Kate mcmahon-parkes - Academia.edu (original) (raw)
Papers by Kate mcmahon-parkes
Nursing times, Aug 1, 2011
The Nursing and Midwifery Council promotes the idea that patients should contribute to the assess... more The Nursing and Midwifery Council promotes the idea that patients should contribute to the assessment of preregistration student nurses. In response, staff, mentors and pre-registration student nurses from the University of West of England Bristol and the Royal United Hospital Bath worked together to develop, pilot and introduce a way of achieving this with a patient testimony tool. The tool, which is a feedback sheet, was developed through consultation with patients and carers, then piloted and is now used in an acute hospital. This article discusses how the tool was developed. It outlines how it was implemented and the challenges this involved, and looks at plans for development.
PubMed, Feb 21, 1998
This article is the eighth in our 'Care is Critical' series on complex interventions nurses have ... more This article is the eighth in our 'Care is Critical' series on complex interventions nurses have to manage in acute general wards and in the community. This article looks at the management of pleural drains and gives an overview of the relevant anatomy and physiology. Some of the conditions that may result in a chest tube being inserted are described and the nursing care discussed.
Intensive and Critical Care Nursing, Feb 1, 1997
Guillain-Barr~ syndrome is a complex disorder that affects around 0.5-2 individuals per 100 000 p... more Guillain-Barr~ syndrome is a complex disorder that affects around 0.5-2 individuals per 100 000 per year (Hund et al 1993). The outcome can range from a sensation of paraesthesia to death. This article discusses the biological nature of Guillain-Barrb syndrome, major diagnostic criteria and the treatment that is available. It highlights the nurse's role in management of the syndrome and describes how the extent of the syndrome in individual patients may be evaluated in the clinical area.
In most cultures, it is largely uncontentious that when a person is expected to die, that their e... more In most cultures, it is largely uncontentious that when a person is expected to die, that their end is made as comfortable and peaceful as possible, and that loved ones* should be permitted to be present at their death. In such cases, family presence offers comfort both to the dying person, and to those who are close to them. However, when death is not anticipated, a resuscitation attempt is often initiated. The interventions required can appear brutal and undignified, and although resuscitation is undertaken with the aim of saving life, it is a reality that in the majority of instances when full cardiopulmonary resuscitation is instigated, the patient will die during the attempt. For many years, international and professional guidelines have recommended that loved ones be allowed to remain with patients during resuscitation. However, although in paediatric cases, family witnessed resuscitation (FWR) is commonplace, when the patient is an adult, friends and family members are still frequently prevented from being present. Various justifications have been presented within medical and nursing literature as to why FWR is not promoted. These include the views of healthcare professionals that the experience would be too traumatic for relatives, that loved ones may hamper the attempt, or that patient dignity or confidentiality could be compromised. Although these justifications appear beneficent in origin, I will suggest that restricting FWR is morally problematic. Firstly, concerns about relative’s welfare and patient confidentiality are unjustifiably paternalistic, particularly when empirical data demonstrate that these ‘justifications’ for preventing FWR are largely based on conjecture rather than evidence. Secondly, it is inconsistent that FWR be widely facilitated for paediatrics but not adults. Thirdly, there are no convincing reasons why relatives should be prevented from being with a patient at the end of their life, simply because of the nature of the patient’s death. And finally, in cases where loved ones may be aware of the patient’s end of life preferences, and particularly where the patient has nominated a healthcare advocate, their exclusion during resuscitation inhibits legitimate decision making processes, and increases the likelihood that continuation or cessation of treatment may be against patient’s wishes, and therefore non-beneficent. Consequently, in the absence of compelling individual reasons to the contrary, FWR should be practiced in all cases where loved ones or advocates wish to be present.
