What is the initial nursing intervention if the patient complains of pain or cramping during enema?

16 May, 2006

An enema is the administration of a substance in liquid form into the rectum. This may be performed to aid bowel evacuation or to administer medicines.

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Ian Peate Professor of nursing, Gibraltar Health Authority, Gibraltar

Rationale and key points

This article aims to help nurses to undertake the administration of enemas in a safe, effective and patient-centred manner, ensuring privacy and dignity. The administration of an enema is a common healthcare procedure, which can be used to deliver medication or aid bowel evacuation.

The administration of an enema should be undertaken by a competent nurse.

An enema is a liquid preparation inserted into the rectum.

The nurse must explain the procedure to the patient and should assist the individual before, during and after the procedure.

The nurse should document all care given.

Reflective activity

Clinical skills articles can help update your practice and ensure it remains evidence based. Apply this article to your practice. Reflect on and write a short account of:

How you felt performing this intimate procedure.

The positive elements of care delivery and those that could be enhanced.

Subscribers can upload their reflective accounts at: rcni.com/portfolio.

Nursing Standard. 30, 14, 34-36. doi: 10.7748/ns.30.14.34.s43

All submissions are subject to external double-blind peer-review and checked for plagiarism using automated software.

Received: 29 June 2015

Accepted: 17 September 2015

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Page 2

Lowina Mukundu Staff nurse, Leicester Royal Infirmary, Leicester, England

Milika Ruth Matiti Senior lecturer, College of Social Science, School of Health and Social Care, University of Lincoln, Lincoln, England

This article presents a literature review of the benefits of pulmonary rehabilitation in the management of chronic obstructive pulmonary disease (COPD). Pulmonary rehabilitation has been shown to decrease patient mortality and hospital admissions. The literature search resulted in 13 articles being selected for review. Three themes were identified: improvement in exercise tolerance, improvement in breathlessness and improvement in health-related quality of life. This review enhances our knowledge of the mechanisms through which pulmonary rehabilitation benefits patients and provides an evidence base to guide nursing decisions regarding patient education, health promotion and psychological support.

Nursing Standard. 30, 14, 38-43. doi: 10.7748/ns.30.14.38.s44

All articles are subject to external double-blind peer review and checked for plagiarism using automated software.

Received: 31 October 2014

Accepted: 10 March 2015

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Page 3

Julie McGarry Associate professor, University of Nottingham School of Health Sciences, Queens Medical Centre, Nottingham, England

Charley Baker Baker Assistant professor, and academic lead for safeguarding, University of Nottingham School of Health Sciences, Royal Derby Hospital, Derby, England

Claire Wilson Assistant professor, University of Nottingham School of Health Sciences, Royal Derby Hospital, Derby, England

Anne Felton Assistant professor, University of Nottingham School of Health Sciences, Nottingham, England

Safeguarding vulnerable adults and children is a legal requirement and is essential in nursing and healthcare practice. This article describes the development and establishment of a structured approach to safeguarding education and student support in one pre-registration nursing programme in the UK. This approach involved the development of an academic safeguarding lead role, extensive curriculum development, and implementation of policies and procedures for raising and escalating concerns. The authors suggest that this integrative and comprehensive model should be used in all higher education institutions providing nurse education.

Nursing Standard. 30, 14, 44-48. doi: 10.7748/ns.30.14.44.s45

All articles are subject to external double-blind peer review and checked for plagiarism using automated software.

Received: 01 March 2015

Accepted: 07 July 2015

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Page 4

Belinda Allen Adjunct lecturer, Department of Management, Monash Business School, Monash University, Caulfield, Australia

Bullying is a pervasive problem in healthcare organisations. Inquiries and reports on patient care and poor practice in the NHS have emphasised the substantial negative effects this behaviour may have on patient care. If bullying is to be addressed, it is crucial we develop clarity about what behaviours constitute bullying and how these behaviours differ from other negative behaviours in the workplace. It is important that we recognise the extent of the problem; statistics on the prevalence of bullying are likely to be an underestimate because of under-reporting of bullying. Effective interventions may only be designed and implemented if there is knowledge about what precipitates bullying and the magnitude of the changes required in organisations to tackle bullying. Individuals should also be aware of the options that are available to them should they be the target of bullying behaviour and what they should do if they witness bullying in their workplace.

Nursing Standard. 30, 14, 50-60. doi: 10.7748/ns.30.14.50.s46

All articles are subject to external double-blind peer review and checked for plagiarism using automated software.

Received: 15 June 2015

Accepted: 13 August 2015

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Page 5

Jennifer Preston Paediatric nurse and social work student, Edge Hill University, Lancashire

A CPD article enhanced Jennifer Preston’s knowledge and understanding of completing the literature review process

Literature reviews can help to improve evidence-based practice and promote positive change in nursing. They aim to analyse, evaluate and clarify ideas presented by various authors and summarise them. After reading the CPD article on critiquing research literature, I have gained an understanding of the process that I would use to carry out a literature review.

Nursing Standard. 30, 14, 61-62. doi: 10.7748/ns.30.14.61.s47

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Page 6

Norman Young Nurse consultant, Cardiff and Vale University Health Board, Cardiff University

Early intervention is key to improving care for people with psychosis, and nurse consultant Norman Young is committed to developing better services

Since I started my mental health nurse training in 1991, it has been my mission to improve the health and wellbeing of people with psychosis, a condition that affects around 1% of the UK’s adult population.

