Every year there are seasonal spikes in infant hospital admissions for bronchiolitis, a common respiratory infection that affects vulnerable infants and usually occurs between November and March. Bronchiolitis is the most common cause of infant hospital admissions during the winter months and since 2004, admissions have increased by more than 50%.
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.
The first part of this two-part series on breathlessness (JCN 28(5): 83–90) looked at the emotional and physical distress and social isolation caused by the condition for both patients and their families, as well as examining the assessment of the condition. Refractory breathlessness, i.e. that which persists even when measures to optimise the underlying condition have been implemented, is one of the most distressing symptoms experienced by patients with advanced life-limiting illnesses. This, the second part of the series, looks at how community nurses can successfully manage patients, including lifestyle changes, self-management, psychological therapy and pharmacology.
The first part of this series (JCN, 28(5): 30–32) provided the background to the study, which used semi-structured interviews with 18 nurses based in Afghanistan during 2013 to focus on factors affecting the delivery of mental health care in the field. This, the second part of the series, details the results of the study in the form of analysis of the interviewees’ verbatim transcripts. The study offers an insight into the role of deployed mental health nurses and examines some of the challenges they face. The findings demonstrate that managing the mental health of armed forces personnel on an operational deployment requires the ability to develop trusting relationships, identify factors leading to stress, and help staff to feel supported.
Shingles, or herpes zoster, is a relatively common viral infection in the UK, which is caused by a reactivation of the varicella-zoster virus after patients have had an earlier infection with chickenpox. The condition results in a painful rash and in severe cases patients can develop post herpetic neuralgia (PHN), an intense chronic pain at the affected area, despite resolution of the skin lesions. Shingles can also affect the nerves in the eyes and ears, as well as causing scarring. It is important that community nurses are aware of this condition and able to advise on supportive treatments such as topical medications, pain relief and, in appropriate cases, vaccination.
Through events and consultations held by the Queen’s Nursing Institute’s (QNI) homeless health network, community nurses are identifying emerging issues affecting their patients and their workforce.
The title of Queen’s Nurse (QN) is open to all community nurses who want to demonstrate their commitment to client/patient-centred values and continually improving practice. Find out more.
Increasing demographic changes in the type and age of patients as well as further government directives requiring more care at home, mean that there is a growing emphasis on primary care-led services. Large caseloads and patients with multiple and chronic health problems are stretching available community nursing resources. Against this background, continence promotion tends not to be a priority and at times it may seem easier and better to prescribe pads for patients with urinary incontinence. This article provides community nurses with guidance on the initial assessment and management options available for patients who present with urinary incontinence. Many patients will subsequently experience improvement in their symptoms (although not always complete resolution), with a corresponding improvement in overall quality of life.
Community nurses offer holistic nursing care to patients at home, including attending to people with leg ulcers. It is known that leg ulcers can have a significant impact on patients’ quality of life. Nonetheless, little is known about community nurses’ views and experiences of providing holistic leg ulcer care and, in particular, their insights into the impact of leg ulcers on patients’ quality of life. Using a focus group of five healthcare support workers and four individual interviews with two associate nurses and two district nurses, this study explored community nurses’ experience of attending to patients with leg ulcers. Following transcription of the data, a thematic analysis was undertaken. It was concluded that community nurses need more training to support their work in leg ulcer management and more time to deliver patient-centred care.
Cellulitis is an acute bacterial infection of the skin and underlying subcutaneous tissue, mostly caused by Group A Streptococci (Mortimer, 2000; Cox, 2009) and Staphylococcus aureus (Hadzovic et al, 2012) (Figure 1). It can occur anywhere on the body, but most commonly affects the lower limb in 75–90% of cases (Tsao and Johnson, 1997).
