End of life can be a frightening and uncertain time for patients and families and the role of the community nurse can be vital in easing this phase of life. This article outlines some of the issues that community nurses should be aware of when caring for a patient who is dying at home. It identifies the signs which signify that death is approaching, and explains the need for a change in care emphasis at this point. The author also outlines some key management aspects that can improve the quality of a patient’s death, including communication, care coordination, symptom and pain control, and support for nurses and carers.
Pain is experienced by many patients in primary and secondary care and its assessment and management is a fundamental aspect of nursing treatment. Community nurses need to possess a strong knowledge base of the various ways of treating pain to inform and advise their patients. This in turn enables nurses to help and empower patients to effectively control their pain with minimal side-effects. This article, the second in a two-part series on pain, provides an update on the management of acute and chronic non-malignant pain (the first part of this article, on the assessment of pain, appeared in Journal of Community Nursing 28[4]: 83–86).
Pain is experienced by many patients in primary and secondary care and the assessment of pain is a fundamental aspect of nursing. Community nurses need to possess a strong knowledge base to inform and advise their patients, this in turn enables them to help and empower their patients to effectively control pain with minimal side-effects. This two-part series on pain provides an update on the assessment and management of acute and chronic non-malignant pain. This first part of the series examines how community nurses can recognise and categorise pain and start to draw up a plan of care for the patient. The second part in this series will deal with the management of pain.
Chronic wounds have many psychosocial consequences, including stress, negative mood, pain, and social isolation. In addition to these, frequent dressing changes can cause the individual anxiety and stress. This article explores how wound management can influence both psychological outcomes and, potentially, the rate of healing. Implications for practice are identified, which need to be successfully employed to ensure that patient health is maximised and that the stress and pain associated with wound care are minimised in order that wound healing is improved.
Yvonne Franks discusses the use of low level LASER therapy in the management of chronic wounds.
John Robinson gives a brief overview of his ongoing research projects into whether patients complain of pain on removal of catheters.
John Robinson RGN RMN, NDN (Cert) is a District Charge Nurse, Catheter Specialist, Bay Community NHS Trust, Morecambe.
Article accepted for publication January 2000
Lindsey McKirdy discusses the pro's and cons of wound cleansing in burn wound management.
Lindsay McKirdy RGN, BA (Hons) is a Clinical Nurse specialist, Burns & Plastic Surgery Unit, South Manchester University Hospital Trust.
Article accepted for publication January 2001.
Rosie Pudner examines the properties of low and non-adherent dressings in wound management.
Rosemary Pudner, BA (Hons) RGN RCNT Dip.N.Ed. Dip.App.S.S. (Open), Senior Lecturer, Kingston University and St George’s Hospital Medical School, Faculty of Health and Social Care Sciences.
Article accepted for publication May 2001.
Vivien Ogden describes a literature review and a pilot study of anaesthetic gel insertion in male recatheterisation.
Vivien Ogden RGN, Dip DN Community Nursing Studies is a District Nursing Sister, Grovelands Medical Centre, Reading, Berks.
Article accepted for publication: July 2002
Dr Kate Springett discusses the reasons why all practitioners have a responsibility for caring for the 'at risk' foot - and gives a few pointers on how this should be done.
Dr Kate Springett, Senior Lecturer, MSc Podiatry Course Leader, School of Health Professions, University of Brighton. Article accepted for publication: September 2003
