Aim To investigate the prevalence of secondary traumatic stress among Emergency nurses in the West of Scotland and explore their experiences of this. Background Unexpected death, trauma and violence are regular occurrences that contribute to the stressful environment nurses working in the Emergency department experience. A potential consequence of repeated exposure to such stressors can be referred to as secondary traumatic stress. Design Triangulation of methods of data collection, using two distinct phases: Phase 1 – quantitative Phase 2 – qualitative Methods Quantitative data were collated via postal questionnaire, from a convenience sample of Emergency nurses. Qualitative data were subsequently collated from a focus group constituting of a random sample of these Emergency nurses. Descriptive statistics were computed and thematic analysis conducted. All data were collated during February 2013. Results/findings 75% of the sampled Emergency nurses reported at least one secondary traumatic stress symptom in the last week. Participants said that acute occupational stressors such as resuscitation and death were the influencing factors towards this. Strategies such as formal debriefing and social support were cited as beneficial tools for the management of secondary traumatic stress; however, barriers such as time and experience were found to inhibit their common use. Conclusion Secondary traumatic stress is a prevalent phenomenon among Emergency nurses in the West of Scotland and if not managed appropriately, could represent a significant barrier to the mental health of this group and their capacity to provide quality care.

Non-adherence with prescribed medicines in CKD is a complex phenomenon, which has implications for clinical outcomes and cost. Adherent behaviour may change over time. Further research in this field is needed. No single intervention is likely to enhance adherence for all and clinicians should consider a variety of options to improve adherence with prescribed medicines.

For an older person in hospital a fall can have devastating consequences, prolonging hospital stay and leading to loss of confidence. Falls cost the NHS between pounds 5340 and pounds 12,500 per patient in delayed discharge, and can cause nurses to question their own practice and blame themselves. Further, the efforts of clinicians and researchers implementing falls prevention interventions are hampered because of inconsistencies in assessing risk. The use of falls risk assessment tools varies throughout the U.K. In Scotland some hospitals use them while others do not. Unlike England and Wales, Scotland has no national guidelines. To deal with this problem, the authors conclude that it is important to develop an evidence-based guideline that covers the whole of the UK.

Population trends show an increasing proportion of people older than 65 years of age. This report aims to describe the facilities/services accessible to the older adult living in Glasgow, Scotland and in San Francisco, United States of America. This comparative study serves to develop a broader understanding of what is involved in the process of ageing, and describes how these two cities are responding to the needs of older people. Long-term caring provision is complex and involves multiple agencies, often leaving both lay and professional individuals ill-informed as to which services exist and how best to use them. The nurse can be instrumental in providing information, viable alternatives and services. In this article, options available for caring of the older adult and financing of care are discussed along with a number of recommendations based on observations described, data collected and literature researched. With the advent of care being provided in the community, there is now a continuum of services ranging from independent living at home to dependent care in hospital. Whether an individual remains at home depends on the availability and affordability of, and access to, other resources/facilities. Creative alternatives are needed for care of the older adult in this millennium. This report describes the need for an integrated system of care, which can adjust to variations in clients' needs. Progressive care facilities, intergenerational sharing, community volunteer service programmes for the older person and Edenizing are a few recommendations discussed by the authors.

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