Rationality, religion and refusal of treatment in an
Nursing times, 2011
The Nursing and Midwifery Council promotes the idea that patients should contribute to the assess... more The Nursing and Midwifery Council promotes the idea that patients should contribute to the assessment of preregistration student nurses. In response, staff, mentors and pre-registration student nurses from the University of West of England Bristol and the Royal United Hospital Bath worked together to develop, pilot and introduce a way of achieving this with a patient testimony tool. The tool, which is a feedback sheet, was developed through consultation with patients and carers, then piloted and is now used in an acute hospital. This article discusses how the tool was developed. It outlines how it was implemented and the challenges this involved, and looks at plans for development.
In most cultures, it is largely uncontentious that when a person is expected to die, that their e... more In most cultures, it is largely uncontentious that when a person is expected to die, that their end is made as comfortable and peaceful as possible, and that loved ones* should be permitted to be present at their death. In such cases, family presence offers comfort both to the dying person, and to those who are close to them. However, when death is not anticipated, a resuscitation attempt is often initiated. The interventions required can appear brutal and undignified, and although resuscitation is undertaken with the aim of saving life, it is a reality that in the majority of instances when full cardiopulmonary resuscitation is instigated, the patient will die during the attempt. For many years, international and professional guidelines have recommended that loved ones be allowed to remain with patients during resuscitation. However, although in paediatric cases, family witnessed resuscitation (FWR) is commonplace, when the patient is an adult, friends and family members are still ...
Nursing times
This article is the eighth in our 'Care is Critical' series on complex interventions nurs... more This article is the eighth in our 'Care is Critical' series on complex interventions nurses have to manage in acute general wards and in the community. This article looks at the management of pleural drains and gives an overview of the relevant anatomy and physiology. Some of the conditions that may result in a chest tube being inserted are described and the nursing care discussed.
Resuscitation, 2009
Aim of the study: To compare the preferences of patients who survived resuscitation with those ad... more Aim of the study: To compare the preferences of patients who survived resuscitation with those admitted as emergency cases about whether family members should be present during resuscitation. Methods: We used a case control design and recruited, from four large hospitals, 21 survivors of resuscitation and 40 patients admitted as emergency cases without the experience of resuscitation (control group) who were matched by age and gender at a ratio of 1:2. Data collection involved face-to-face interviews using a standardised 22 item questionnaire. Data analysis sought to identify differences between the two groups. Results: Both groups were broadly supportive of the practice, however resuscitated patients were more likely to favour witnessing the resuscitation of a family member (72% versus 58%), preferred to have a relative present in the event they required resuscitation (67% versus 50%) and believed that relatives benefited from such an experience (67% versus 48%). Additionally, both groups indicated that staff should seek patient preferences about family witnessed resuscitation following hospital admission, and stated that they were unconcerned about confidential matters being discussed with family members present during resuscitation (91% and 75%, respectively). However none of these differences between the two groups achieved statistical significance. Conclusion: Hospitalised patients report a favourable disposition towards family witnessed resuscitation, and this view appears to be strengthened by successfully surviving a resuscitation episode. Practitioners should strive to facilitate family witnessed resuscitation by establishing, documenting and enacting patient preferences. Research exploring the perceptions of the wider public would help further inform this debate.
Intensive and Critical Care Nursing, 1997
Guillain-Barr~ syndrome is a complex disorder that affects around 0.5-2 individuals per 100 000 p... more Guillain-Barr~ syndrome is a complex disorder that affects around 0.5-2 individuals per 100 000 per year (Hund et al 1993). The outcome can range from a sensation of paraesthesia to death. This article discusses the biological nature of Guillain-Barrb syndrome, major diagnostic criteria and the treatment that is available. It highlights the nurse's role in management of the syndrome and describes how the extent of the syndrome in individual patients may be evaluated in the clinical area.
