first on Nursing Times.



Cornwall declares critical incident in adult social care

Council leaders in Cornwall have declared a joint critical incident with the NHS in the county as providers struggle to meet demand. The move will potentially see Cornwall Council redeploy some of its own staff into different roles to support the sector, as Covid-19-related staff…

The post Cornwall declares critical incident in adult social care appeared first on Nursing Times.



Care home to end nursing provision over nurse recruitment struggles

A care home in County Durham has been forced to remove its nursing care services because it cannot recruit enough nurses – adding to ongoing concerns about recruitment and retention issues facing the sector. Dipton Manor Care Home in Stanley will close its 20-bed nurse…

The post Care home to end nursing provision over nurse recruitment struggles appeared first on Nursing Times.



Trust trials body-worn cameras for staff following spike in abuse

An NHS trust is trialling the use of body-worn cameras for frontline clinicians, as part of a new campaign aiming to curb rising levels of abusive behaviour against staff. Oxford University Hospitals NHS Foundation Trust (OUH) has launched the There’s No Excuse campaign this week…

The post Trust trials body-worn cameras for staff following spike in abuse appeared first on Nursing Times.



Return of NHS pension penalties ‘risks worsening staffing crisis’

Concerns have been raised that the upcoming removal of special pension measures will trigger a mass exodus of nursing staff at a time when the NHS is “already facing a workforce crisis”. A temporary suspension on pension penalties for NHS nurses and colleagues who returned…

The post Return of NHS pension penalties ‘risks worsening staffing crisis’ appeared first on Nursing Times.



Group seeks changes to support neurodiverse nurses

Plans to launch a new network for nurses who are neurodiverse are back on track after taking a pause due to Covid-19, and those behind the project are also seeking other changes to support these staff. NeuroDiverse Nurses UK is a group set up in…

The post Group seeks changes to support neurodiverse nurses appeared first on Nursing Times.



Cushing’s Syndrome

 Description

  • Cushing’s Syndrome results from excessive secretion of one or all of the adrenocortical hormones which includes glucocorticoid cortisol (predominant type), the mineralocorticoid aldosterone, and the adrogenital corticoids.
Types of Cushing’s Syndrome:
  1. Pituitary Cushing’s syndrome (Cushing’s disease) is the most common cause of Cushing’s syndrome, and stems from hyperplasia of both adrenal glands caused by over stimulation by adrenocorticotropic hormone (ACTH), usually from pituitary adenoma. The syndrome mostly affects women between ages 20 and 40.
  2. Adrenal Cushing’s syndrome is associated with adenoma or carcinoma of the adrenal cortex. The disease may recur after surgery.
  3. Ectopic Cushing’s syndrome results from autonomous ACTH secretion by extrapituitary tumors (such as the lungs) producing excess ACTH.
  4. Iatrogenic Cushing’s syndrome is caused by exogenous glucocorticoid administration.

Cushing's Syndrome

Causes    Anemia in Pregnancy

The most common cause of Cushing syndrome is side effects from taking anti-inflammatory steroid medications for conditions such as asthma and rheumatoid arthritis.

The second most common cause is Cushing’s disease, which occurs when the pituitary gland makes too much of the hormone ACTH. ACTH stimulates the adrenal glands to produce cortisol.

Cushing’s disease affects women more often than men.

Cushing syndrome can also be caused by the following:

  • Tumor of the pituitary gland or adrenal gland
  • Tumor elsewhere in the body (ectopic Cushing syndrome)
Assessment

1. Signs and symptoms of excess glucocorticoid (cortisol) secretion:

  • Weight gain or obesity.
  • Heavy trunk; thin extremities.
  • Fat pad (Buffalo Hump) in neck and supraclavicular area.
  • Rounded face (moon face); plethoric, oily complexion.
  • Skin – fragile and thin; striae and ecchymosis, acne.
  • Musculoskeletal – muscle wasting causes by excessive catabolism, osteoporosis, characteristic kyphosis, back ache.
  • Mental disturbances – mood changes, psychosis.
  • Increased susceptibility to infections.

