Simply trying to cope can be a challenge for the many people in the UK who have a stoma — this can include issues such as how to clean and maintain the appliance and what to do if there is a complication once they have been discharged home into the community. The community nurse is often the first point of contact when there are problems with a stoma in the patient’s home and may have to advise on how to change a stoma appliance as well as how to deal with issues such as skin stripping and leaking.
JCN talks to those working in the community.
Faye Jeffries is a district nurse team leader at Bristol Community Health.
JCN talks to those working in the community.
Amanda Munday, Community Nursing Sister, and Jane Jennion, Community Staff Nurse are both community nurses who work for Berkshire Healthcare. They work in West Berkshire, which is a large rural area with a spread out population. They aim to deliver care that enables people to stay in their homes, rather than going into hospital.
JCN talks to those working in the community.
Kate Arkley is a community RGN in Connemara, Ireland specialising in tissue viability and wound management. She has recently enrolled as a doctoral student.
JCN talks to those working in the community.
Nicky Darby and her health visiting team at Calderdale and Huddersfield Foundation Trust.
JCN talks to those working in the community.
Sally Lee, social worker, North Dorset Local Social Services
W hen a client recently turned to me and said: ‘I didn’t know I could do this,’ it was not only clear that I was witnessing someone tackling a new challenge; it also brought home to me the varied and rewarding nature of my role with Integrated Neurological Services (INS).
Compression bandages provide the mainstay of treatment for venous diseases and their sequellae of ulceration and oedema. Selection should depend not only on the effectiveness and cost of treatment, but also on patient acceptability. If correctly applied, compression bandages provide sustained graduated pressure. This article explores the negative impact that having a leg ulcer can have on patient quality of life and introduces a new, moisturising, odour-reducing inelastic two-layer compression bandaging system that aims to improve patient wellbeing and comfort which, in turn, promotes concordance.
Wound debridement can be challenging for community nurses, who need to be able to quickly identify a wound’s status in order to proceed with treatment. This article looks at some of the basic factors that nurses should consider when debriding and cleaning a wound, paying particular attention to assessment and ‘seeing’ the wound, and how clinicians can better remove potentially damaging material such as slough and necrosis. The article also investigates how clinicians caring for patients with leg ulceration can treat the ‘whole leg’. Finally, the authors consider the benefits of a new product, the UCS® debridement cloth (medi UK), and its ability to help community nurses gently debride and clean wounds of all types, as well as reducing the burden of using buckets of water to clean patients’ lower limbs. This has important implications for many community nurses, particularly concerning strain to the back during lower limb cleansing and the infection risk of transporting, cleaning and storing buckets in patients’ homes. There is also a time factor, as debridement cloths mean that visiting nurses can reduce the time associated with filling and emptying buckets in both clinic and home environments.
