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Engaging Students with Twitter

26 Mar, 17 | by josmith

Kirsten Huby, Lecturer Children’s Nursing, University of Leeds (@KirstenHuby)

Emma Wilson, Children’s Nursing Student, University of Leeds (@Emzieness

The latest Horizon report (Adams Becker et al., 2017) recognises collaborative learning as one of the key trends that will be driving Higher Education for the next few years. It suggests that collaborative learning improves engagement, encourages learning that relates to practice and enables communities of practice to be developed. For healthcare students this type of learning can be used to develop the skills to think critically, problem solve and become open to recognising the diverse nature of the health and social care arena. Technology can help to promote collaborative learning but will only be successful if we can engage students and ensure they see the purpose of what is to be achieved.

 

It has been suggested social networking sites (SNS) encourage the type of collaborative learning advocated by (Adams Becker et al., 2017, Prestridge, 2014) ,we cannot assume that a particular type of SNS will necessarily work. In a study on the use of Twitter, students tended to use a tweet to ask a question of a lecturer rather than to collaborate between themselves. The author considers that students may need to be guided and supported to recognise the depth of knowledge and understanding that can be shared in this way (Prestridge, 2014). This implies that in order to be fully engaged students need to understand the purpose of the interaction and the tool that is being used.

To do this, informative learning opportunities and consultation with students needs to occur. The twitter community is diverse; some nurses opt to have separate ‘nursing’ accounts, others opt to combine professional and personal tweets as one online personality. Ultimately this comes down to personal preference. However, it must be considered that social media guidance has been set by the NMC (Nursing and Midwifery Council, 2015) and this and the requirements of the NMC Code must be adhered to at all times; on and offline and regardless of whether an account is identified as personal, professional or both. Student nurses therefore need to have an awareness of their responsibilities and potential accountabilities surrounding any social media use in relation to this.

A significant factor which potentially hinders student participation with SNS in a learning environment is whether they are comfortable with lecturers/mentors potentially having the ability to view personal posts/tweets. One such way around this is to have a specific agreement to not follow students back from University curated accounts. This means that students can view informative tweets / retweets on their timelines, but their own postings aren’t automatically or as easily visible. This leads to an element of ‘privacy’ and choice, allowing students to choose whether to engage with lecturers if they want to, but also benefit from some of the wider aspects of using SNS such as furthering knowledge / sharing views on current research or topical issues and collaborating and engaging with other students and professionals. As we take the next steps with the @UoLchildnursing account we hope to increase our engagement with students and with the help of motivated student twitter champions such as @Emzieness we hope this will be possible.

Adams Becker, S. et al. 2017. NMC Horizon Report: 2017 Higher Education Edition. 2017 ed. Austin, Texas: The New Media Consortium.

Nursing and Midwifery Council. 2015. Guidance on using social media responsibly. London.

Prestridge, S. 2014. A focus on students’ use of Twitter – their interactions with each other, content and interface. Active Learning in Higher Education. 15(2), pp.101-115.

To tell or not to tell? Honesty and hope in cancer nursing.

19 Mar, 17 | by dibarrett

Jan Hunter, Lecturer in Nursing, University of Hull

In the rather paternalistic past of the NHS, the established wisdom was that ‘doctor knew best’. If it was deemed a patient didn’t need to know they had a poor prognosis, then they didn’t find out (unless they had the wherewithal to put two and two together, or the audacity to ask outright). Thankfully, we are moving away from the days of selectively withholding information, with candour and truth-telling now at the centre of patient care. Nurses – with their ability to forge strong bonds of trust with patients – are well-placed to act as leaders in the discussion of disease progression and prognosis. Though this cements the place of nurses as autonomous practitioners, it also requires us to face one of the key challenges in cancer care: how do we balance truth-telling with the desire to reduce distress and give hope to patients and carers?

In some patients, there may be a temptation to try and ‘soften the blow’ of bad news. For example, a measured disclosure of bad news over time may be deemed the most appropriate approach in patients we judge to be vulnerable or those we perceive to have a lower ability to cope. Superficially, holding back some information might be viewed as nothing more than a ‘white lie’ to protect patients and help prepare them for bad news. However, no matter how well intentioned, making judgements on when to offer full disclosure may serve to undermine the bond of trust between a patient and nurse.

more…

Desert Island Discs and the role of the health care professional in addressing child health inequalities….