2. Manifestation of excess mineralocorticoid (aldosterone) secretion:

  • Hypertension
  • Hypernatremia, hypokalemia
  • Weight gain
  • Expanded blood volume
  • Edema

3. Manifestation of excess androgens:

  • Females experience virilism (masculinization) with hirsutism (excessive growth of hair on the face and midline of trunk); atrophied breast, enlarged clitoris, masculinized voice, loss of libido, hermaphroditism (if exposed in utero).
  • Males – loss of libido.
Diagnostic Evaluation
  • Excessive plasma cortisol levels and loss of diurnal variation.
  • Increased blood glucose levels, decreased serum potassium level.
  • Plasma ACTH elevated in patients with pituitary tumors, very low in patients with adrenal tumor.
  • Eosinophils decreased on complete blood count.
  • Elevated urinary 17-hydroxycorticoids and 17-ketogenic steroids.
  • Overnight dexamethasone suppression test, possibly with cortisol urinary excretion measurement, to check for:
    • Unsuppressed cortisol level in Cushing’s syndrome cause by adrenal tumors.
    • Suppressed cortisol level in Cushing’s disease caused by pituitary tumor.
  • Skull X-ray detects erosion of the sella turcica by a pituitary tumor; CT scan and ultrasonography locate tumor.
Primary Nursing Diagnosis
  • Fluid volume excess related to abnormal retention of sodium and water
Medical Management

Treatment is usually directed at the pituitary gland because most cases are due to pituitary tumors rather than tumors of the adrenal cortex

  • Surgical removal of the tumor ( transphenoidal hypophysectomy) is the treatment of choce (90% success rate)
  • Radiation of the pituitary gland is successful but takes several months for symptom control
  • Adrenalectomy is performed in patients with primary adrenal hypertrophy
  • Post operatively, temporary replacement therapy with hydrocortisone maybe necessary until the adrenal glands begin to respond normally ( maybe several moths)
  • If bilateral adrenalectomy was performed lifetime replacement of adrenal cortex hormones is necessary
  • Adrenal enzyme inhibitors ( E.g. metyrapone or mitotine) maybe used with ectopic ACTH- secreting tumors that cannot be totally removed; monitor closely for inadequate adrenal function and side effects
  • If Cushing’s syndrome results from exogenous corticosteroids, taper the drug to the minimum level or use alternate-day therapy to treat the underlying disease
Pharmacologic Intervention
  • Mitotane 2–16 g per day in divided doses PO an antineoplastic, inhibits activity of adrenal cortex; used to treat inoperable adrenocortical carcinomas and Cushing’s syndrome
  • Cyproheptadine 4 mg 2–3 times a day PO an antihistamine agent ; serotonin antagonist, inhibits the release of ACTH from pituitary gland; drug is considered last resort and often causes no improvement
  • Other Drugs: Aminoglutethimide inhibits cholesterol synthesis, and metyrapone partially inhibits adrenal cortex steroid synthesis. These drugs may be used in conjunction with surgery or radiation if the tumor is not completely resectable or if complete remission is not expected.
Nursing Intervention
  • Monitor intake and output, daily weights, and serum glucose and electrolytes.
  • Monitor for signs of infection because risk is high with excess glucocorticoids.
  • After hypophysectomy, monitor for diabetes insipidus, hypothyroidism, and other endocrine changes.
  • Assess the skin frequently to detect reddened areas, skin breakdown or tearing, excoriation, infection or edema.
  • Handle skin and extremity gently to prevent trauma; prevent falls by using siderails.
  • Avoid using adhesive tape on the skin to reduce trauma on its removal.
  • Encourage the patient to turn in bed frequently or ambulate to reduce pressure on bony prominences and areas of edema.
  • Assist the patient with ambulation and hygiene when weak and fatigued. Use assistive devices during ambulation to prevent falls and fractures.
  • Help the patient to schedule exercise and rest. Advise the patient how to recognize signs and symptoms of excessive exertion.
  • Instruct the patient to correct body mechanics to avoid pain or injury during activities.
  • Provides foods low in sodium to minimize edema and provide foods high in potassium (bananas, orange juice, tomatoes) and administer potassium supplements as prescribed to counteract weakness re;ated to hypokalemia.
  • Report edema and signs of fluid retention.
  • Encourage the patient to verbalize concerns about the illness, changes in appearance, and alters role function.
  • Explain to female patient who has benign adenoma or hyperplasia that, with proper treatment, evidence of masculinization can be reversed.
Documentation Guidelines
  • Physical response: Vital signs, neurological assessment, cardiopulmonary assessment, wound healing, signs of infection (fever, wound drainage, productive cough), important laboratory deviations (serious electrolyte imbalances, alterations in glucose levels)
  • Nutrition: Daily weights, appetite, food tolerance, food preference, response to diet teaching, calorie count if indicated
  • Emotional response: Concerns over body image, self-concept, mood, affect
Discharge and Home Healthcare Guidelines

Describe the pathophysiology of the disease. Identify factors that aggravate the disease (stress, changes in diet, injury), as well as the signs and symptoms. Explore complications of the disease, and ask whom to notify if they occur. Describe the treatment plan and expected effects, as well as possible complications. Describe all medications, including the name, dosage, action, side effects, route, and importance of lifelong dosing if indicated.

