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Aims and objectives To review literature on nurses’ and health care workers’ experiences of caring for people with dementia on orthopaedic wards. Background Dementia is a condition that affects a large number of the older population worldwide. It is estimated that there are 47·5 million people worldwide living with dementia with 4·6 million new cases being diagnosed annually. This number is said to increase to 75·6 million by 2030 and triple by 2050. It is also acknowledged that older people are at a greater risk of falls that are a devastating problem causing a tremendous amount of morbidity, mortality and use of health care services (Rubestein, Age and Ageing, 35, 2006, 37). Falls usually result from identified risk factors such as weakness, unsteady gait, confusion and certain medication. Therefore, it is reasonable to assume that a large population of older people suffering from dementia may be admitted to orthopaedic wards with various injuries. Nurse and support health workers may experience a range of difficulties when caring for this population of patients. Design A systematic review. Methods An extensive literature search using; CINAHL, MEDLINE, Academic Search Complete, National Health Service Evidence, websites like Department of Health, Dementia and Alzheimer's Society. Results The search generated several articles on dementia in general, however, only 14 articles dealing with care of these people in an acute hospital setting were found. No studies dealing with the care of people with dementia on orthopaedic wards were found; therefore, this review has taken a generalist nature and applies the findings to orthopaedic wards. The main themes identified from the review were: challenging behaviour and unsuitable care environment; lack of education on dementia; strain from nursing patients with dementia; and ethical dilemmas arising from care of people with dementia. Conclusion It would be an over-simplification to say that the care of people with dementia on medical wards is the same as the care of trauma patients with dementia. Therefore, there is a need for a study to explore nurses’ and health care worker's experiences of caring for trauma patients with dementia on orthopaedic wards. Relevance to clinical practice The results of this study could provide guidance on the effective care of people with dementia on orthopaedic wards.

As the workforce in the British National Health Service (NHS) has become more diverse, several researchers have reported that experiences of overseas’ nurses have been largely negative. This paper explores black African nurses’ experiences of equal opportunities, racism, and discrimination in four NHS trusts in the North East of England. Thirty nurses from sub-Saharan countries working in four NHS trusts were interviewed between 2006 and 2008 using semi-structured interviews and focus group discussions to gain an insight into their experiences in the NHS. This study suggests that black African nurses experienced discrimination and racism emanating from white colleagues and other overseas nurses, managers, patients, and their relatives, as well as lack of opportunities in their workplaces. Managers seemed to be treating British and other overseas nurses more favorably than black African nurses. Although much progress has been made in valuing and embracing diversity in the NHS, this paper highlights areas in which more work is required.

Aims and objectives. To explore sub-Saharan African nurses' reasons for moving to the UK, their views on the skills and brain drain, and what can be done to stem the situation. Background. The UK and other developed nations such as the USA, Canada and Australia have been recruiting internationally qualified nurses including those from sub-Saharan African, which has raised concerns of skills and brain drain from these countries that are known to suffer from nurse shortages. Methods. A purposeful sample of 30 nurses from sub-Saharan African was drawn from four National Health Service trusts in the north-east of England. Using focus group discussions and personal interviews, the study explored and examined nurses' views on their motivation to move to the developed countries and what can be done to reduce nurse migration from sub-Saharan African and give those countries a chance to develop their health systems by retaining their health personnel. Results. Five main themes emerged from data analysis: poor remuneration, lack of professional development in the home countries, poor health care and systems, language and education similarities and easy availability of jobs and visas. Conclusion. Data indicate that migration motives for nurses are complex and inherent in historical links and in global values. Nurses stressed that they would like to stay in their own countries and help develop healthcare there, but reasons for moving were often strong and apparently not within their control. Relevance to clinical practice. Nurse migration from sub-Saharan African has often been cited as a limitation in providing effective healthcare in those countries. Delineating motivational factors for nurses could help to stem this migration. © 2013 Blackwell Publishing Ltd.