'It's the relationship you develop with them': emotional intelligence in nurse leadership. A qualitative study.

AIM: to investigate emotional intelligence (EI) and its relationship to nursing leadership. BACKGROUND: strong, effective leadership is core to organisational competency and significantly influences care quality. EI is the ability to understand one's own feelings and to assess and respond to the feelings of others. It is linked to self-awareness, self-management, social awareness and social skills, all of which are vital in leadership roles. However, insufficient research explores EI in nursing leadership from the perspective of nurse leaders. DESIGN: a qualitative study employed interpretive phenomenological analysis methods, using a purposive sample of band 7 sisters/charge nurses/team managers (n=5) from one Welsh health board. Semistructured interviews were recorded and analysed in four stages. FINDINGS: four clusters of themes were identified, each with two to three subthemes. These were: sensing others-the empathetic leader; experiencing the affected sense of self; strategies employed to build the team; and reading the flux of the organisation. CONCLUSION: although the nurse leaders were unfamiliar with the concept of EI, their narratives reflected some core values of EI. However, significant barriers around time, pressure and staffing levels impeded their potential to use EI to become more effective leaders. Nurse leaders should harness the power of emotions to influence others to achieve excellent care.

Paediatric nurses' adoption of aseptic non-touch technique.

BACKGROUND:: in 2015, NHS Wales introduced a national standardised approach to aseptic non-touch technique (ANTT). This approach aims to standardise practice and promote better clinical outcomes. AIM:: to provide insight into the challenges faced by clinical staff adopting ANTT during intravenous therapy. METHODS:: focused ethnography across two paediatric wards in NHS Wales. Data collection included participant observation, audit questionnaires and semi-structured interviews. Data were analysed according to Wolcott's (1994) process and emerging themes were reflected upon against the theoretical framework of Kirkpatrick's (1994) model of training evaluation. FINDINGS:: absence of feedback following training, individual preference, lack of opportunity to practise the ANTT technique, lack of clarity and standardisation and expectations of parents/medical staff are all challenges faced by registered nurses. IMPLICATIONS OF THE STUDY:: the findings may be used by NHS managers to support national initiatives within staff training and development programmes, and to improve infection prevention initiatives. Organisational culture is a modifier of healthcare worker behaviour and requires further attention locally and nationally. Quality assurance in the adoption of standardised best practice must take into account staff training and development needs, and workplace culture.

Hormonal physiology of childbearing: evidence and implications for women, babies and maternity care.

Report review runs alongside Guideline commentary and the other evidence series articles, examining local, national and international reports that have implications directly or indirectly for midwives. It helps readers to understand what reports mean for midwifery practice and to place report recommendations into context. As with all our evidence series articles, report reviews support you to critique recommendations and have implications for your own practice. This month, Alys Einion celebrates the common-sense approach of Sarah Buckley's 2015 report from the USA.The report summarises the ways in which the human female is physiologically designed to birth in a protected environment. The hormonal interactions around labour and birth, when fully expressed, facilitate better birth experiences and longer-term wellbeing for mothers and babies. The report shows how obstetric interventions and routine medical practices during labour and birth, many of which are not fully evidence-based, can disrupt the hormonal processes fundamental to labour, birth and maternal/neonatal wellbeing in the postnatal period and beyond, and recommends that women are educated to understand their own physiology so that they can birth confidently. It provides further evidence for a physiological basis for core midwifery practices including one-to-one care, a quiet calm environment, and extended skin-to-skin contact after birth, as part of a physiological approach to birth and the transition to parenthood.

Guideline commentary.

Guideline commentary is a series to help readers make sense of published guidelines by offering a detailed appraisal of a guideline, or a specific section of a guideline, in a careful and considered manner. In doing so we can advance our knowledge and understanding of reviewing guidelines to inform our practice.This process is designed to assess the usefulness of the guideline and underpinning evidence, in terms of decision making and implications for practice.

Research unwrapped Midwifery practice during birth: ritual companionship.

Research unwrapped is a popular series to help readers make sense of published research by undertaking a detailed appraisal of an article in a careful and considered manner. In doing so we can advance our knowledge and understanding of a research topic and apply it to our practice. This process is designed to assess the usefulness of the evidence in terms of decision making and application to practice. The research being discussed here is a qualitative study focusing on perhaps the most fundamental dimension and function of midwifery practice: that of the impact of a midwife on a woman's birth experience.

Aromatherapy in midwifery practice.

Aromatherapy is a complementary therapy that uses essential oils of plants to achieve therapeutic effects. Midwives can offer complementary therapies to women if they have been trained in their use and follow the required professional frameworks for regulation, permissions, monitoring and insurance. This article explores the use of aromatherapy to ease a common condition of pregnancy: that of lower back pain. This may be due to the lordosis of pregnancy, caused by the hormone relaxin--which increases in pregnancy and causes greater flexibility of joints and connective tissue--and by changes in body mass and centre of gravity; but it could also be caused by something else, such as strain or repeated movement. Any midwife offering aromatherapy should ensure that all other potential conditions and contraindications have been considered before commencing treatment, and would carry out a full assessment including taking adetailed history.