Background: A number of international studies have explored the views of family members and healt... more Background: A number of international studies have explored the views of family members and healthcare professionals on the concept of family witnessed resuscitation. However, the perspective and preferences of patients have been under-researched. Objectives: To explore the views and preferences of resuscitation survivors and those admitted as emergency cases, as to whether family members should be present at their resuscitation. Design: This paper reports the qualitative findings of a wider study, whose aim was to explore patient preferences towards family witnessed resuscitation. Settings: Study sites included four acute university hospitals in two large cities of the SouthWest of England. Participants: A purposive sample of 21 patients who underwent successful resuscitation and 41 patients, who presented to hospital as emergency cases, but without the experience of resuscitation, were recruited to the study. Methods: To generate in-depth understanding about the phenomenon under inquiry, qualitative data were collected from faceto-face interviews. All responses were hand written and analysed using recognised qualitative techniques. Findings: Three main themes emerged and these included: 'being there', 'welfare of others' and 'professionals' management of the event'. While the majority of participants supported the premise of having loved ones present during resuscitation, their motives varied and often related to the needs of families. Participants recognised that healthcare professionals had to exercise discretionary judgements to manage the resuscitation, which could embrace shielding relatives from distressing scenes and dealing with issues of confidentiality. Conclusions: The study provides a unique understanding of patient preferences of family witnessed resuscitation with some of their views contesting arguments in the literature. Patients' perspectives suggest both relatives and they themselves benefit in different ways. Although participants recognised that family members had emotional, informational and proximity needs, these had to be balanced with allowing the resuscitation team to manage the clinical emergency and make decisions. It is also evident that not all patients wish their families to be present. Healthcare professionals should strive to identify the wishes of patients and relatives in respect to family witnessed resuscitation and facilitate the presence of loved ones as appropriate. Further research into the area is still required.
In their recent article, Erbay et al considered whether a seriously injured patient should be abl... more In their recent article, Erbay et al considered whether a seriously injured patient should be able to refuse treatment if the refusal was based on a (mis)interpretation of religious doctrine. They argued that in such a case ‘what is important…is whether the teaching or philosophy used as a reference point has been in fact correctly perceived’ (p 653). If it has not been, they asserted that this eroded the patient's capacity to make an autonomous decision and that therefore, in such cases, it is the role of the healthcare professional (HCP) to ‘assist patients to think more clearly and rationally’ (p 653). There are, however, a number of problems with the reasons why Erbay et al suggest we should help patients to rationalise their decisions and how HCPs should go about this. In this article, the author explores some of their main arguments regarding consent and rationality (particularly in relation to religious beliefs), as well as Erbay et al's normative claim that HCPs have...
Despite worldwide efforts to reduce the consumption of tobacco, legislative and educational measu... more Despite worldwide efforts to reduce the consumption of tobacco, legislative and educational measures have failed to eradicate the practice of cigarette smoking. Indeed, in many populations, particularly in the developing world, its prevalence is increasing. Consequently were alternative strategies to become available to address the problem, they would deserve serious consideration. One potential strategy which may become a real possibility in the future might be the vaccination of children against the pleasurable effects of nicotine. Were such a vaccine to become available, children who had been inoculated would be less likely to start smoking, and even if they did, would be able to quit more easily. However, as Hasman and Holm discussed, vaccinating against a behavior rather than a disease is not ethically unproblematic, and they concluded that inoculation of infants and young children with a permanently effective nicotine conjugate vaccine should not take place, as it robbed child...
Journal of Clinical Nursing
Nurse Education in Practice, 2015
In recent years, changes to undergraduate nursing curricula in the United Kingdom have been coupl... more In recent years, changes to undergraduate nursing curricula in the United Kingdom have been coupled with increasing expectations that service users be involved in assessment of student nurses. These factors lead to the development of a tool to facilitate gathering of feedback from patients/carers on the competency of adult field student nurses in practice. This study evaluated experiences of those involved in the process of using the feedback tool. Using an exploratory qualitative research design, four patients, four mentors and five pre-registration adult field nursing students were interviewed. Thematic analysis of the data identified three interconnecting themes; value of the patient's voice, caring and protection, and authenticity of feedback. A sub-theme of timing of giving feedback was also identified. Patients felt they should be involved in giving feedback, were comfortable in doing so, and felt best placed to judge students' performance in several aspects of care. Students and mentors shared these opinions. Additionally they felt service user feedback potentially helped improve students' competence and confidence, and facilitated mentors in their assessment of students' professional values, communication and interpersonal skills. However, mentors were more reticent about the possibility of receiving feedback from service users on their own practice.
