Key Nursing Skills

359 Pages·2003·3.51 MB·English

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Key Nursing Skills
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Key Nursing Skills
BARBARA A WORKMAN CLARE L BENNETT
RGN, MSc, BSc(Hons), RNT, RCNT, RGN, MA, BSc(Hons), DipN,
Dip N(Lond) PGCHE
Senior Lecturer, Middlesex University Senior Lecturer, Middlesex University
With contributions from
FRANCES GORDON NORA COOPER
PhD, MEd, RN, RNT, RCNT RGN, BA(Hons), PGCEA
Principal Lecturer, Middlesex University Senior Lecturer, Middlesex University
W
WHURR PUB LIS HE RS
LONDON AND P HILADE LPHIA
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© 2003 Whurr Publishers Ltd
First published 2003 by
Whurr Publishers Ltd
19b Compton Terrace,London N1 2UN,England and
325 Chestnut Street,Philadelphia PA19106,USA
All rights reserved.No part of this publication may be
reproduced,stored in a retrieval system,or transmitted in
any form or by any means,electronic,mechanical,
photocopying,recording or otherwise,without the prior
permission of Whurr Publishers Limited.
This publication is sold subject to the conditions that it
shall not,by way of trade or otherwise,be lent,resold,
hired out,or otherwise circulated without the Publisher’s
prior consent,in any form of binding or cover other than
that in which it is published,and without a similar
condition including this condition being imposed upon
any subsequent purchaser.
British Library Cataloguing in Publication Data
A catalogue record for this book is available from the
British Library.
ISBN 1 86156 322 1
Printed and bound in the UK by Athenaeum Press
Limited,Gateshead,Tyne & Wear
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Contents
Preface vii
SECTION I 1
Assessment procedures
Chapter 1 3
Beginning the assessment process
Barbara Workman and Nora Cooper
Chapter 2 19
Observations
Clare Bennett
SECTION II 45
Principles of caring
Chapter 3 47
Infection control
Barbara Workman
Chapter 4 60
Personal hygiene
Frances Gordon
Chapter 5 78
Preventing the complications of bed-rest
Frances Gordon
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Key Nursing Skills
SECTION III 91
Caring for patients who need nursing support
Chapter 6 93
Drug administration
Barbara Workman
Chapter 7 134
Maintaining fluid balance
Barbara Workman
Chapter 8 178
Respiratory care
Clare Bennett
Chapter 9 214
Assisting patients to meet their nutritional needs
Clare Bennett
Chapter 10 235
Elimination
Clare Bennett and Barbara Workman
Chapter 11 275
Aseptic procedures
Barbara Workman
Chapter 12 307
Principles of pre- and post-operative care
Barbara Workman
References 323
Index 331
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Preface
The authors, who all have wide experience in teaching and practising
adult nursing, collaborated to write this book, which evolved from a
clinical skills module. It became apparent that students loved learning
the introductory nursing skills, but there were few easily accessible
texts to support their learning. This book is therefore aimed at nursing
students embarking on their nursing education, although some of it
will also be suitable for care assistants who are involved in delivering
direct nursing care to patients. It may also be useful as a teaching
resource for qualified nurses who provide support to learners in the
clinical area and those who are returning to practice who need to be
clinically updated. The book is not intended to be a substitute for
appropriate supervision in clinical practice, and no responsibility can
be taken by the writers or publisher for any damage or injury to persons
or property.
As the emphasis is on introductory skills there are inevitable
omissions of specific procedures. Once the introductory skills have
been acquired, new skills can be learnt easily as principles for practice
will be transferable to the new situation.
Each chapter focuses on a specific area of care and related skills.
Each intervention is presented within a ‘Nursing problem’ that states
the nature of the patient problem and then the goal. The currently
available evidence base is outlined and related to the problem before
the procedure is explained in simple steps. Experienced nurses’ tips
have been integrated into the procedures, so alerting the learner to
anticipate individual patients’ needs or anxieties, or to improve upon
their own performance. Each chapter concludes with key texts to sup-
plement the procedural steps with more theory. However, the book is
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Key Nursing Skills
not a substitute for detailed study of broader nursing texts and we must
emphasize that although there is a lot of detail in some procedures,
knowledge and understanding of the full nursing curriculum should be
further pursued.
Where applicable, specific terms have been defined to aid learn-
ers in developing their own vocabulary of specialist words, and to
remind them that nursing jargon is also incomprehensible to patients.
Another language issue is gender: both nurses and patients can be
either male or female. However, to avoid the constant repetition of
phrases such as he or she throughout this book nurses are generally
referred to by using she or her, and patients by using he or him, and so
on, except where a specific patient is being discussed. This does not
imply any assumptions by the authors about typical nurses or patients,
and is merely intended to simplify the text.
Section I introduces a structured approach to aid patient assess-
ment. Although this is not an actual ‘procedure’, it is one that is done
so automatically by experienced nurses that the knowledge and
observation skills used are often not made explicit. We have tried to
articulate many of these skills. We know from our contact with
students that the opportunity to work with experienced nurses is high-
ly valued and very beneficial: it offers the opportunity to learn more
than just fundamental care because it provides a rich source of nursing
knowledge and skill. Development of such skills in assessment is vital
when planning, implementing and evaluating care.
Section II addresses nursing skills that are fundamental to a
patient’s wellbeing, recovery or comfort. These are skills that are often
delegated to students or care assistants because they apparently do not
require much technical knowledge. The delivery of safe and effective
care, using evidence-based principles, is as essential here as more tech-
nical care. It requires knowledge and theoretical understanding, and
application of principles such as infection control and patient comfort.
These are the kind of skills that make a patient feel really ‘well nursed’
– or not, as the case may be – and are central to providing a caring
environment for recovery and comfort.
Section III details technical skills that student nurses are frequent-
ly involved in, and outlines more detailed knowledge and procedures for
effective nursing practice. Where appropriate the interventions are
cross-referenced between chapters. For example, methods of respiratory
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Preface
medication are included in Chapter 8 on respiratory care, but the
principlesof drug administration are in Chapter 6. The final chapter, on
principles of pre- and post-operative care, draws on other interventions
from throughout the book, and provides a useful summary of their
application.
The report Fitness for Practice (UKCC 1999) identified that
nursing skills were deficient in the diploma preparation for nursing. It
is hoped that the nursing interventions described here will contribute
to rectifying this deficiency and provide a solid basis for acquiring
essential nursing skills.
We hope that this book will be useful and informative, and that it
will contribute to the delivery of high quality nursing care.
Barbara Workman
Clare Bennett
August 2002
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