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Abstract: Background: Despite concern expressed in recent government documents in the UK about the inappropriate use of sedation when a patient is agitated or confused and cannot consent, there is little nursing literature on the topic. The general legal and ethical principles apply that a patient who is unable to consent should be given care that is in his or her ‘best interests’. Aim: The aim of this paper is to report on qualitative data concerning nurses’ use of sedation which were obtained as part of a larger study to explore the way in which nurses obtain consent prior to nursing care procedures. Method: A purposive sample of 30 qualified nurses in two teaching hospitals in England was obtained. One hundred critical incidents were collected through 30 in-depth interviews as a means of focusing on specific incidents concerning informed consent prior to nursing care procedures in clinical practice. Findings: The administration of sedation to patients who cannot consent was a major theme to emerge. Sedation was sometimes given in the interests of other patients or staff rather than the patient and before alternative strategies had been considered. Nurses were uneasy about the use of sedation in such circumstances, and lacked knowledge as to when it may be appropriate to do so. Conclusions: Nurses need to be familiar with the relevant ethical and legal principles and professional guidance in their own countries for caring for people who cannot consent, and need to be confident in their understanding and application of these principles to ensure that sedation is administered appropriately. [Copyright &y& Elsevier]

The aim of this paper is to examine the way in which nurses manage patients who are unable to consent to nursing care procedures. This paper reports on a qualitative study using focus groups and critical incidents collected through in-depth interviews to explore the way in which nurses obtain consent prior to nursing care procedures. The finding indicate that nurses are uneasy about administering care to a patient who cannot consent. When complicating factors are present this unease is exacerbated and sometimes the appropriate delivery of care is withheld. [Copyright &y& Elsevier]

Abstract Background Inflammatory Bowel Disease is a chronic, untreatable condition represented by two illnesses, Crohn's and Ulcerative Colitis. Despite high incidence in well-developed industrialised countries, and the significant impact of symptoms on patient's quality of life, little is known about living with Inflammatory Bowel Disease. Aim To explore the patients' experiences of living with Inflammatory Bowel Disease. Design A qualitative systematic review. Data sources CINAHL, Medline, British Nursing Index and PsycINFO were searched using the following keywords: Inflammatory Bowel Disease AND experiences. We have limited the search to studies published in English from 2000 to 2017. Review method Thematic synthesis. Results Data from 23 studies, identified that fatigue, incontinence and uncertainty about future, body image, and lack of information from healthcare professionals dominated the experiences of those living with Inflammatory Bowel Disease. Also, patients living with Inflammatory Bowel Disease were reluctant to disclose their illness due to lack of public awareness and stigma surrounding symptoms. From these, an overarching theme has been identified: Living in isolation and exclusion. Conclusion Patients with Inflammatory Bowel Disease face a variety of problems, often their priorities and those of healthcare professionals differ greatly. Healthcare professionals have little evidence needed to provide adequate, holistic care to this group. With a rise in the Inflammatory Bowel Disease population in newly industrialised countries it is estimated that the condition is turning into a global disease, potentially making long term care unsustainable. More evidence is needed to understand the concerns of this group. [ABSTRACT FROM AUTHOR]

Abstract Aim The aim of this integrative literature review was to explore the quality of the dying and death experience in the Emergency Department from the perspective of staff and carers. Background Death in the Emergency Department is common. Understanding the quality of the death and dying experience of patients and their family members is crucial to building knowledge and improving care. Design Systematic integrative literature review reported following the PRISMA guidelines. Data sources Pubmed, Cumulative Index to Nursing and Allied Health Literature, Magonline (internurse), and the Cochrane library. Articles used were published in English during 1990- 2017. Review method Appraisal and thematic analysis. Results Sixteen articles are included. Eight themes emerged from the literature: care in the Emergency Department is about living not dying, staff perceive that death is a failure, staff feel underprepared to care for the dying patient and family in this environment, there is limited time for safe standards of care, staff stress and distress, staff use of distancing behaviours, the care of the dying role is devolved from medics to nurses at the end of life, and patients and staff perceive that the Emergency Department is not the preferred place of death Conclusion There are areas of concern about end of life care in the Emergency Department. To improve practice and to ensure that a good death occurs, further research is needed. There is a need to understand more about the experience of caregivers when a relative or friend dies in the Emergency Department. [ABSTRACT FROM AUTHOR]