Nursing times, Aug 1, 2011
The Nursing and Midwifery Council promotes the idea that patients should contribute to the assess... more The Nursing and Midwifery Council promotes the idea that patients should contribute to the assessment of preregistration student nurses. In response, staff, mentors and pre-registration student nurses from the University of West of England Bristol and the Royal United Hospital Bath worked together to develop, pilot and introduce a way of achieving this with a patient testimony tool. The tool, which is a feedback sheet, was developed through consultation with patients and carers, then piloted and is now used in an acute hospital. This article discusses how the tool was developed. It outlines how it was implemented and the challenges this involved, and looks at plans for development.
PubMed, Feb 21, 1998
This article is the eighth in our 'Care is Critical' series on complex interventions nurses have ... more This article is the eighth in our 'Care is Critical' series on complex interventions nurses have to manage in acute general wards and in the community. This article looks at the management of pleural drains and gives an overview of the relevant anatomy and physiology. Some of the conditions that may result in a chest tube being inserted are described and the nursing care discussed.
Intensive and Critical Care Nursing, Feb 1, 1997
Guillain-Barr~ syndrome is a complex disorder that affects around 0.5-2 individuals per 100 000 p... more Guillain-Barr~ syndrome is a complex disorder that affects around 0.5-2 individuals per 100 000 per year (Hund et al 1993). The outcome can range from a sensation of paraesthesia to death. This article discusses the biological nature of Guillain-Barrb syndrome, major diagnostic criteria and the treatment that is available. It highlights the nurse's role in management of the syndrome and describes how the extent of the syndrome in individual patients may be evaluated in the clinical area.
In most cultures, it is largely uncontentious that when a person is expected to die, that their e... more In most cultures, it is largely uncontentious that when a person is expected to die, that their end is made as comfortable and peaceful as possible, and that loved ones* should be permitted to be present at their death. In such cases, family presence offers comfort both to the dying person, and to those who are close to them. However, when death is not anticipated, a resuscitation attempt is often initiated. The interventions required can appear brutal and undignified, and although resuscitation is undertaken with the aim of saving life, it is a reality that in the majority of instances when full cardiopulmonary resuscitation is instigated, the patient will die during the attempt. For many years, international and professional guidelines have recommended that loved ones be allowed to remain with patients during resuscitation. However, although in paediatric cases, family witnessed resuscitation (FWR) is commonplace, when the patient is an adult, friends and family members are still frequently prevented from being present. Various justifications have been presented within medical and nursing literature as to why FWR is not promoted. These include the views of healthcare professionals that the experience would be too traumatic for relatives, that loved ones may hamper the attempt, or that patient dignity or confidentiality could be compromised. Although these justifications appear beneficent in origin, I will suggest that restricting FWR is morally problematic. Firstly, concerns about relative’s welfare and patient confidentiality are unjustifiably paternalistic, particularly when empirical data demonstrate that these ‘justifications’ for preventing FWR are largely based on conjecture rather than evidence. Secondly, it is inconsistent that FWR be widely facilitated for paediatrics but not adults. Thirdly, there are no convincing reasons why relatives should be prevented from being with a patient at the end of their life, simply because of the nature of the patient’s death. And finally, in cases where loved ones may be aware of the patient’s end of life preferences, and particularly where the patient has nominated a healthcare advocate, their exclusion during resuscitation inhibits legitimate decision making processes, and increases the likelihood that continuation or cessation of treatment may be against patient’s wishes, and therefore non-beneficent. Consequently, in the absence of compelling individual reasons to the contrary, FWR should be practiced in all cases where loved ones or advocates wish to be present.
Rationality, religion and refusal of treatment in an
Nursing times, 2011
The Nursing and Midwifery Council promotes the idea that patients should contribute to the assess... more The Nursing and Midwifery Council promotes the idea that patients should contribute to the assessment of preregistration student nurses. In response, staff, mentors and pre-registration student nurses from the University of West of England Bristol and the Royal United Hospital Bath worked together to develop, pilot and introduce a way of achieving this with a patient testimony tool. The tool, which is a feedback sheet, was developed through consultation with patients and carers, then piloted and is now used in an acute hospital. This article discusses how the tool was developed. It outlines how it was implemented and the challenges this involved, and looks at plans for development.
