The empowerment of patients can be considered an important part of the nurses' role in the management of chronic venous leg ulcers. This article describes how one individual's healing rate improved when she was given greater control over her own care by a partnership formed with her nursing team. The negative impact of a subsequent change to a more autocratic care regime is discussed. The authors investigate how nurse education, reflection and sharing best practice could overcome barriers to patients becoming more involved in their own individualized wound management and treatment. The role of the Leg Club Model (a clinic held in a social environment as opposed to a medical setting) in promoting an environment of collaborative working, open communication and knowledge sharing is examined.

The ways in which current nurse education is delivered, combined with rapid increases in technological advances in health care, are having a major impact on the delivery of care to patients. This article focuses on one aspect of that care: the establishment, development and maintenance of the therapeutic relationship. The authors argue that the changes in education delivery and the rapid introduction of technologies are contributing to the possible demise of the contemporary nurse-patient relationship and, therefore, the loss of that essence of nursing which is essential to the patients' well-being and the nurses' professional satisfaction. The article explores the requisite knowledge and skills competences essential for the formation of the therapeutic relationship and asks whether these are being impeded by simulated educational activities and the advent of ubiquitous computing. The authors acknowledge the difficulties associated with the assessment of an effective therapeutic relationship and suggest a possible framework in which a performance of understanding of the formation of a therapeutic relationship can be established.

Patients' perspectives on their illness and care are increasingly recognized as the focus for the organization of health care, yet patient stories are rarely examined on their own. Mostly, they are dissected for data, and so the impact is lost. This article presents a number of story tellers, all patients with leg wounds attending a social clinic. Reading their stories helps us understand the experience of being a patient and living with difficult and painful leg wounds. They also show how nurses can play a critical role in optimizing the power of the story in the patient's journey towards physical and psychological healing.

Service level agreements (SLAs)