12 Mar, 17 | by atwycross

Blog written by Kath Evans 

This week’s EBN Twitter Chat on Wednesday 15th March between 8-9 pm (UK time) will focus on the role of the health care professional in addressing child health inequalities. The Twitter Chat will be hosted by Kath Evans (@kathevans2) a children’s nurse who works at NHS England and leads on improving experiences of care in maternity, infant, children and young people’s services and Professor Alison Twycross (@alitwy) – editor of Evidence Based Nursing. This Blog provides some context for the Chat.

Participating in the Twitter chat requires a Twitter account; if you do not already have one you can create an account at www.twitter.com. Once you have an account contributing is straightforward, You can follow the discussion by searching links to #ebnjc, or contribute by creating and sending a tweet (tweets are text messages limited to 140 characters) to @EBNursingBMJ and add #ebnjc (the EBN chat hash tag) at the end of your tweet, this allows everyone taking part to view your tweets.

I love listening to Desert Island discs as I run (admittedly at a pretty slow pace) around my local park, it was Dame Carol Black and her desert island discs that got me running again back in February 2016. She’s still running in her 70s, and as I’m in my 40s I didn’t think I had any excuse not to lace up my running shoes and get plodding!

However it was Sir Michael Marmott’s  desert island discs podcast (who published ‘Fair Society, Healthy Lives’  ‘The Marmot Review’  )  that got me thinking that we now know so much about child health inequalities and the reasons for them, and yet they continue to exist.

As health care professionals we also see child health inequalities day in day out on our wards, in schools, A&E or Urgent Care centres in fact anywhere where healthcare is delivered. The infant brought in dead having suffocated after co-sleeping, the 4 year old drinking cola from a bottle whilst being admitted for dental extractions due to tooth decay, the obese five year old, the 8 year old awaiting a child protection medical so malnourished and with hair so matted and infested that the play specialist and nurse spend hours bathing and treating her with such kindness that shines a light on compassion in practice and exemplifies the non-judgemental attitude of health care professionals, whilst knowing the social deprivation many of the children are facing. more…

Women with sickle cell disease carry additional risks for pregnancy

7 Mar, 17 | by josmith

Professor Allison Shorten, Director Center for Interprofessional Education and Simulation, University of Alabama, and Associate Editor Evidence-Based Nursing

 One of our most recent EBN commentaries reminds us of the health challenges faced by women with sickle cell disease globally. One of our expert commentators, Dr Eugene Oteng-Ntim from Guy’s and St Thomas’ Hospital, discusses a recent study by Bogfor et al (2016), highlighting the need for future research to address the high rates of maternal and infant morbidity and mortality associated with sickle cell disease in pregnancy. Globally, sickle cell disease is one of the most common genetic conditions, and when combined with pregnancy, risks are higher, regardless of whether women are living in low or high income countries. Read more about this recent systematic review and meta-analysis, and recommendations for health policy and clinical management.

Commentary: Oteng-Ntim, E. (2017) Pregnancy in women with sickle cell disease is associated with risk of maternal and perinatal mortality and severe morbidity, Evidence Based Nursing,

http://dx.doi.org/10.1136/eb-2016-102450

Reference:

Boafor TK, Olayemi E, Galadanci N, et al. Pregnancy outcomes in women with sickle-cell disease in low and high income countries: a systematic review and meta-analysis. BJOG 2016;123:6918.

Do Nurse-Led Programs Make a Difference?

26 Feb, 17 | by rheale

This week’s EBN Twitter Chat is on Wednesday 1st of March, between 8-9 pm (UK time) and will be hosted by Roberta Heale (@robertaheale) Associate Editor at EBN.

The Twitter chat this week will focus on a commentary about a nurse-led exercise program for hemodialysis patients. Nursing care very often incorporates health promotion and disease prevention programming, particularly related to chronic disease management. In fact, the development and implementation of health programs are somewhat unique skills to nursing; that often go unrecognized. In this age of fiscal accountability, it’s important to highlight and evaluate nurse-led programs to offer evidence to both improve and sustain them. It’s even more important to determine positive patient outcomes from these programs. We’ll explore the prevalence of nurse-led programs along with facilitators and barriers. How are programs evaluated and what recommendations do nurses who have participated in a health program have for those of us thinking about developing one?