Nursing Diagnosis
  1. Risk for injury and Risk for infection related to weakness and changes in protein metabolism and inflammatory response.
  2. Self-care Deficit: weakness, feeling of tiredness, muscle atrophy and changes in sleep patterns.
  3. Impaired skin integrity related to edema, impaired healing and the skin is thin and fragile.
  4. Disturbed Body Image related to changes in physical appearance, sexual dysfunction and decreased activity levels.
  5. Disturbed Thought Processes related to fluctuations in emotions, irritability and depression.


Naturalism Philosophy of Education      Congestive Heart Failure 

Scottish government comments on student nurse placements raise concern

Nursing leaders in Scotland have stressed to ministers that student nurses on placements are there to learn and not to fill staffing gaps during the pandemic. The warning came in reponse to a press release put out today by the Scottish Government titled “Placements help pandemic…

The post Scottish government comments on student nurse placements raise concern appeared first on Nursing Times.



New leadership programme hopes to help nursing students enact change

A new leadership programme is being launched to help “empower” nursing and other healthcare students across the UK to enact positive change for their colleagues and patients. Applications are now open for the union Unison’s new ‘Future Health Leaders Programme’, which is due to begin…

The post New leadership programme hopes to help nursing students enact change appeared first on Nursing Times.



Redeployment and dismissal processes outlined in mandatory jab guidance

New guidance on the implementation of mandatory vaccination rules for patient-facing NHS staff, including redeployment processes and information on termination of employment, has been published. The 24-page document from NHS England and NHS Improvement covers the key implementation dates, how to communicate and engage with…

The post Redeployment and dismissal processes outlined in mandatory jab guidance appeared first on Nursing Times.



NHS launches star-studded campaign to increase awareness of talking therapies

NHS England has launched a new mental health campaign using a rendition of Help! by The Beatles to encourage people to seek out its talking therapies service. Statistics suggest around 2.3m people have sought out NHS talking therapies since the start of the pandemic, but…

The post NHS launches star-studded campaign to increase awareness of talking therapies appeared first on Nursing Times.



Surging Omicron cases leaving trusts ‘struggling to cope’, warn staff

Nurses are “guilt-stricken” and hospitals are “struggling to cope” with the current surge in Omicron cases, according to reports received by unions from staff at 40 trusts across England. This warning comes amid calls to delay the mandatory vaccination of the NHS workforce to avoid…

The post Surging Omicron cases leaving trusts ‘struggling to cope’, warn staff appeared first on Nursing Times.



Nurse thanks hospital colleagues for making ‘Olympic dream’ possible

A nurse in Scotland, who uses sport to help deal with the sometimes stressful situations she faces at work, is gearing up to represent Great Britain at the 2022 Winter Olympics in Beijing next month. Vicky Wright, a curling gold medallist and generical surgical nurse…

The post Nurse thanks hospital colleagues for making ‘Olympic dream’ possible appeared first on Nursing Times.



RCN appoints Patricia Marquis as new director for England

The newly appointed Royal College of Nursing director for England has pledged her determination to “fight” for nurses to address issues negatively impacting the workforce – especially around safe staffing and fair pay. Patricia Marquis has been appointed to the role permanently, the college has…

The post RCN appoints Patricia Marquis as new director for England appeared first on Nursing Times.



‘We are far from out of the woods’: Warning over Omicron complacency

Health leaders have warned against complacency around Omicron, despite a fall in national infection rates, with nurses and colleagues remaining concerned that current pressures and demands are compromising the quality and safety of patient care. The NHS Confederation has today issued a statement explaining that,…

The post ‘We are far from out of the woods’: Warning over Omicron complacency appeared first on Nursing Times.



New self-isolation reduction should not apply to nurses, says RCN

Nursing union leaders have said health staff must be made “exempt” from the new self-isolation rule, following the government’s announcement today that the isolation period for people who test positive for Covid-19 will be further reducing from seven days to five days. Health and social…

The post New self-isolation reduction should not apply to nurses, says RCN appeared first on Nursing Times.