'Oh no, no, no, we haven't got time to be doing that': challenges encountered introducing a breast-feeding support intervention on a postnatal ward.

Research unwrapped is a popular series to help readers make sense of published research by undertaking a detailed appraisal of an article in a careful and considered manner. In doing so we can advance our knowledge and understanding of a research topic and apply it to our practice. This process is designed to assess the usefulness of the evidence in terms of decision making and application to practice. The research being discussed here looks at the factors affecting the implementation of a breastfeeding support intervention, on a postnatal ward, which includes considerations of time, workload and clinical context. It has been evaluated using the Critical Appraisal Skills Programme (CASP) tool for evaluating qualitative research as a guide (CASP 2013).

Resilience, midwifery and professional identity: changing the script of midwifery culture through narrative. Part 1.

Midwives can and should create their own culture through self-development, which fosters both positivity and resilience. One means of cultural and identity re-construction is through developing a critical and conscious awareness of the stories that we tell ourselves, each other and others, understanding how we co-create our identities through interactive narrative sharing. A small, narrative study of student midwives' learning journals shows a number of themes appearing. Characterisation of self and of clients raises questions about midwifery practice and resilience and how to change midwifery culture for the better.

Hypnosis and hypnobirthing for labour - a critical selective narrative review.

The provision of woman-centred care is at the heart of midwifery practice, and there appear to be increasing numbers of women choosing alternative forms of support for their childbearing journey. Women are often fearful of the experience of labour and birth, and in particular express concern about pain and its management; the literature shows that fear of childbearing is associated with increased pain (Leeman et al 2003). Although there are many pharmacological and non-pharmacological approaches to managing the pain of labour, these depend on availability, women's preferences, and on the woman's perception of their efficacy. This literature review focuses on the use of hypnosis, including complex programmes of antenatal preparation known as hypnobirthing, as a means of coping with the experience of labour and birth. A key word search of the literature was carried out to identify published research and literature on this topic. The articles chosen for critical review will be evaluated and explored.

Mindfulness and perinatal mental health: a systematic review.

Research unwrapped is a popular series to help readers make sense of published research by undertaking a detailed appraisal of an article in a careful and considered manner. In doing so we can advance our knowledge and understanding of a research topic and apply it to our practice. This process is designed to assess the usefulness of the evidence in terms of decision making and application to practice. The research being discussed here is a systematic review of articles which look at the implementation of mindfulness approaches and whether these can enhance or improve mental health and wellbeing in pregnancy and childbearing; it was evaluated using the critical appraisal skills programme (CASP) (2013) tool for assessing systematic reviews.

Pregnant pause: should we screen for sleep disordered breathing in pregnancy?

Physiological and hormonal changes in pregnancy can contribute towards sleep disordered breathing in pregnant women (SDBP). When present, SDBP increases the risk of several adverse maternal and fetal outcomes independent of factors such as age, weight and pre-existing maternal comorbidities. SDBP is underdiagnosed and may be hard to recognise because the presentation can be difficult to differentiate from normal pregnancy and the severity may change over the course of gestation. Timely intervention seems likely to help reduce adverse outcomes, but the relative benefits of intervention are still unclear. The definition of what constitutes a sleep-related breathing "disorder" in pregnancy may be different to the general population and so traditional thresholds for intervention may not be relevant in pregnancy. Any modifications to the disease definition in this group, or implementation of more intensive screening, may result in overdiagnosis. Further research is needed to help clinicians evaluate the balance of benefits and harms in this process. Until this is clearer there is a strong imperative for shared decision making in screening and treatment decisions, and screening programmes should be monitored to assess whether improved outcomes can be achieved at the healthcare system level. KEY POINTS: Untreated sleep disordered breathing in pregnancy poses risks to maternal and fetal wellbeing, but it is underdiagnosed.Careful approaches to screening could improve rates of diagnosis, but thresholds for and benefits of intervention are unclear.Clinical guidelines and screening programmes for sleep disordered breathing in pregnancy need to consider the potential harms of overdiagnosis and should involve shared decision making and careful monitoring of outcomes relevant to the individual. EDUCATIONAL AIMS: Explore current knowledge of the prevalence of sleep disordered breathing in the pregnant population.Explore the relationship between sleep disordered breathing and adverse outcomes.Understand the approaches to diagnosis and management of sleep disordered breathing in pregnancy.Explore issues around screening, underdiagnosis and overdiagnosis in the context of sleep disordered breathing in pregnancy.

Women's attitude towards and use of complementary therapies during pregnancy.

Research unwrapped is a popular series to help readers make sense of published research by undertaking a detailed appraisal of research articles in a careful and considered manner. In doing so we can advance our knowledge and understanding of a research topic and apply it to our practice. This process is designed to assess the usefulness of the evidence in terms of decision making and application to practice. Of the research I review here, that by Warriner et al (2014) has been appraised using the Critical Appraisal Skills Programme (CASP) tool for evaluating qualitative research and the CASP tool as a guide (CASP 2013). The Hall and Jolly research (2014) was reviewed with reference to standard research texts and practice.