To read the commentary, please click on this link: http://ebn.bmj.com/content/19/1/12

Participating in the Twitter chat requires a Twitter account; if you do not already have one you can create an account at www.twitter.com. Once you have an account, contributing is straightforward. You can follow the discussion by searching links to #ebnjc, or contribute by creating and sending a tweet (tweets are text messages limited to 140 characters) to @EBNursingBMJ and add #ebnjc (the EBN Twitter chat hash tag) at the end of your tweet, this allows everyone taking part to view your tweets.

Questions to consider prior to the Twitter Chat:

  1. What are your experiences with nurse-led programs? What were the outcomes?
  2. What do you think are important considerations for nurse-led programs?
  3. What are the facilitators and barriers to nurse-led programs?

 

 

Do you Choose Wisely?

20 Feb, 17 | by rheale

By Roberta Heale, Associate Editor BMJ @EBNursingBMJ  #ebnjc  @robertaheale

There is a growing trend for overuse of healthcare interventions, including prescriptions and treatments. Choosing Wisely is a global initiative with a mission to improve decision making between health care providers and patients and to decrease the use of unnecessary, or unwarranted tests and treatments. Choosing Wisely encourages discussion with patients related to the following five questions:

  1. Do I really need this test, treatment or procedure?
  2. What are the risks or downsides?
  3. What are the possible side effects?
  4. Are there simpler, safer options?
  5. What will happen if I do nothing?

(see Choosing Wisely UK http://www.choosingwisely.co.uk/about-choosing-wisely-uk/)

Health care provider groups can participate in this initiative by developing lists of tests or treatments that are widely used, but have little or no supporting evidence. It isn’t only physician groups with concerns about unwarranted tests or treatments. Appropriate, evidence-based nursing care is essential to optimal patient outcomes and our care deserves evaluation. The Canadian Nurses Association recruited 12 participants to develop a list of nine nursing interventions that “Patients and Nurses Should Question”. Check them out here: http://www.choosingwiselycanada.org/recommendations/nursing/

Choosing Wisely provides a systematic and positive platform for the critique of routine care and these processes have the potential to lead to better implementation of evidence into practice.

Living with paediatric chronic illness: What are the developmental challenges?

12 Feb, 17 | by atwycross

 

Abbie Jordan (@drabbiejordan), University of Bath and Line Caes (@LineCaes5), University of Stirling will be leading this week’s EBN Twitter Chat (#ebnjc) on Wednesday 15th February between 8-9pm UK time focusing on the developmental challenges of living with a paediatric chronic illness.

 

 

 

Participating in the Twitter Chat requires a Twitter account; if you do not already have one you can create an account at www.twitter.com. Once you have an account contributing is straightforward:

  • Go to your Twitter account
  • Follow the discussion by searching for #ebnjc once linked to the discussion, click “all tweets” to keep up-to-date with recent tweets
  • Add the EBN chat hash tag (#ebnjc) to your tweets to join in, this allows everyone taking part to view your contribution

Chronic illness in childhood is common, with figures estimating as many as one in four families in the US reporting caring for a child or adolescent with an ongoing health condition (Compas et al., 2012).  As noted by Christie and Katun (2012), receiving a diagnosis of a chronic condition marks the start of a long and challenging journey for children and their families. This journey may change along the way as children grow up and develop new skills. To explore this, research has focused on exploring what it is actually like for children and their families to live and grow up with a chronic condition (Compas et al., 2012; Palermo et al., 2014).  In addition to the challenges associated with managing a chronic illness (e.g. repeated hospital appointments, daily treatment requirements), a substantial number of children who live with a chronic illness experience emotional and social difficulties. Not only the child, but their entire family is affected, with some parents and siblings reporting emotional distress and poor relationship functioning (Knecht et al., 2015; Palermo and Eccleston, 2009).

more…

Nursing attitudes to deliberate self-harm

6 Feb, 17 | by hnoble

Clare Carswell, Undergraduate mental health nursing student  & Dr Helen Noble, Lecturer, Queens University Belfast

