From watching whales off the Mexican coast to dealing with on-board norovirus outbreaks, the life of a cruise-ship nurse is rarely dull. Here, Gary de Beer explains what it is like to be part of an on-board medical team, which might have access to state-of-the-art equipment, but can be many miles out to sea...
JCN talks to those working in the community.
Soline Jerram, director of clinical quality and primary care, Brighton and Hove, Clinical Commissioning Group
In each issue of the Journal of Community Nursing we investigate a hot topic currently affecting our readers. Here, Jason Beckford-Ball looks at the latest plan for the future of the NHS in England and asks the question...
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.
