Characteristics and Symptom Profiles of Patients Evaluated By A Nurse Practitioner Consultant In A Multidisciplinary Palliative Radiotherapy Clinic.

Palliative radiation therapy is an essential but often impromptu service, depending on the patient condition and symptom burden. Radiation oncologists are the usual consultant in this setting, however, there is potential to extend capacity with the addition of advanced providers such as a nurse practitioner. Purpose: to examine characteristics and symptom profiles of patients individually evaluated by a nurse practitioner with those evaluated by a radiation oncologist in a rapid access, multidisciplinary palliative radiotherapy clinic. Methods & Materials: Data were retrieved from an ethics-approved, prospective database. Patients were grouped and analyzed based on the consultant. Results: The nurse practitioner completed consultations for a total of 137 patients, the radiation oncologist for 98. No significant differences were observed in symptom profile, functional status or whether radiotherapy was prescribed. By working as a team, 58% more patients with painful bone metastases were able to access the clinic. Conclusions: An experienced nurse practitioner can significantly enhance access to consultation in a palliative radiotherapy clinic. We expect this research to inform ways that advanced providers can improve access to timely care and reduce suffering.

Evaluation of a personal professional mentor scheme for newly qualified nurses

Background: Newly qualified nurses are known to experience a range of feelings and fears in the first transitional 12 months post-qualifying, with absence and turnover among potential outcomes. Aim: To evaluate the personal professional mentor role and scheme, a new pastoral support initiative, from the perspective of participating newly qualified nurses. Methods: Newly qualified paediatric nurses (n=10), who had been assigned a personal professional mentor (an experienced nurse who worked elsewhere in their employing NHS Trust), completed a semi-structured interview. The data were analysed using thematic analysis. Findings: The personal professional mentor counteracted some aspects of transition isolation for the newly qualified nurses. They were an independent, accessible, experienced confidant and a welcome new supportive role. Conclusion: Pairing experienced nurses with newly qualified nurses provided a new type of workplace support during transition. Inexpensive to set up and run, it is an easy addition to any portfolio of support strategies.

Effectiveness of wet cupping therapy on relieving pain in patients with chronic migraine: an observational study

Background Chronic migraine is a disabling condition that negatively affects many aspects of migraineurs’ lives. Patients who use pharmacological agents experience various side effects. Some studies have reported clinical improvement following wet cupping therapy in migraine patients. This study examined the effectiveness of wet cupping therapy on headache severity and its complications in patients with migraine. Methods In this study, a total of 29 patients previously diagnosed with migraine were treated with wet cupping therapy and followed up for headache severity. The severity of pain was measured before therapy, 1 h after therapy, and one month after therapy. The wet cupping therapy was performed by an experienced nurse who was not part of the research team. Results The mean age of the patients was 36.17 (Sta. Deviation: 10.74 years; range: 22–68 years), and on average, patients had experienced migraine for 11.14 years. The severity of headache pain was decreased significantly from 6.66 (very intense pain) before cupping therapy to 2.48 (discomforting pain) 1 h after cupping therapy and 0.72 (very mild pain) one month after cupping therapy (p<0.001). The observed complications were skin pigmentation (6.9%), skin scarring (24.1%), and itching in the cupping region (31.0%). Conclusions The present study suggests a significant improvement in the severity of headache in migraine patients 1 h and one month after wet cupping therapy.

A Nurse-Led Education Program for Pneumoconiosis Caregivers at the Community Level

Pneumoconiosis is an irreversible chronic disease. With functional limitations and an inability to work, pneumoconiosis patients require support from family caregivers. However, the needs of pneumoconiosis caregivers have been neglected. This study aimed to evaluate the effectiveness of a nurse-led education program, which involved four weekly 90-min workshops led by an experienced nurse and guided by Orem’s self-care deficit theory. A single-group, repeated-measure study design was adopted. Caregivers’ mental health (Hospital Anxiety and Depression Scale, HADS, four single items for stress, worriedness, tiredness, and insufficient support), caregiving burdens (caregiving burden scale, CBS), and unmet direct support and enabling needs (Carer Support Needs Assessment Tool, CSNAT) were measured at the baseline (T0), immediately after (T1), and one month after intervention (T2); 49, 41, and 28 female participants completed the T0, T1, and T2 measurements. Mean age was 65.9 years old (SD 10.08) with a range between 37 and 85 years old. The program improved the caregivers’ mental wellbeing, and reduced their caregiving burdens and their unmet support and enabling needs, both immediately (T1) and one-month after the intervention (T2). In particular, the intervention improved the caregivers’ mental wellbeing significantly, specifically depression symptoms, stress, and tiredness immediately after the intervention; and reduced most of their unmet support needs and unmet enabling needs one-month after the intervention. This was the first nurse-led program for pneumoconiosis caregivers and should serve as a foundation for further studies to test the program with robust designs.

Quality of training in endoscopic retrograde cholangiopancreatography (ERCP) for nurse assistants: a survey

Background: Endoscopic retrograde cholangiopancreatoscopy (ERCP) is a technical and complex procedure requiring highly skilled and trained endoscopists and assistants. Literature so far has highlighted a need for better training for assistants of ERCP, as well as linking the volumes of procedures performed to improved success rates and reduced complication rates. Methods: A survey was undertaken of 51 ERCP nurse assistants' experience of training in ERCP from district general, teaching and tertiary hospitals in the UK. Nursing assistants are registered nurses with endoscopy skills or nursing practitioners of band 4 and above with experience in ERCP. Findings: Of those surveyed, 93% had undertaken fewer than 50 procedures supervised by experienced nurse assistants prior to being deemed competent, with 63% having performed fewer than 25 procedures. Only 40% felt confident at independently assisting. Attending formal training had little impact on this, but did improve confidence in out-of-hours work. Participants' main suggestions for training were a course involving familiarisation with equipment, close supervision and anatomy training. Conclusions: There is a lack of guidance on the correct training and experience required for nurse assistants. This survey's findings suggest many are commencing independent practice feeling underprepared. More work needs to be done to improve the quality of nurse training and support their learning, and further studies are needed to look into the impact this has on patient outcomes.

Meeting demand for opioid dependency in an Inner London borough

This paper is looking at the development of the Benzodiazepine and Opiate Withdrawal Service (BOWS) in the borough in Inner London to implement a model that would treat patients effectively in GP practices. It is to illustrate what can be achieved with experienced nurse prescribers in treating an emerging group of patients in primary care. Often patients are aware of their dependency on opiate medications and do want to reduce and come off their medications. This paper describes the BOWS service and its approach, illustrating what can be possible, in terms of treatment for patients in general practice. It also shows what can be designed in NHS services to address the growing issue of dependency on prescribed drugs and argues that services having experience in addictive behaviours can play a very large role in achieving this.