RCN consults members on delayed Northern Ireland pay deal

The Royal College of Nursing is asking its members in Northern Ireland whether they think the 3% pay award they have received for 2021-22 is acceptable or unacceptable. While a pay decision was delayed for nurses in all four UK countries last year, those in…

The post RCN consults members on delayed Northern Ireland pay deal appeared first on Nursing Times.



Palliative care patients ‘becoming collateral damage’ in pandemic

Results from a survey of palliative care nurses and doctors have indicated that the NHS patient backlog has led to premature deaths. The Association of Palliative Medicine (APM) carried out the poll to help understand the effects of the pandemic on people with long-term and…

The post Palliative care patients ‘becoming collateral damage’ in pandemic appeared first on Nursing Times.



Covid-19-related staff absences across England ‘still troublingly high’

The number of NHS England staff off work due to Covid-19 “remains troublingly high”, nursing leaders have warned, though the growth of absences appears to be slowing in some areas. Latest data published today by NHS England showed there were more than 40,000 staff off…

The post Covid-19-related staff absences across England ‘still troublingly high’ appeared first on Nursing Times.



Workforce concerns drive calls to delay mandatory Covid-19 jabs for NHS staff

The government has been urged to delay the implementation of mandatory Covid-19 vaccination for NHS staff amid serious workforce concerns. The Royal College of Nursing has today warned that worsening staff shortages are already preventing nurses from being able to care for their patients safely…

The post Workforce concerns drive calls to delay mandatory Covid-19 jabs for NHS staff appeared first on Nursing Times.



Midlands trials ‘bespoke’ leadership course for minority ethnic nurses and midwives

A bespoke programme has been created to enhance the leadership skills of nurses and midwives from minority ethnic backgrounds who are looking to take the next steps in their careers. Nursing Times spoke to the nurse leader behind the initiative and some of those taking…

The post Midlands trials ‘bespoke’ leadership course for minority ethnic nurses and midwives appeared first on Nursing Times.



Nursing Education Quiz Series - 19

CNOs and NMC write to nursing directors over Omicron pressures

Nurse leaders have written a letter of support to nursing directors across the UK, as the latest wave of the coronavirus pandemic continues to cause severe strain. The letter is signed by the UK's four chief nursing officers and the chief executive and registrar of…

The post CNOs and NMC write to nursing directors over Omicron pressures appeared first on Nursing Times.



Nurse referred to NMC after inquiry into stillborn birth in prison

A prison nurse has been referred to the Nursing and Midwifery Council over her failure to attend to an inmate who later delivered a stillborn baby in a toilet. The Prisons and Probation Ombudsman determined that the nurse had shown a “serious error of judgement”…

The post Nurse referred to NMC after inquiry into stillborn birth in prison appeared first on Nursing Times.



New support network launched for Spanish nurses in the UK

A new association for Spanish nurses living and working in the UK has been launched and is seeking more members to join. The group is the brainchild of Joan Pons Laplana, a well-known senior nurse currently working at Health Education England. “We underestimate the cultural…

The post New support network launched for Spanish nurses in the UK appeared first on Nursing Times.



Interview: Meet the hepatology specialist nurse named nurse of the year

When Dianne Backhouse travelled down from Yorkshire to London for the Nursing Times Awards ceremony, her friends and colleagues were confident that she stood a good chance of winning the night’s big prize – the Nurse of the Year category. Ms Backhouse herself was not…

The post Interview: Meet the hepatology specialist nurse named nurse of the year appeared first on Nursing Times.



Nursing Education Quiz Series - 18

Former Wales CNO appointed by NMC to lead education steering group

The recently retired chief nursing officer of Wales has been appointed to help guide national work on modernising nursing and midwifery education in the wake of Brexit. Professor Jean White has been selected by the Nursing and Midwifery Council to chair the Future Programme Standards…

The post Former Wales CNO appointed by NMC to lead education steering group appeared first on Nursing Times.



PPE confusion leading to variation in nurse access, warns union

Some nurses across the UK are facing problems accessing high-grade personal protective equipment (PPE) amid confusion over what protection staff should be wearing, a nursing leader has told. In an interview with Nursing Times, Rose Gallagher, the Royal College of Nursing’s professional lead for infection…

The post PPE confusion leading to variation in nurse access, warns union appeared first on Nursing Times.



Exclusive: Nurses reveal pain of ‘never-ending’ Covid-19 pandemic

Trapped in what feels like a “never-ending” cycle of coronavirus demand, while bearing the brunt of deteriorating staffing levels and pre-existing workplace pressures, nurses across health and social care have told Nursing Times about the impact the latest Omicron wave is having on them and…

The post Exclusive: Nurses reveal pain of ‘never-ending’ Covid-19 pandemic appeared first on Nursing Times.