Deliberate self-harm is a term that can be used to describe a variety of behaviours that involve an individual inflicting some form of physical harm to their own body. It is most typically associated with self-inflicted lacerations and self-poisoning. Self-harm is a growing issue, with an increase in the incidence within Britain and worldwide. A longitudinal examination of presentations to Irish hospitals for self-harm found an increase of 2-6% per year between 2006 and 2009 [See Perry et al 2012 http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0031663]. The most recent report by the Royal College of Psychiatrists (2010) also noted that self-harm is one of the five top causes of hospital admissions, although this report is due for review. http://www.rcpsych.ac.uk/pdf/position%20statement%204%20website.pdf

A number of studies suggest that only 10-20% of people who self-harm present to hospital or seek treatment and as the incidence of self-harm is typically measured by the number of people who present to hospital the scope of the issue could be vastly underestimated. While the increase in rate of self-harm globally, coupled with the existing high incidence, is valid justification for developing an understanding for practice in this area; another rationale for exploring the topic is the link between self-harm and suicide. Self-harm has been shown to be the most important factor when assessing risk of suicide meaning that appropriate early intervention is essential. Mental health trained practitioners are the professionals typically associated with providing comprehensive assessment and interventions, however the vast majority of individuals who self-harm will make first contact with emergency department personnel. It is crucial that the practice of emergency department nurses is compassionate, empathetic and effective in assessing and treating these patients, especially due to the associated risk of repeat episodes of self-harm and suicide following an initial presentation.

Attitudes can have a significant effect on behaviour meaning that the attitudes nurses hold can have an impact on their nursing practice. Patients who self-harm report high levels of stigma and negative attitudes, stating that they have been called ‘attention seeking’ or ‘manipulative’ as a result of the self-injurious behaviour. The text Blades, Blood and Bandages tells the stories of 25 people’s experiences of self-injury and investigates how those who self-injure are ‘affected by suffering, ritual and stigma’ http://www.palgrave.com/br/book/9780230252813

These negative attitudes and beliefs have originated from not only their friends and family, but also from medical professionals and emergency department personnel following presentation for their injuries. These attitudes can be interpreted through the professional’s behaviour and can have a profound effect on the patient. They can determine whether the patient decides to stay in the hospital for assessment, treatment or referral and whether they are instilled with a sense of hope and validation which in turn can help reduce the risk of further incidents of self-harm and even suicide. Attitudes can also have a more direct impact on nursing practice, for example nurses may feel unequipped or unprepared to perform a comprehensive assessment or to refer on to specialist mental health services. Referral to services can be problematic with this patient group. An understanding of the attitudes held by emergency department nurses may be able to inform areas for improvement in the education and practice of general nurses. One potential area for improvement could be a need for further education or training on the subject of self-harm, as an increased knowledge of self-harm has been shown to improve attitudes towards this patient group. Another area for improvement may be in the practice of emergency department nurses and improved access to mental health services, either through a mental health liaison nurse, a crisis intervention team or an unscheduled care team. More collaborative working between emergency departments and acute or community mental health services, and the opening of the lines of communication between services, may also be an appropriate change to practice. NICE Guidelines (2004) on self-harm recommend that emergency department services and mental health services should play a joint role in developing training on the treatment, assessment and management of self-harm. Emergency department nurses may feel that they do not have the resources, the capabilities, the appropriate skill set or be in the correct setting to adequately address the needs of the patient group meaning that involvement of mental health nurses could be crucial to improving the service provision for individuals who self-harm.

 

 

 

The power of reflection in nursing

30 Jan, 17 | by dibarrett

Lizzie Ette. Lecturer in Nursing, The University of Hull

This week’s EBN Twitter Chat is on Wednesday 1st February between 8-9 pm (UK time).

The chat will be led by Lizzie Ette (j.ette@hull.ac.uk ), Lecturer in Pre-registration Nursing, The University of Hull.

Participating in the Twitter chat requires a Twitter account; if you do not have one you can create an account at www.twitter.com. Once you have an account, contributing is straightforward. You can follow the discussion by searching links to #ebnjc, or contribute by creating and sending a tweet (tweets are text messages limited to 140 characters) to @EBNursingBMJ adding #ebnjc (the EBN Twitter chat hash tag) to your tweet, this allows everyone taking part to view your tweets

The power of reflection in nursing

As is so often the case, professional and personal lives are intricately related, and the recent experience of losing our family cat Reggie, following a road traffic accident at Christmas, really got me to reconsider the power of reflection on a personal level, and this got me thinking deeply about how important reflection is in my professional capacity, as a nurse.

