Although community nurses often work in isolation, it’s good know someone at a national level has got your back. Jason Beckford-Ball went to meet Viv Bennett and asked her about her vision for public health nursing in England.
Although many people say they would like to die at home, only 20% actually do, with the majority dying in hospitals, hospices and care homes. As a student nurse, Ilhan Wardhere found reflection helpful in working through clinical challenges. Here she shares her experiences of dealing with end of life care in the community.
Community nurses are frequently involved in the care of patients after they are discharged from hospital, including many who have undergone stoma-forming surgery. There is evidence that it takes some time to adjust to life with a stoma, with much of this adjustment occurring in the first three months following surgery. During this period, nurses can use their skills to resolve any
problems that might occur, helping patients to adapt and improve their quality of life. If community nurses cannot resolve any issues patients may have with their stomas, referral to a specialist such as the local stoma specialist nurse, might be necessary.
Jennie Burch, Enhanced Recovery Nurse, St Marks Hospital, Surgery, Harrow, Middlesex
Irritable bowel syndrome (IBS) is associated with a significant impairment of quality of life. Due to the nature of its symptoms, the role of the nurse is central to the care of patients who may have IBS. The often embarrassing symptom profile means that patients may rely on nurses to provide psychological and physical support in helping them to improve their symptoms. In this article, the author discusses the management of patients with irritable IBS, including the optimal delivery of care for patients and the role of community nurses in dealing with this chronic condition.
Isobel Mason, Nurse Consultant, Gastroenterology, Royal Free London NHS Foundation Trust, London
Eating well in later life is an essential part of enabling older people to live independently at home for longer. However, with increasing funding cuts to community care services in the context of an ageing society, is enough being done to encourage good nutrition in later life? This article discusses the importance of nutrition for older people and explores how community practitioners are ideally placed to spot the early warning signs of malnutrition and encourage patients to take better care of their diet.
Helen Willis, Dietitian, Wiltshire Farm Foods
Literature has shown that patients with leg ulcers can have a significantly poorer quality of life compared to those without leg ulcers. In addition, research has identified problematic relationships between patients with leg ulcers and practitioners, such as community nurses. The author contends that this mismatch needs to be addressed in order to improve patient quality of life through leg ulcer bandaging. He makes several recommendations for practice and highlights that community practitioners need to use innovative practice to help improve the quality of leg ulcer bandaging care they deliver. The overall aim of this article is to establish the extent of community practitioners’ understanding of the impact of leg ulcer bandaging on patient quality of life.
Edwin Tapiwa Chamanga, Tissue Viability Service Lead, Ipswich Hospital NHS Trust
An advanced wound care dressing that uses a natural resource in its ability to absorb and retain moisture as well as to provide antimicrobial properties, offers a new multi-functional, biointeractive protease modulator to the wound dressing arena. Several factors indicate the need for such a dressing, namely: an ageing population inevitably increases the prevalence of wounds managed across acute and community settings, the prevention and management of infection remains a priority and the use of natural resources is becoming more important. This article considers the literature supporting this product and, using care study examples, demonstrates its potential impact on patient outcomes.
Jackie Stephen-Haynes, Professor and Consultant Nurse, Practice Development Unit, Birmingham City University and Worcestershire Health and Care Trust
Elaine Gibson, Tissue Viability Nurse Specialist, East Kent University Hospitals, NHS Foundation Trust, Clinical Manager, Aspen
Medical Europe Ltd
Michelle Greenwood, Consultant Nurse Tissue Viability, Walsall Healthcare NHS Trust and Associate Lecturer, Practice Development Unit, Birmingham City University
Exit sites are commonly encountered in the community setting as a result of a shift in clinical practice that means more patients with complex conditions are being managed at home. The management of exit sites varies according to indication, but there are principles of practice that are common to all sites, and these are outlined in this article. Kendall™ AMD Antimicrobial Foam Dressing with PHMB has been used to successfully prevent and manage infection of exit sites, and to manage overgranulation, a common complication of these wounds.
Julie Evans, Tissue Viability Nurse, Abertawe BroMorgannwg University Health Board, Swansea
Psoriasis can be a long-term condition, which is a significant problem for approximately 2% of the UK population. Recent NICE guidance on the treatment of psoriasis provides much-needed advice and reminds clinicians of the importance of assessment (both physical and psychological) and of talking to patients about side-effects and mode of action. Primary care nurses are in a great position to work with patients to ensure that they have the optimum treatment regimen, and that they have realistic expectations as to how it will work. An optimum regimen should always include an emollient, a topical product to treat plaques on the body along with topical products for scalp, face and flexures as necessary.
Rebecca Penzer, Community Dermatology Specialist Nurse/Clinical Lead Community Dermatology, Community Nursing and Therapy Norfolk Community Health and Care NHS Trust
This article describes an initiative in which the Good Care Group and Dementia UK formed a unique partnership that enables specialist dementia care services delivered by a highly qualified Admiral nurse to be provided to clients, families and professional carers in home care settings. Admiral nurses are specialist mental health nurses supported by Dementia UK, and the Good Care Group is the only home care provider to offer this service to its clientele. Admiral nurse support clearly improves quality in the delivery of live-in care provision; support that is substantially beneficial for community nurses and other healthcare professionals.
Zoe Elkins, Head of Care Strategy, The Good Care Group;
Ian Weatherhead, Lead Nurse, Admiral Nursing Direct, Dementia UK
