Nurses must account for the ethical standards of their practice if called to do so by their professional regulatory body, therefore ethics is a part of daily nursing practice. Ethics is about making a personal judgement, meaning ethical standards are usually broad; however, this can make them appear unclear or intimidating. Therefore, it is important that nurses and nursing students understand how the topic of ethics manifests in ethical theory, the degree to which ethical theory can inform their practice, and its limitations. This article describes the perspectives and drawbacks of the main ethical theories, discusses how philosophers scrutinise ethical decisions, and considers the use of an ethical framework in healthcare decision-making. The author uses a scenario depicting an ethical dilemma in nursing practice to illustrate the points discussed. The author concludes that, whatever the limits of ethical theory as a definitive guide to nursing practice, reflection on ethical theories can help nurses to critically balance workplace demands for efficiency with the need to be compassionate and caring towards patients.

Hospital-associated deconditioning is a recognised and well-known condition. It refers to a loss of physiological fitness and functional ability in a patient resulting from prolonged immobility, inactivity or bed rest during a period of hospitalisation. Many patients who experience deconditioning also have new or existing continence issues, although the link between deconditioning and incontinence is not well understood. This article explores deconditioning and incontinence among older people in acute care settings. It outlines the multifactorial links between the two conditions and reviews current practice with regards to continence care. The author also suggests some preventative strategies to reduce the risk of deconditioning and promote continence, thereby supporting patients to remain as independent as possible after their discharge from hospital.

Effective communication in palliative or end of life care, which includes the care and support offered to an individual's family, is crucial to ensuring a positive patient experience. Communication in palliative or end of life care can be considered as a therapeutic intervention that shapes care, treatment and support for patients and their families during the most vulnerable periods in their life. This article explores the multifaceted nature of communication in palliative and end of life care. It discusses some evidence-based models and frameworks that can guide best practice and support nurses to communicate effectively. The article also considers the importance of self-care for nurses who are supporting patients and families in the palliative or end of life care context.

Young onset dementia, which comprises a group of neurodegenerative conditions, affects adults aged under 65 years and has significant adverse effects on their lives and those of their families. Early recognition of symptoms and diagnosis can facilitate timely access to treatment and support. However, younger adults typically experience a significantly longer wait for a dementia diagnosis than older adults, in part due to a lack of recognition of symptoms and initial misdiagnosis. This article provides an overview of young onset dementia, discusses some of the barriers to timely diagnosis and describes the associated signs and symptoms in younger adults. The author discusses ways in which the diagnostic process and post-diagnosis support may be improved for this population and poses questions for nurses to consider with regards to local service improvement. The author includes a fictional case study to illustrate the experiences of younger adults with dementia and their families.

Nursing documentation is a fundamental component of safe clinical practice, supporting effective communication, continuity of care and patient safety. However, the increasing demands associated with electronic health records have contributed to a growing administrative workload for nurses. In response, artificial intelligence (AI) technologies are being explored as tools to support clinical documentation and improve the management of healthcare information. This narrative overview examines emerging evidence on the impact of AI on nursing documentation and patient safety, with particular focus on acute hospital care. The author reviews the literature on key AI technologies, including natural language processing, machine learning, generative AI and ambient AI, and their potential applications in nurses' record-keeping.

Nurses often have to manage anger from patients, relatives and carers in their practice. However, in emotionally charged situations, it can be challenging to maintain professionalism, respond with empathy and set clear limits. This article presents a practical, transferable strategy for responding to anger in healthcare settings using active listening and structured information gathering. Drawing on de-escalation literature, communication theory and evidence from communication skills training, the author outlines a stepwise approach that nurses can use to de-escalate confrontations involving patients, relatives and carers. This approach emphasises the importance of early recognition of escalation, empathic engagement, validation, collaborative problem-solving and clear limit-setting.

Early recognition of patient deterioration is essential for reducing preventable harm in the acute hospital. While early warning score systems such as the National Early Warning Score (NEWS) 2 standardise the way patients are assessed and monitored, they do not necessarily capture the full spectrum of cues which can alert healthcare professionals that a patient is deteriorating. Nurse intuition, non-numerical observations, family and patient concerns, and trends in vital signs, consciousness level and function all have a role as early markers of patient deterioration that may precede measurable physiological changes. This article presents the rationale for integrating these early and often subtle signs of deterioration in clinical practice alongside early warning scores, and proposes a framework that offers a structured way of doing so.