  Reggie: 2000-2017

more…

Turning Japanese – the global inequalities of ageing

22 Jan, 17 | by josmith

Dr Fiona McGowan, School of Health Care Studies, Hanze University of Applied Sciences, Eyssoniusplein Netherlands f.e.mcgowan@pl.hanze.nl

We are all very much aware of how societies are ageing and this ‘demographic transition ‘ is widely recognised as a global phenomenon. How this shift in population composition impacts health and illness is not so conclusive. While trends have emerged indicating the rise in non-communicable diseases such as heart disease, cancer and diabetes, global patterns of health problems also reflect disparities between and within countries. Different ‘ peoples’ experience ageing in different ways and these are not equal.

WHO (World Health Report 2013) showed that health inequalities remain ingrained globally and reflect disparities marked by sex, age, socio economic status, education, place and other more specific factors including migrant status, race, ethnicity and religion. Mortality data shows that in high-income countries, 7 in every 10 deaths are among people aged 70 years and older. People predominantly die of chronic diseases. Only 1 in every 100 deaths is among children under 15 years. In low-income countries, nearly 4 in every 10 deaths are among children under 15 years, and only 2 in every 10 deaths are among people aged 70 years and older. People predominantly die of infectious diseases and complications of childbirth. (World Health Statistics 2015). These facts illustrate the contrast between what an ageing society looks like in a developed, high-income country and in a low income, developing country (a further example being expected years of retirement which is 24 years in France but only 9 years in Mexico – both countries have retirement age at 65) This also highlights how our knowledge and understanding of ageing societies has been shaped by inequality. The focus remains on how westernised societies experience ageing. The social constructionist approach to ageing largely applies to societies in which people are living longer and sufficiently long enough to experience what Laslett (1996) has defined as a ‘Third Age’. A period post retirement, conceptualised as ‘the crown of life’, a time of self- fulfilment and achievement(Jones et al. 2008).

More recent theorising in the field of social gerontology, categorises the third age and later life as a ‘new cultural and social field’ particular to Westernised consumer society marked by sustaining a youthful appearance, and a ‘performing fit, healthy and sexualised lifestyle’ is maintained (Gilleard & Higgs, 2005). While this presents a more positive approach to ageing – in contrast to dependency and disengagement theories – again the focus is on a specific demographic cohort and this ‘generational field’ is not globally situated. Whether a ‘later life’ is experienced mirrors the accumulative process of ageing and the extent to which illness and disability are suffered. While the worldwide ‘epidemiologic shift’ that has accompanied socioeconomic development is reflected in both individual and population health, inequality remains as a powerful determining force. Global health then is dependent on the global context – environmental, economic, political and social. How a society ages is similarly shaped. As Michael Marmot writes in The Health Gap, “ Societies have cultures, values and economic arrangements that set the context through the life course that influence health” (2015, p259). This is clearly supported by Life expectancy indicators (OECD 2016) which show, for example, Nigeria – 54.5 years, Japan – 83 years.

References

Gilleard, C. & Higgs, P. ( 2005) Contexts of Ageing: Class, Cohort and Community. Polity Press. Cambridge.

Jones, I. , Hyde, M. , Victor, C., Wiggins, R. , Gilleard, C. and Higgs, P (2008) Ageing in a Consumer Society: From passive to active consumption in Britain. The Policy Press. Bristol.

Laslett, P. (1996) A Fresh Map of Life: The Emergence of the Third Age ( 2nd ed). Palgrave MacMillan.

Marmot, M. (2015) The Health Gap: The Challenge of an Unequal World. Bloomsbury. London.

Organisation for Economic Co-operation and Development (OECD) (2016) OECD Data: Life Expectancy at Birth. https://data.oecd.org/healthstat/life-expectancy-at-birth.htm Accessed 2nd July 2016.

World Health Organisation (WHO) National Institute on Aging (2011) Global Health and Aging. http://www.who.int/ageing/publications/global_health.pdf?ua=1 Accessed 1st July 2016.

World Health Organisation (WHO) World Health Report 2013. Research for universal health coverage. http://www.who.int/whr/en/ Accessed 2nd July 2016.

World Health Organisation (WHO) (2015) Global Health Observatory (GHO) Data

World Health Statisitics 2015. http://www.who.int/gho/publications/world_health_statistics/2015/en/ Accessed 1st July 2016.

 

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