Nursing Standard. 30, 14, 63-63. doi: 10.7748/ns.30.14.63.s48

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Page 7

Volunteering to work on a hospital ship in Africa is a challenge that many nurses find brings them greater confidence and new skills, says Layla Haidrani

Docked in Toamasina, on the east coast of Madagascar, the world’s largest floating hospital ship is home to hundreds of nurses delivering health care to the world’s fourth-largest island nation.

Nursing Standard. 30, 14, 64-65. doi: 10.7748/ns.30.14.64.s49

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Page 8

Courses, events, grants, and awards to progress your career

Nursing Standard. 30, 14, 64-65. doi: 10.7748/ns.30.14.64.s50

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Page 9

I trained as a children’s nurse in York for three years, working on a ward for five years. Throughout my career, I kept returning to Mercy Ships because I am passionate about helping people without access to hospitals.

Nursing Standard. 30, 14, 65-65. doi: 10.7748/ns.30.14.65.s51

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Page 10

Nicola Davies Health psychology consultant

Nicola Davies on ways nursing students can keep mentally healthy to ensure their demanding course is less stressful

Nurse training can be notoriously difficult, and can take its toll on your physical, mental and emotional health. The demands of nurse training can also put stress on your personal relationships and social life.

Nursing Standard. 30, 14, 66-66. doi: 10.7748/ns.30.14.66.s52

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Page 11

Graham Scott Editor

Most chancellors of the exchequer give with one hand and take with the other, but George Osborne hit nursing with a double whammy last week. First he announced that nursing students starting courses from 2017 will have to pay tuition fees, then added to the woe by revealing that they would not receive a bursary either. So the next generation of newly qualified nurses will start their careers on not much more than £21,000 and have debts that will take years to clear.

Nursing Standard. 30, 14, 3-3. doi: 10.7748/ns.30.14.3.s1

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Page 12

We have five copies of this book to give away.

Nursing Standard. 30, 14, 6-6. doi: 10.7748/ns.30.14.6.s2

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Page 13

Jennifer Sprinks

The government’s decision to scrap bursaries for nursing students in England and replace them with loans will saddle many graduates with debt and deter entry into the profession, nursing unions and students warn.

Nursing Standard. 30, 14, 7-7. doi: 10.7748/ns.30.14.7.s3

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Page 14

Many patients have sent a card or some chocolates to thank healthcare staff, but David Barker went further by naming his racehorse after his nurse.

Nursing Standard. 30, 14, 7-7. doi: 10.7748/ns.30.14.7.s4

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Page 15

Chancellor George Osborne’s plans for interest-free loans to cover up to 40% of the costs of newly-built homes in London will do little to help the capital’s nurses get on the housing ladder, say health worker unions.

Nursing Standard. 30, 14, 8-8. doi: 10.7748/ns.30.14.8.s5

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Page 16

The Mary Seacole Memorial Statue Appeal is to benefit from £240,000 gathered in banking fines, chancellor George Osborne announced in his autumn statement.

Nursing Standard. 30, 14, 8-8. doi: 10.7748/ns.30.14.8.s6

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Page 17

Fears have been raised that cuts to public health services outlined in the government’s comprehensive spending review last week will undermine the £3.8 billion cash injection promised for front line NHS services for 2016/17.

Nursing Standard. 30, 14, 8-8. doi: 10.7748/ns.30.14.8.s7

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Page 18

Chris Longhurst

The Nursing and Midwifery Council (NMC) has said the proportion of its fitness to practise hearings not concluded within 15 months could rise to around a third between now and March.

Nursing Standard. 30, 14, 9-9. doi: 10.7748/ns.30.14.9.s8

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Page 19

A safe staffing app giving up-to-date information on the number of nurses on the wards at Nottingham University Hospitals NHS Trust scooped top prize at the inaugural Academy of Fabulous NHS Stuffawards in London last week.

Nursing Standard. 30, 14, 9-9. doi: 10.7748/ns.30.14.9.s9

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Page 20

A roundup of the latest nursing news

Nursing Standard. 30, 14, 10-10. doi: 10.7748/ns.30.14.10.s10

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Page 21

About 500 nurses, academics and other healthcare professionals were expected to attend the chief nursing officer (CNO) for England’s summit in Birmingham this week.

Nursing Standard. 30, 14, 10-10. doi: 10.7748/ns.30.14.10.s11

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Page 22

The RCN has advised nurses to continue to work as normal during planned industrial action by junior doctors.

Nursing Standard. 30, 14, 10-10. doi: 10.7748/ns.30.14.10.s12

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Page 23

Chris Longhurst

An acute care nurse consultant who contributed to a national report on sepsis has questioned why all hospitals do not have formal protocols for its diagnosis and treatment.

Nursing Standard. 30, 14, 11-11. doi: 10.7748/ns.30.14.11.s13

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Page 24

Blackpool Teaching Hospitals NHS Foundation Trust’s sexual health team has held HIV testing events in the town as part of a national initiative.

Nursing Standard. 30, 14, 11-11. doi: 10.7748/ns.30.14.11.s14

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Page 25

While a reduction in the number of recorded physical assaults on staff is to be welcomed, a third of incidents are going unreported. Jennifer Sprinks reports

The number of reported physical assaults against all NHS staff in England in 2014/15 has fallen slightly on the previous year – down from 68,683 in 2013/14 to 67,864.

Nursing Standard. 30, 14, 12-13. doi: 10.7748/ns.30.14.12.s15

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Page 26

Danish study concludes that women are better off not being screened

The best thing a woman can do to lower her risk of becoming a breast cancer patient is to avoid going to screening, concludes uncompromising research by the Nordic Cochrane Centre in Denmark.

Nursing Standard. 30, 14, 14-14. doi: 10.7748/ns.30.14.14.s16

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