Disulfiram

 Drug Name   


Generic Name : disulfiram

Brand Name: Antabuse

ClassificationAntialcoholic drug, Enzyme inhibitor

Pregnancy Category C

Dosage & Route               Bumetanide

Available forms : Tablets—250 mg.

BLACK BOX WARNING: Never administer to an intoxicated patient or without patient’s knowledge. Do not administer until patient has abstained from alcohol for at least 12 hr.

ADULTS

  • Initial dosage: Administer maximum of 500 mg/day PO in a single dose for 1–2 wk. If a sedative effect occurs, administer at bedtime or decrease dosage.
  • Maintenance regimen: 125–500 mg/day PO. Do not exceed 500 mg/day. Continue use until patient is fully recovered socially and a basis for permanent self-control is established.
  • Trial with alcohol (do not administer to anyone > 50 yr): After 1–2 wk of therapy with 500 mg/day PO, a drink of 15 mL of 100 proof whiskey or its equivalent is taken slowly. Dose may be repeated once, if patient is hospitalized and supportive facilities are available.
Therapeutic actions
  • Disulfiram inhibits aldehyde dehydrogenase, the oxidative enzyme of acetaldehyde, a metabolite of alcohol. The latter is accumulated in the blood, thus producing unpleasant symptoms of disulfiram-alcohol reaction when a patient has taken small amounts of alcohol.
Indications
  •  Aids in the management of selected chronic alcoholics who want to remain in a state of enforced sobriety
Adverse effects
  • Drowsiness, fatigue, lassitude, psychotic reactions, peripheral and optic neuropathies, hepatotoxicity, garlic-like or metallic after-taste, GI upset, body odour, bad breath, headache, impotence.
  • Potentially Fatal: Respiratory depression, CV collapse, arrhythmias, myocardial infarction, acute CHF, convulsions, sudden death.
Contraindications
  • Hypersensitivity, CVS diseases; peripheral neuropathy, psychosis. Not to be used in patients with alcohol intoxication.
Nursing considerations
Assessment
  • History: Allergy to disulfiram or other thiuram derivatives; severe myocardial disease or coronary occlusion; psychoses; current or recent treatment with metronidazole, paraldehyde, alcohol, alcohol-containing preparations (eg, cough syrups, tonics); diabetes mellitus, hypothyroidism, epilepsy, cerebral damage, chronic and acute nephritis, hepatic cirrhosis or impairment; pregnancy
  • Physical: Skin color, lesions; thyroid palpation; orientation, affect, reflexes; P, auscultation, BP; R, adventitious sounds; liver evaluation; LFTs, renal function tests, CBC, SMA-12
Interventions
  • Do not administer until patient has abstained from alcohol for at least 12 hr.
  • Administer orally; tablets may be crushed and mixed with liquid beverages.
  • Monitor liver function tests before, in 10–14 days, and every 6 mo during therapy to evaluate for hepatic impairment.
  • Monitor CBC, SMA-12 before and every 6 mo during therapy.
  • Inform patient of the seriousness of disulfiram-alcohol reaction and the potential consequences of alcohol use. Disulfiram should not be taken for at least 12 hr after alcohol ingestion and a reaction may occur up to 2 wk after disulfiram therapy is stopped; all forms of alcohol must be avoided.
  • Arrange for treatment with antihistamines if skin reaction occurs.
  • WARNING: Institute supportive measures if disulfiram-alcohol reaction occurs; oxygen, carbon dioxide combination, massive doses of vitamin C IV, ephedrine have been used.
Teaching points
  • Take drug daily; if drug makes you dizzy or tired, take it at bedtime. Tablets may be crushed and mixed with liquid.
  • Abstain from forms of alcohol (beer, wine, liquor, vinegars, cough mixtures, sauces, aftershave lotions, liniments, colognes, liquid medications). Using alcohol while taking this drug can cause severe, unpleasant reactions—flushing, copious vomiting, throbbing headache, difficulty breathing, even death.
  • Wear or carry a medical ID while you are taking this drug to alert any medical emergency personnel that you are taking it.
  • Have periodic blood tests while taking drug to evaluate its effects on the liver.
  • You may experience these side effects: Drowsiness, headache, fatigue, restlessness, blurred vision (use caution driving or performing tasks that require alertness); metallic aftertaste (transient).
  • Report unusual bleeding or bruising, yellowing of skin or eyes, chest pain, difficulty breathing, ingestion of any alcohol.