In most cultures, it is largely uncontentious that when a person is expected to die, that their e... more In most cultures, it is largely uncontentious that when a person is expected to die, that their end is made as comfortable and peaceful as possible, and that loved ones* should be permitted to be present at their death. In such cases, family presence offers comfort both to the dying person, and to those who are close to them. However, when death is not anticipated, a resuscitation attempt is often initiated. The interventions required can appear brutal and undignified, and although resuscitation is undertaken with the aim of saving life, it is a reality that in the majority of instances when full cardiopulmonary resuscitation is instigated, the patient will die during the attempt. For many years, international and professional guidelines have recommended that loved ones be allowed to remain with patients during resuscitation. However, although in paediatric cases, family witnessed resuscitation (FWR) is commonplace, when the patient is an adult, friends and family members are still ...
Nursing times
This article is the eighth in our 'Care is Critical' series on complex interventions nurs... more This article is the eighth in our 'Care is Critical' series on complex interventions nurses have to manage in acute general wards and in the community. This article looks at the management of pleural drains and gives an overview of the relevant anatomy and physiology. Some of the conditions that may result in a chest tube being inserted are described and the nursing care discussed.
Resuscitation, 2009
Aim of the study: To compare the preferences of patients who survived resuscitation with those ad... more Aim of the study: To compare the preferences of patients who survived resuscitation with those admitted as emergency cases about whether family members should be present during resuscitation. Methods: We used a case control design and recruited, from four large hospitals, 21 survivors of resuscitation and 40 patients admitted as emergency cases without the experience of resuscitation (control group) who were matched by age and gender at a ratio of 1:2. Data collection involved face-to-face interviews using a standardised 22 item questionnaire. Data analysis sought to identify differences between the two groups. Results: Both groups were broadly supportive of the practice, however resuscitated patients were more likely to favour witnessing the resuscitation of a family member (72% versus 58%), preferred to have a relative present in the event they required resuscitation (67% versus 50%) and believed that relatives benefited from such an experience (67% versus 48%). Additionally, both groups indicated that staff should seek patient preferences about family witnessed resuscitation following hospital admission, and stated that they were unconcerned about confidential matters being discussed with family members present during resuscitation (91% and 75%, respectively). However none of these differences between the two groups achieved statistical significance. Conclusion: Hospitalised patients report a favourable disposition towards family witnessed resuscitation, and this view appears to be strengthened by successfully surviving a resuscitation episode. Practitioners should strive to facilitate family witnessed resuscitation by establishing, documenting and enacting patient preferences. Research exploring the perceptions of the wider public would help further inform this debate.
Intensive and Critical Care Nursing, 1997
Guillain-Barr~ syndrome is a complex disorder that affects around 0.5-2 individuals per 100 000 p... more Guillain-Barr~ syndrome is a complex disorder that affects around 0.5-2 individuals per 100 000 per year (Hund et al 1993). The outcome can range from a sensation of paraesthesia to death. This article discusses the biological nature of Guillain-Barrb syndrome, major diagnostic criteria and the treatment that is available. It highlights the nurse's role in management of the syndrome and describes how the extent of the syndrome in individual patients may be evaluated in the clinical area.
