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Dr Michael Sullivan
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Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
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FECAL INCONTINENCE
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Dr Hans Groth, Chairman of the Board, World Demographic & Ageing Forum
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From Surviving to Thriving - Paul Vaughan
1.
2. Nurses and midwives: meeting the challenge of providing health care for
everyone, everywhere
Paul Vaughan RN, Nursing Now England, NHS England and NHS Improvement
3. Content of this presentation
• What is Nursing Now?
• Nursing and global health – the context for Nursing
Now
• Nursing Now England
• Purpose of today
4. Our goal
Nursing Now aims to
improve health globally by
raising the status and
profile of nursing and
midwifery.
Credit: Morgana Wingard for IntraHealth International
5. Credit: The Royal College of Nursing
Who we are
• A global campaign
• 225 groups in over 80 countries
• In collaboration with
International Council of Nurses
and World Health Organization
• Programme of the Burdett Trust
for Nursing
Credit: Tim Bekir for THET
6. April 2019
February 2018
A growing global
influence:
• 225 regional, national
and local groups
• Over 80 countries
7. Global and local
health challenges 1
• There is demand for a big expansion in the health workforce – recruitment and
retention challenges, pay, conditions and morale need improving
• Work roles are changing as needs change – ‘carequake’
• A (financial) shift away from hospitals and towards communities and homes.
• There is greater emphasis on disease prevention and health
8. Global and local
health challenges 2
• The engagement of patients and citizens alongside health workers is increasingly
seen as essential in improving access, quality and costs.
• Technology is beginning to play a more prominent part – as the internet becomes
the organising principle of the age.
• Knowledge of what works is at a premium as countries struggle to achieve the goal
of good access, high quality and value for money.
10. The health workforce: a best buy in sustainable
development
3x return on
investment
Economic
growth
Social
development
Health and
human security
11. What we want to
achieve with
Nursing Now
• Change policy globally
and nationally
• Promote influential
leadership
• Strengthen evidence of
impact
• Increase investment
• Achieve triple impact
Credit: Tim Bekir for THET
13. 2020 Year of the
Nurse & Midwife
A once in a generation opportunity to put nurses and
midwives at the centre of global and health policy.
A celebration of all that nurses and midwives do
to improve health and health care.
14. The path to Universal
Health Coverage
Invest and develop nursing and
midwifery workforce.
In particular:
• Nurse-led clinics
• More specialist nurses
• Develop midwifery services
• Primary health care
• Health promotion and disease
prevention
Credit: The Royal College of Nursing
15. Credit: The Royal College of Nursing
Join the
NIGHTINGALE
CHALLENGE
Champion influential leadership roles
for nurses and midwives
Provide development opportunities
for young nurses and midwives
during 2020
Healthcare is changing fast and so
should the workforce – invest in
nurses and midwives, and prepare
them for the future
Demonstrate that nursing and
midwifery are exciting and rewarding
careers
Read more at nursingnow.org
16. Credit: THET
WHO’s first ever
State of the World’s
Nursing Report
with the International
Council of Nurses and
Nursing Now
• Inform national policy
• Drive investment in
nursing workforce to
achieve UHC and SDGs
Credit: THET
17. Paul Vaughan RN MSc, Head of Nursing Now England, NHS
England & NHS Improvement
Elizabeth Carter, Transformation Lead, NHS England & NHS
Improvement
Bev Matthews RN MSc, Transformation Associate, Horizons,
NHS England & NHS Improvement
Credit: Guy’s and St Thomas’ NHS Foundation Trust
#NursingNowEngland #FutureMidwifery
18. Nursing Now
England Priorities
• Primary school
• Secondary school
• Adult learners
Young people
in education
• Current workforce
• Return to practice
Nursing and
midwifery
• Public
• Media
• Professional groups
• Politicians and policy makers
Key
influencers
Inspire
Ignite
Influence
#NursingNowEngland #FutureMidwifery
19. Credit: Guy’s and St Thomas’ NHS Foundation Trust
Specific Focus
Men in
Nursing
Learning
Disabilities
Mental
Health
BAME
Primary
Care
Community
Nursing
#NursingNowEngland #FutureMidwifery
20. The 30 Day Challenges:
#NursingNowEngland #FutureMidwifery
21. • Everyone from first year students to all
registrants on NMC and supporters, newly
qualified nurses and midwives
• Practitioners from all stages in their
career across all disciplines and sectors
• People working across health and care
sectors, including voluntary organisations
We are igniting a social movement across the
system and our ambition is that the network
grows to over 200 registered midwifery
ambassadors and 5,000 nursing
ambassadors.