Pulse oximetry is a non-invasive method of obtaining an indirect measure of a patient's peripheral oxygen saturation of haemoglobin in the blood (SpO 2), and is commonly used in acute and primary care settings. Obtaining an SpO 2 measurement involves the use of a pulse oximeter, which is typically attached to the patient's fingertip. This article describes how pulse oximetry works, discusses its limitations as a single metric and explores its applicability to the airway, breathing, circulation, disability and exposure (ABCDE) assessment approach and to the National Early Warning Score (NEWS) 2 'track and trigger' tool. The article also discusses the use of pulse oximetry in patients with chronic obstructive pulmonary disease and considers some of the challenges associated with its use, specifically in relation to skin integrity and patient comfort, skin tone, suboptimal peripheral circulation and the effects of nail polish on the accuracy of readings.

Anorexia nervosa - commonly referred to as anorexia - is a significant mental health condition characterised by excessive weight loss and distorted body image. However, although anorexia may be regarded primarily as a mental health issue, nurses from all fields and specialties should have the necessary knowledge and skills to identify and care for individuals with the condition in the community and non-specialist healthcare settings. This article outlines the aetiology of anorexia and considers how individuals with the condition might be identified in primary care or emergency settings. It details the relevant assessment methods and appropriate management of anorexia, including refeeding. The article also considers the role of families and carers in providing support.

Skin and soft tissue abscesses (SSTAs) are painful localised collections of pus in the epidermis, dermis and subcutaneous tissue which, without timely and effective intervention, can progress to serious complications including systemic sepsis and necrotising fasciitis. The evidence emphasises the limitations of a one-size-fits-all surgical approach, where treatment of SSTAs often defaults to incision and drainage. This article discusses the aetiology, assessment and management of patients presenting with purulent SSTAs and identifies opportunities for nurses to refine their assessment practices, optimise interventions and enhance patient outcomes. Emphasis is placed on comprehensive history-taking, detailed physical examination, and accurate evaluation of abscess size, depth and anatomical location. The author also discusses alternative surgical practices that nurses should be aware of to ensure they are able to provide patients with evidence-based care.

In Scotland, nursing students receive a non-repayable bursary to support them throughout the duration of their education programme. The underlying assumption of this funding structure is that it protects students' supernumerary status while they are on practice placements. However, evidence suggests that this financial support is inadequate, with a high percentage of nursing students reporting that financial stress adversely affects their academic performance, engagement with practice placements and mental health. In this article, the author examines the effects of financial precarity on nursing student retention and practice learning, and considers how the funding structure in Scotland intersects with education quality and workforce sustainability.

Inflammatory bowel disease (IBD) is a chronic health condition characterised by gastrointestinal tract inflammation. The two main types of IBD are Crohn's disease and ulcerative colitis. More than half a million people in the UK have a diagnosis of IBD, therefore nurses working in a range of settings - including general practice, community care and acute care - may encounter patients with these conditions. A wide range of interventions are used to diagnose IBD and for ongoing monitoring post-diagnosis. This article details the main investigations patients with IBD are likely to undergo, including blood tests, stool tests, endoscopy and medical imaging. It is important that nurses have an understanding of these investigations to enable them to support patients throughout the diagnostic and monitoring processes.

Non-medical prescribing has expanded significantly in the UK since its introduction in the early 1990s, bringing increased responsibilities and accountability for non-medical prescribers (NMPs). It is essential that NMPs are equipped to maintain high standards of prescribing practice. This article discusses crucial factors for NMPs to consider when making prescribing decisions, focusing on effectiveness, appropriateness, safety and cost-effectiveness. The author highlights the importance of referring to guidance and research, consulting local policy and drug formularies, thorough patient assessment and history-taking, accurate and objective patient education, and shared decision-making and person-centred prescribing. To remain competent and confident, NMPs must be provided with continuing professional development and opportunities for reflective practice.

Early recognition and management of acute deterioration is essential to reduce the risk of patients experiencing catastrophic events, such as cardiac arrest, and to prevent potentially avoidable deaths. Common signs and symptoms of acute deterioration include increased respiratory rate, alteration in skin temperature, increased heart rate, hypotension, reduced urine output and acute onset confusion. Nurses undertake clinical monitoring and observation of patients in acute care settings and are therefore ideally placed to recognise and act on these signs and symptoms. This article explores the pathophysiology of common signs and symptoms of acute deterioration in relation to body systems, aligned with the airway, breathing, circulation, disability and exposure (ABCDE) approach and with reference to the National Early Warning Score (NEWS) 2 'track and trigger' tool. The author also considers the contribution of clinical intuition, clinical judgement and effective communication in the management of the deteriorating patient.