Background: A number of international studies have explored the views of family members and healt... more Background: A number of international studies have explored the views of family members and healthcare professionals on the concept of family witnessed resuscitation. However, the perspective and preferences of patients have been under-researched. Objectives: To explore the views and preferences of resuscitation survivors and those admitted as emergency cases, as to whether family members should be present at their resuscitation. Design: This paper reports the qualitative findings of a wider study, whose aim was to explore patient preferences towards family witnessed resuscitation. Settings: Study sites included four acute university hospitals in two large cities of the SouthWest of England. Participants: A purposive sample of 21 patients who underwent successful resuscitation and 41 patients, who presented to hospital as emergency cases, but without the experience of resuscitation, were recruited to the study. Methods: To generate in-depth understanding about the phenomenon under inquiry, qualitative data were collected from faceto-face interviews. All responses were hand written and analysed using recognised qualitative techniques. Findings: Three main themes emerged and these included: 'being there', 'welfare of others' and 'professionals' management of the event'. While the majority of participants supported the premise of having loved ones present during resuscitation, their motives varied and often related to the needs of families. Participants recognised that healthcare professionals had to exercise discretionary judgements to manage the resuscitation, which could embrace shielding relatives from distressing scenes and dealing with issues of confidentiality. Conclusions: The study provides a unique understanding of patient preferences of family witnessed resuscitation with some of their views contesting arguments in the literature. Patients' perspectives suggest both relatives and they themselves benefit in different ways. Although participants recognised that family members had emotional, informational and proximity needs, these had to be balanced with allowing the resuscitation team to manage the clinical emergency and make decisions. It is also evident that not all patients wish their families to be present. Healthcare professionals should strive to identify the wishes of patients and relatives in respect to family witnessed resuscitation and facilitate the presence of loved ones as appropriate. Further research into the area is still required.
In their recent article, Erbay et al considered whether a seriously injured patient should be abl... more In their recent article, Erbay et al considered whether a seriously injured patient should be able to refuse treatment if the refusal was based on a (mis)interpretation of religious doctrine. They argued that in such a case ‘what is important…is whether the teaching or philosophy used as a reference point has been in fact correctly perceived’ (p 653). If it has not been, they asserted that this eroded the patient's capacity to make an autonomous decision and that therefore, in such cases, it is the role of the healthcare professional (HCP) to ‘assist patients to think more clearly and rationally’ (p 653). There are, however, a number of problems with the reasons why Erbay et al suggest we should help patients to rationalise their decisions and how HCPs should go about this. In this article, the author explores some of their main arguments regarding consent and rationality (particularly in relation to religious beliefs), as well as Erbay et al's normative claim that HCPs have...
Despite worldwide efforts to reduce the consumption of tobacco, legislative and educational measu... more Despite worldwide efforts to reduce the consumption of tobacco, legislative and educational measures have failed to eradicate the practice of cigarette smoking. Indeed, in many populations, particularly in the developing world, its prevalence is increasing. Consequently were alternative strategies to become available to address the problem, they would deserve serious consideration. One potential strategy which may become a real possibility in the future might be the vaccination of children against the pleasurable effects of nicotine. Were such a vaccine to become available, children who had been inoculated would be less likely to start smoking, and even if they did, would be able to quit more easily. However, as Hasman and Holm discussed, vaccinating against a behavior rather than a disease is not ethically unproblematic, and they concluded that inoculation of infants and young children with a permanently effective nicotine conjugate vaccine should not take place, as it robbed child...
Journal of Clinical Nursing
Nurse Education in Practice, 2015
In recent years, changes to undergraduate nursing curricula in the United Kingdom have been coupl... more In recent years, changes to undergraduate nursing curricula in the United Kingdom have been coupled with increasing expectations that service users be involved in assessment of student nurses. These factors lead to the development of a tool to facilitate gathering of feedback from patients/carers on the competency of adult field student nurses in practice. This study evaluated experiences of those involved in the process of using the feedback tool. Using an exploratory qualitative research design, four patients, four mentors and five pre-registration adult field nursing students were interviewed. Thematic analysis of the data identified three interconnecting themes; value of the patient's voice, caring and protection, and authenticity of feedback. A sub-theme of timing of giving feedback was also identified. Patients felt they should be involved in giving feedback, were comfortable in doing so, and felt best placed to judge students' performance in several aspects of care. Students and mentors shared these opinions. Additionally they felt service user feedback potentially helped improve students' competence and confidence, and facilitated mentors in their assessment of students' professional values, communication and interpersonal skills. However, mentors were more reticent about the possibility of receiving feedback from service users on their own practice.