As health care providers our philosophy is to deliver the very highest quality of care to our patients. However within many hospitals there are not firm policies to allow family members to see their loved ones in the immediate postoperative period. Thus parents are routinely not being encouraged to comfort and support their children within the Post Anaesthetic Care Unit. The evolution of ‘family centred’ care should result in parents being encouraged to be with and care for their children during hospitalisation. This has been found to be beneficial to all parties. Whilst parental presence in the anaesthetic room has become more accepted practice the same cannot be said of Post Anaesthetic Care Units despite the recommendations made by the Department of Health [1991] and ‘The Patients’ Charter [1996]. Why does this situation exist? Is it due to preconceived attitudes of the staff involved, parental ignorance or historical reasons? This article will examine available research and attempt to identify possible reasons why such situations exist within many Post Anaesthetic Care Units and suggest possible solutions.

This article continues the series on cardiac monitoring in the peri-operative area by reviewing those arrhythmias that are classified as atrial or supraventricular. Whilst these arrhythmias are rarely life threatening, their haemodynamic effects can be significant and may not be tolerated in conjunction with the concurrent operative procedures. These arrhythmias are however, very commonly seen in perioperative practice and may be associated with anaesthetic procedures, surgical techniques and the recovery phase. In this increasingly technological age, it is imperative that perioperative practitioners can recognise and respond appropriately to the rhythms observed on the cardiac monitor.

The shift in the philosophy of care for people with learning disabilities from institutional care to living in the community has placed greater demands on generic health services. Alack of training and appropriate skills have been identified as problem areas for health care providers who may be required to care for this group of people. The dental health of people with learning disabilities has shown no improvement over the last fifty years despite advances in dental treatment. Requests for dental care present practitioners with ethical and legal problems due to a reduced capacity to give informed consent. The provision of dental care for patients with learning disabilities in the day surgery unit of a local hospital is critically evaluated and recommendations are then made as to how current practice may be improved with reference to the findings of current literature.