Living with an indwelling urethral catheter in a community setting: Exploring triggers for unscheduled community nurse "out-of-hours" visits.

AIMS AND OBJECTIVE: To explore the experiences of community patients living with a urethral catheter and those caring for them. BACKGROUND: Living at home with an indwelling urethral catheter often results in consequences that create a double-edged burden: first, on patients and their relative carers and second, in terms of unscheduled community nurse service "out-of-hours" provision. DESIGN: One-to-one interviews were conducted with patients living at home, their relative carers, qualified community nurses, augmented home carers and healthcare assistant. Quantitative data in relation to frequency, duration and reason for visits were extracted from the community nurse "out-of-hours" service database. RESULTS: Quantitative data showed that 20% of all community nurses unscheduled "out-of-hours" visits were triggered by an indwelling urethral catheter consequence. Qualitative data revealed that health and social care staff felt knowledgeable and skilled in urethral catheter management. Conversely, patients and relative carers felt poorly equipped to manage the situation when something went wrong. The majority of patients described the catheter as being a debilitating source of anxiety and pain that reduced their quality of life. CONCLUSION: Urethral catheter complications are frequent and impact seriously on quality of life with informal carers also affected. Community nurses experienced frequent unscheduled visits. Patients often feel isolated as well as lacking in knowledge, skills and information on catheter management. Having better urethral catheter information resources could increase patient and relative carer confidence, encourage self-care and problem solving, as well as facilitate meaningful consistent dialogue between patients and those who provide them with help and support. RELEVANCE TO CLINICAL PRACTICE: Better patient information resources regarding urethral catheter management have potential to improve patient and relative carer quality of life and reduce service provision burden.

The link lecturer role; inconsistent and incongruent realities.

BACKGROUND: The United Kingdom (UK) Nursing and Midwifery Council (NMC) suggest that the link lecturer role which is intended to support student nurse practice-based learning should account for 20% of the university-based nurse lecturer's remit. Meantime, a long-standing academic discussion indicates that this role lacks clarity. OBJECTIVE: Nurse lecturer (provider) and final year undergraduate student nurse (intended beneficiary) experiences and perceptions of the link lecturer role were explored and compared. METHODOLOGY: Data from four focus groups with nurse lecturers and four with student nurses were thematically analysed. These groups were carried out in a Scottish university where link lecturers visit student nurses in clinical placements. FINDINGS: Three themes were identified from a multitude of perceived link lecturer responsibilities; information, advice and support, professional development and partnership working. The link lecturer role was experienced as ad hoc and varied, while dialogue about its purpose, objective and contribution to learning revealed inconsistencies and incongruence at an individual level and within and across the homogenous participant groups. CONCLUSIONS: Narrowing the inconsistent and incongruent realities highlighted firstly in participant dialogue, and secondly in relation to policy directive versus practical application is important for reducing the confusion that surrounds the link lecturer role. Formalising the role in terms of a universally recognised and workable model of practice has potential to reduce future debate.