The ambassadors are all championing the
wonderful profession and opportunities in
midwifery
What is the
Ambassadors’ role
#NursingNowEngland #FutureMidwifery
22. Credit: Guy’s and St Thomas’ NHS Foundation Trust
An Ambassador …
Acts as a local ambassador for nursing and midwifery, representing our professions in a
positive light and by doing so, building awareness and positive perceptions
Creates a bridge between activities to promote nursing and midwifery locally and the
nationwide campaign
Speaks for local organisations and the nurses and midwives in them within the national
campaign
Brings back the ideas and calls to action from the national campaign and customise,
remix and reshape then so they will work in a local context
Leads the local version of the campaign and get people engaged and taking action
#NursingNowEngland #FutureMidwifery
23. What is in it for you?
You will …
1. receive coaching and mentoring support
2. have an opportunity to build your own and
collective agency for change
3. join a growing national network
4. share what works and develop your
knowledge and learning
5. take part in an exciting programme of
events and challenges including a regular
newsletter and opportunity to participate in
virtual and face to face meetings like today
6. be able to demonstrate your passion and
pride for the professions
Our voices are stronger together
#NursingNowEngland #FutureMidwifery
24. Today
• How do inspire young people from a BAME background to take up
nursing as a career?
• How do we retain the current BAME nurses in the system?
Celebrate
Role models Nightingale
Challenge
#NursingNowEngland #FutureMidwifery
25. Credit: Guy’s and St Thomas’ NHS Foundation Trust
Sign up to be an ambassador today!
Midwifery
Ambassadors
Nursing
Ambassadors
#NursingNowEngland #FutureMidwifery
The influence nurses have, a lot of lip service done to nurses and midwifery so why haven’t we got the support – 225 groups in over 80 countries ( of nursing now ).
Wonderful work about encouraging young people to join nursing, which is something we want to work on in this country.
Challenges are around recruitment and retention. Royal college of Nursing, wondering why we have the conversation about pay. Until we change the perception that people have on Nursing and Midwifery and the value of the professions, pay will not be changed. Politicians and public need to see the value of Nurses and Midwifes. What can we do differently? ( that’s the real challenge that we have). How do we get the public to understand what we do and engage with us to what matters to them to make a difference. The way forward, technology using technolofy to engage with people differently.
Triple impact of nursing, you get better ourcomes and economies and gender equality.
A triple return on investment, with catalytic impact on economic growth, social development and global health security.
A changing narrative: not a ‘cost’ but an investment:
The health and social sectors + scientific and technological industries act as an engine of inclusive economic growth, boosting skills, innovation, decent jobs and formal employment, especially among women and youth. SDGs: 4 (education), 5 (gender equality), 8 (economic growth & employment), 9 (innovation).
The foundation for the equitable distribution of essential promotive, preventive, curative and palliative services that are required to maintain and improve population health and remove people from poverty. SDGs 1 (poverty), 2 (nutrition), 3 (healthy lives).
The first line of defence to meet core capacity requirements on the International Health Regulations (2005) & Global Health Security. SDGs 3 (healthy lives), 9 (resilient infrastructure).
Showcase what is is that Nurses and midwifes do.
Across the globe 20,000 people under 35 will get through a leadership course. Part of the work needs to be about the role a nurse and midwife can have in shaping policy.
Increasing the numbr of young people who apply to nursing and midwifery by 5-10%.
How many of you would recommend your family/young people around you to join the profession?
Unless we start selling the profession ourselves, it won’t happen.
How to influence media and policy makers to do something positive.
How to get more men into nursing, one of the frameworks on BAME individuals
Results
The campaign has yielded results, with more young people signing up for nursing studies. From 2014 to 2017, there was a 20% increase in enrolment into nursing courses at the National University of Singapore, Institute of Technical Education and polytechnics. Of the 2,200 sign-ups in 2017, 940 of them had listed nursing as their first or second choice, compared with two years earlier when only about 600 had it as one of their top two choices.
Now.
Results
The campaign has yielded results, with more young people signing up for nursing studies. From 2014 to 2017, there was a 20% increase in enrolment into nursing courses at the National University of Singapore, Institute of Technical Education and polytechnics. Of the 2,200 sign-ups in 2017, 940 of them had listed nursing as their first or second choice, compared with two years earlier when only about 600 had it as one of their top two choices.
In 2020, how will we celebrate the contribution of BAME nurses in the year of the Nurse. Role models and the nightingale challenge, how we make a difference with the things that we have there.
Now.
Results
The campaign has yielded results, with more young people signing up for nursing studies. From 2014 to 2017, there was a 20% increase in enrolment into nursing courses at the National University of Singapore, Institute of Technical Education and polytechnics. Of the 2,200 sign-ups in 2017, 940 of them had listed nursing as their first or second choice, compared with two years earlier when only about 600 had it as one of their top two choices.