Mean arterial blood pressure and the assessment of acutely ill patients.

This article discusses the role of vital sign data collection in the acute setting when assessing patients at risk of or actually clinically deteriorating. Specifically, the article focuses on explaining the important concepts of mean arterial blood pressure and pulse pressure as indicators of clinical deterioration.

Simple writing skills for students, part two: researching your subject.

This is the second in a three part series on skills for academic writing. This article gives a brief guide to the principles of using evidence to support ideas in academic writing, how to undertake simple literature searches and how to reference this evidence. The hierarchy and ranges of evidence available to support discussions in work are discussed, along with some guidance on using evidence from websites.

Reporting behaviours of nursing students who have experienced verbal abuse.

Aim: This paper is a report of a study exploring the reporting behaviours of nursing students who had experienced verbal abuse while gaining clinical experience.

Background: Under-reporting of incidents of verbal abuse has been identified internationally as a limitation leading to incomplete data collection when researching aggression in healthcare facilities. This can call into question conclusions, recommendations and policy initiatives based on the research.

The art of auscultation: evaluating a patient's respiratory pathology.

This article considers national policy drivers promoting the development of advanced assessment skills and practical procedures for the safe and effective use of the stethoscope in the clinical area. The evidence base underpinning effective use of the stethoscope in clinical practice is explored, including the preparation of the patient and the environment, applying infection control policies, and placing an emphasis on privacy and dignity. This is followed by a practical guide to auscultation technique of the respiratory system for nurses developing advanced practice skills.

Managing alcohol related aggression in the emergency department (Part II).

Violence in the emergency department (ED) is a global problem. In our first paper, we highlighted the potential psychological effects of alcohol intoxication, the literatures discussion of alcohol related violence in the emergency department and the importance of developing positive nurse/service user relationships. In this second paper, we discuss personal and organisational strategies clinical nursing staff may consider appropriate to minimise the risk of assault when caring for service users projecting alcohol related aggression.

Managing alcohol related aggression in the emergency department (Part I).

Internationally, violence in the emergency department (ED) is of a constant concern to emergency practitioners. Frequently, both original research papers and anecdotal reports emphasise the phenomenon of alcohol related aggression in the ED. In this first paper, we highlight the literatures discussion of alcohol related violence in the emergency department and the potential psychological effects of alcohol intoxication.

Verbal abuse experienced by nursing students.

Aim: This paper is a report of a study to describe the nature, severity, frequency and sources of verbal abuse experienced by nursing students while gaining clinical experience.

Background: Verbal abuse of healthcare workers is currently receiving considerable attention and nursing students have been identified as a group vulnerable to experiencing workplace verbal abuse.

Method: Questionnaires were distributed in 2005 to a convenience sample of 156 third year nursing students from one pre-registration nursing programme in England.

Considering theories of aggression in an emergency department context.

Internationally literature emphasises concern regarding the phenomenon of violence and aggression within the emergency field. This paper emphasises the important role education and training may play in reducing the risk of staff being exposed to violent or aggressive experiences. Furthermore, the paper emphasises, explores and discusses well recognised theories relating to aggression development.

Characteristics of people who assault nurses in clinical practice.

This article discusses certain variables relating to the characteristics of people who assault nurses, including patients, relatives and friends. The author suggests that the nature of nurses' occupational roles and responsibilities puts them at risk in their work but that individual or organisational strategies can be developed to minimise this risk.

Respiratory auscultation: how to use a stethoscope.

This article outlines the correct procedure for respiratory assessments using a stethoscope, how to use a stethoscope and how to interpret your findings.

Factors that influence aggressive behaviour in acute care settings.

Patients with critical illness or severe trauma may feel fear, anxiety and powerlessness, which can lead to aggressive behaviour. This article examines factors that contribute to patient aggression in acute care areas and identifies how these incidents can be minimised.

Violence, aggression and physical assault in healthcare settings.

All healthcare professionals are at risk from violent and aggressive patients, however, it has been found that nurses are at particular risk. The actual incidence is difficult to determine because the definition of what constitutes a physical assault or a violent event is vague. This article considers how the terms violence, aggression and physical assault are conceptualised in the healthcare setting and suggests that nursing staff need to identify and act on any incident that compromises their personal safety.

Under-reporting of violent incidents against nursing staff.

This article examines factors that contribute to nurses failing to report incidents of violence and aggression in the clinical area and it develops the information published in a previous article (Ferns and Chojnacka 2005). Broader social factors are considered, including gender, violence experienced by women, the status of the nursing profession and bureaucratic structures that contribute to under-reporting. The life experiences of individual nursing staff play a significant role in how they react to violence in the clinical area.

Conducting respiratory assessments in acute care.

Conducting comprehensive respiratory assessments involves extensive data collection and analysis and requires skill and knowledge. Terry Ferns and Irena Chojnacka examine how to approach these assessments systematically and professionally.

Violence and aggression in the emergency department: factors impinging on nursing research.

This paper examines issues involved in the debate regarding the role of research in nursing. The authors take the example of violence and aggression in the emergency field to discuss methodological, philosophical, professional, logistical, power differentials and leadership theory that influence and explain the process of conducting research surrounding violence and aggression experienced by nurses working in emergency departments. The paper examines the importance of research and discusses practical issues that impinge or frustrate clinical nursing staff who wish to conduct original research.

Terminology, stereotypes and aggressive dynamics in the accident and emergency department.

There is a perception that violence against staff practising in accident and emergency (A&E) departments is increasing [Fernandes, C.M.B.

Personal safety in the accident and emergency department.

Violence and aggression continues to be a significant problem for staff practising in accident and emergency (A&E) areas. In recent years the number of articles examining factors related to violence and aggression in the A&E department have steadily increased, allowing for a more in-depth examination of data. This article considers the characteristics of individuals who assault A&E staff, introducing the reader to the "recreational fighter", an individual who enjoys and is attracted to violent confrontations.

Reporting incidents of violence and aggression towards NHS staff.

Violence and aggression against nursing staff have been the subject of an ongoing campaign. However, incidents of violence continue to be under-reported. This article discusses factors leading to under-reporting of incidents and focuses on how nursing staffs' attitudes and responses to violence may contribute to the likelihood of reporting incidents.

Violence in the accident and emergency department--an international perspective.

Violence and aggression experienced by emergency nurses has been the focus of international concern. This paper examines the phenomena of violence experienced by emergency department nursing staff from an international perspective by reviewing original, published research studies. Methodological inconsistencies and concerns, a lack of comprehensive studies and persistent under-reporting may mean that the reality of clinical practise has not being captured by researchers.

A balanced approach to dealing with violence and aggression at work.

The Government has introduced tough measures in dealing with violence and aggression in the workplace. Employers have a duty to provide adequate safety measures and training to reduce risks and ensure, where possible, the health, safety and welfare of their employees. This article highlights the responsibilities of employers and the pressures in both hospital and community environments on staff at risk from violent or abusive incidents.