A shoulder pain: Not so minor - An emergency department case report study.

Introduction And Importance: Shoulder pain frequently presents as a low priority case in the Emergency Department (ED). However, this is associated with many potential aetiologies, including sickle cell crisis. A thorough history taking and comprehensive assessment, along with an open-minded approach can enhance clinical decision-making processes when caring for patients presenting with shoulder pain.

Managing ankle fracture-dislocation injury in the emergency department: a case study.

Ankle fracture-dislocation is a serious injury that requires prompt and appropriate management. The proximity of various neurovascular structures around the ankle joint means there is a risk of nerve or blood vessel damage. Initial management in the emergency department (ED), therefore, includes the realignment and repositioning of the dislocated joint to its normal anatomical position, referred to as reduction.

Assessment of workplace integration of migrant nurses and midwives within international health care settings: a scoping review protocol.

Objective: The objective of this scoping review is to map the available evidence on the assessment of workplace integration of migrant nurses and midwives in international health care settings.

Introduction: Internationally, migrant nurses and midwives are an increasingly important resource in government strategy for addressing the current and predicted workforce shortages in health care. Much has been documented about the orientation stages of their transition to foreign workplaces but few sources have considered the workplace integration of this population.

Assessment and management of metastatic bone cancer in emergency departments.

A cancer diagnosis in emergency departments (EDs) is often associated with advanced or metastatic cancer. Patients with bone metastases have a complex range of physical and psychological needs. Meeting the needs of patients with cancer is an important part of the role of emergency nurses, but evidence suggests that they often do not feel adequately prepared to provide effective care for this patient group.

Assessment and management of patients with tibial plateau fractures in emergency departments.

Tibial plateau fractures are complex injuries and relatively common presentations in emergency departments (EDs), yet the diagnosis is not always obvious. Patients with this injury are managed increasingly in EDs by registered advanced nurse practitioners (RANPs), who are recognised in Ireland as senior clinical decision-makers. RANPs are broadening their scope of practice to maximise their responses to current and emerging challenges in healthcare services.

Lisfranc injury: assessment and management in emergency departments.

Injuries to the tarsometatarsal joint complex, also referred to as a Lisfranc injury, are relatively uncommon presentations to emergency departments (EDs), however accurate diagnosis is vital to prevent the risk of long-term disability. Advanced nurse practitioners (ANPs) must use a broad range of clinical skills to manage patients' injuries effectively. A high level of suspicion, recognition of the clinical manifestations of Lisfranc injury and appropriate radiographic images are required to formulate a correct diagnosis.

Fight bite injury: emergency department assessment and management.

Human bite wounds to the hand are relatively common injuries and are associated with high infection rates. Given the unique anatomy of the hand, the bite mechanism and the organisms found in human saliva, even the smallest wound can result in an aggressive infection. Failure to recognise and treat human bite wounds appropriately, can therefore have negative outcomes for patients.

Personal and professional challenges of nurse prescribing in Ireland.

This article presents the challenges regarding the development of a collaborative practice agreement in order to undertake nurse prescribing in an emergency department in a large teaching hospital. Nurse prescribing has been introduced quite recently in Ireland. Although there is a plethora of knowledge regarding the topic, there are many personal and professional challenges in relation to this emerging role.

Board's eye view.

THE DEATH of a loved one is a traumatic and emotional experience, to which emergency nurses are frequently exposed.

Emergency nurses' provision of spiritual care: a literature review.

The emergency setting has undergone significant changes in recent years. Notably, the throughput and acuity of patients has increased, with a concomitant improvement in the clinical and technical management of these patients (Dolan, 1998; Coughlan and Corry, 2007). However, there is evidence to suggest that the increase in workload and proliferation of technology, at such a fast pace, has potentially threatened the caring component of nursing, including spiritual care (Wilkin and Selvin, 2004).

Nurses' provision of spiritual care in the emergency setting--an Irish perspective.

The researcher's interest in spiritual care arose during clinical experience in an emergency department. Over a 10-year period, I have observed, that in midst of a busy and increasingly overcrowded setting, nurses find time to provide spiritual care. Although this dimension of nursing practice is not explicitly labelled as spiritual care, it is apparent that interventions such as active listening, touch and ultimately connecting with the patient has, on most occasions, positive effects on the patient's spiritual dimension.

Non-invasive ventilation: a nurse-led service.

Respiratory diseases are the third most common presentations to emergency departments (EDs) in the Republic of Ireland. Evidence suggests that early non-invasive ventilation (NIV) is often the treatment of choice, particularly for patients with chronic obstructive pulmonary disease. Therefore, having access to NIV in EDs is likely to improve patient outcomes and reduce the likelihood of their mechanical ventilation.

Translating change: the development of a person-centred triage training programme for emergency nurses.

Within health care, there has been a change in practice from an illness-orientated service to one that is more health-focused and person-centred. The concept of person-centredness is frequently espoused by practitioners as being not only a desirable, but a necessary element of health care provision. Indeed, nationally and internationally, person-centred care has underpinned many healthcare documents and policies.

Evidence-based care: enhancing the rigour of a qualitative study.

Qualitative research methodology is a suitable approach for clinical inquiry into nursing practice, leading to theory development and advancement in clinical practice. Rigour is necessary to enhance the consistency and quality of qualitative research. It is the framework for demonstrating credibility and integrity of the qualitative research process.

Learning from practice--reflections on a critical incident.

Reflective practice is considered not only as a valuable tool for providing appropriate levels of care but also as an important prerequisite for the provision of professional nursing. Indeed, there appears to be consensus in the literature that reflections have the potential to assist practitioners to tap into knowledge gained from experience and connect theory to practice. However, evidence suggests that nurses, including emergency nurses, neglect reflective techniques.

Exercising restraint: clinical, legal and ethical considerations for the patient with Alzheimer's disease.

The number of older people using emergency care is increasing steadily and older people account for over half of all emergency admissions. In the emergency setting, nurses caring for older people with Alzheimer's disease can be faced with many complex ethical and legal challenges. Moreover, challenges such as the use of physical restraint can precipitate conflict when the nurse is placed in the precarious position of doing good, respecting autonomy and avoiding paternalism.

Clinical teaching and support for learners in the practice environment.

The purpose of planned clinical experience for students of nursing is primarily to provide students with the opportunity to develop their clinical skills, integrate theory and practice, and assist with their socialization into nursing. Nursing, in the main, is a practice-based profession. To this extent, it is essential that nurse education continues to have a strong practical element despite its full integration into higher education institutions (Department of Health, 1999).

A concept analysis of spirituality.

According to the holistic model of care, nurses must consider their patients' spiritual needs in order to provide total patient care (Govier, 2000). There is growing awareness of the contribution that spiritual wellbeing can make to a patient's actual and perceived health and quality of life (Chibnall et al, 2002; Mount, 2003). Spirituality and spiritual care has gained much momentum in the current nursing arena.