Adoption in England: past and present challenges.

Over the last century, changes in legislation, social constructs and the perceptions of what family life 'should' look like have significantly transformed the process of adoption in England. The role of adoption has shifted from providing orphaned children a stable new home to today's regulated process mainly supporting children who have suffered early physical or social adversity. This provides significant challenges to adopters, paediatricians, child psychiatrists and teachers who can only support adopted children by understanding their needs.

Mobile phone use on a young person's unit.

AIMS: To ascertain information about the use of mobile phones on a young person's hospital unit and to obtain the views of nursing staff and young people about the benefits of their use. METHODS: A qualitative study using a pre-piloted questionnaire was given to 50 young people admitted consecutively to the young person's unit of district general hospital in a four-week period. A separate questionnaire was given to nine members of the nursing team over the same time period. FINDINGS: Most young people had access to a mobile phone while on the ward. A total of 30 per cent were told they could use their phone, 75 per cent of those had made calls or sent texts while on the ward, 80 per cent had received calls or texts, and 20 per cent had used the ward phone at the nursing station. All staff agreed that it was helpful for young people to use their phones on the ward to keep in contact with friends and family, to avoid isolation and ease boredom. CONCLUSION: Young people have different social needs to younger children and appreciate the opportunity to use mobile phones. A more flexible approach should be adopted. The advantages of phone use clearly outweigh the risks.

Copying letters to children and parents: audit and survey of nurses' views.

AIM: To discover whether community children's nurses and other members of the multi-disciplinary team had changed their practice in the light of the 'copying letters' initiative recommended by the Department of Health and to seek their views on the process. METHOD: A documentary analysis of the notes was undertaken on 30 sets of notes chosen at random from the community children's nursing team's caseload and the total number of letters in each child's notes was retrospectively recorded for periods before and after the implementation of the 'copying letter initiative'. In addition, 14 community children's nurses were interviewed about their communication practice. RESULTS: Letters accounted for 70 per cent of the total correspondence in the children's notes. Most of the 466 letters were from doctors (65 per cent) with nine per cent having been sent by community children's nurses. Before the initiative 70 per cent of letters from medical staff were copied compared to 74 per cent afterwards, with community children's nurses copying 19% of letters before and 47% afterwards. Only 13 were sent to the child. Nurses commented on changes to their practice since the copying initiative began and reported varying use of other forms of communication such as text messaging and email. CONCLUSION Professionals should be encouraged to copy letters to parents and children. A number of technologies are available to facilitate communication between patients, parents and other health care professionals. Careful consideration must be given to their introduction to ensure their use conforms to legal and professional codes and good practice principles.