I I8 Accident and Emergency Nursing
Naturally, one learns a lot from such an experience. Rest assured we have all recovered except for a few scars. Juliet, the most seriously injured, is, as I write, revising hard for her GCSEs. What did we learn from the skiing trip that never was? Never drive when you are seriously tired. I have spoken to many doctors and nurses since the accident, almost all of whom have had a ‘micro-sleep’ when driving. That is the moment when your head drops and you realize you must open the window, turn up the stereo or some other such useless manoeuvre. Instead, STOP in a lay-by and SLEEP for 2 hours. You may not be as lucky as we were. 0 Always stop at the scene of an accident. You may not be able to do anything medical, but you can call the ambulance service. Rescue l
doesn’t start until that phone call has been made. 0 Never let your children sleep with their heads on the central armrest in the back of the car. In so doing they effectively lose the diagnonal part of the seatbelt, making it easier to be thrown out of a vehicle rolling through its long axis. l Always drive a strong car. I feel that the door pillars prevented Alison and me from suffering more serious injuries. Other memories, and perhaps lessons, remain. In particular, all of us being placed in a four-bedded ward was an act of great sensitivity towards a family injured abroad. As a parent the kindness shown to our children by the French nurses will remain as a shining example to us to try and follow in our own daily work.
Book Reviews Emergency nursing, standards care and quality improvement J Selfridge-Thomas,
W B SaundersCompany, 1995, ISBN 0 72 16 54533, A22.50
Standard setting is a rapidly developing science which is gaining popularity in all branches of nursing. To present a package designed specifically for accident and emergency nursing is a must for all those involved in emergency care delivery and planning. Emergency Nursing, Standards of Cave and Quality Improvement is a detailed comprehensive book, which discusses and presents the fundamental issues of identieing and providing quality care within the accident and emergency department. The book has been presented in a ringfolder format and printed on card which allows for easy access. Individual sheets can be removed for the purpose of photocopying for multiple use. Chapter One explains the basic principles of Standards of nursing care and nursing practice. As indicated in the opening paragraphs, standards of care address the dimensions of patient care. A ‘structure perspective’ relates to patient assessment, a ‘process perspective’ details nursing actions and, finally, an ‘outcome perspective’ relates to the expected end results of care. The second and third chapters acknowledge the work of June Abbey’s FRANCAPS
framework. It is comfortably presented and easy to read. Examples of nursing standards are identified using the now familiar structure process outcome model. The information contained in the chapter is concise and straightforward. Although it is not too detailed it does set an important benchmark for future works to be developed. The chapter discussing nursing practice standards identifies the common aspects of practice for all emergency nurses. Performance indicators and reviews detail expected professional nursing behaviours. Ten comprehensive professional practice standards have been presented. These include triage, human worth, teaching and professionalism. Examples of use have been included which helps clarify use and application. The fifth and last chapter addresses ‘Quality Improvement’. Identified patient problems are measured against the FRANCAPS model with standard threshold measurements of 95-100% being identified. The book concludes with some interesting correlations between nursing and medical diagnoses. The lists are detailed, informative and fascinating. Generally I found this book to be of good academic standard, presented in a straightforward way and a must for all A & E nurses and managers. Denis Del&ridge School of Healthcare Studies Division of Nursing Leeds University, UK