Resources

Growing up, my understanding of what a nurse does was limited. In school I learnt about Florence Nightingale, the ‘Lady with the Lamp’, and at home I dressed up in a nurse’s uniform for a fancy dress party.

Nobody within the health and care system needs to be told how dangerous a fall can be.
Hip fractures caused by falls are the number one source of accidentrelated deaths in older people (Department of Health [DH], 2009).

Thirty percent of older people who have a hip fracture from a fall die within a year — 20% within just four months (DH, 2009). These fractures result in a rapid loss of independence and routine that can be devastating for an individual. 

Over the past decade, the author believes that society has begun to awaken to the
transformative power music can have both for those living with dementia, and those who care for them. There have been a number of viral news stories which have really captured the nation’s hearts and brought us all to tears — think of Paul Harvey with his beautiful Four Notes improvisation and Marta C Gonzalez, a forma prima ballerina living with Alzheimer’s who became animated listening to Swan Lake.

As healthcare professionals, our purpose is to deliver treatments and interventions to patients to aid recovery and prevent deterioration in health. But what does that look like when patients do not wish to follow advice, do not want treatment or interventions, even if that means significant consequences such as loss of limbs, sepsis or death — where do we legally stand in these situations and how do we work with patients to achieve the best possible outcomes for them? Over years of clinical experience, the authors have found that working with those who self-neglect can be complex. This is due
to a range of factors, such as risks to the individual and sometimes others. Other issues involved include healthcare professionals’ views and moral conflict between respecting patient autonomy and their duty of care, challenges in trying to engage patients who may not want services involved, attempting to assess and being clear on the patient’s mental capacity, working within task-orientated systems which may not always be conducive to building rapport, and working with the patient’s socio-economic factors which impact upon their health (Research in Practice, 2020). 

Overactive bladder (OAB) syndrome is a chronic disabling condition that affects both men and women. It is a little known condition and is diagnosed on symptom presentation, which is mainly urgency but with associated frequency, nocturia and urge incontinence. It is important to assess the individual using the correct process and then
initiate first-line conservative therapies, which are usually behaviour modifying. If these are ineffective, second-line pharmacology preparations can be introduced. This article explores these aspects. 

This article, the first in a three-part series on Long Covid, provides a definition of post-Covid-19 syndrome and Long Covid. It highlights the considerations for diagnosis and an overview of the management of commonly reported symptoms through the experience of one of the 90 NHS England commissioned post Covid (Long Covid) assessment clinics, in addition to lived experiences of persons with Long Covid (PwLC). The next two articles in this series will look at the use of digital technology in Long Covid self-management and virtual group assessments.

Interstitial cystitis (IC) is a disease which, despite years of research, remains poorly understood. Once thought to be rare, prevalence rates have increased in recent years, which has been attributed to improved understanding of the disease and more selective diagnostic criteria. Despite this, the condition remains difficult to diagnose, and as a
result many of those affected suffer for years before the cause of their symptoms is confirmed. This article hopes to give nurses and nonmedical prescribers more knowledge of this complex disease so that they can facilitate earlier diagnosis and treatment, reducing the risk of misdiagnosis, which will ultimately improve outcomes and reduce the impact on the health and wellbeing of all those with this condition.

Rheumatoid arthritis (RA) is a condition which causes inflammation in synovial joints. Patients experience pain, stiffness and swelling commonly in their hands and feet, but it can also be a systemic disease which affects the heart, lungs and eyes in some patients. It is more common in women than men, and the peak age for diagnosis is around 70 years; however, it can affect all ages. Early diagnosis and treatment should be prompt to reduce the chance of permanent damage to the joints, as this will cause functional impairment and affect quality of life, and work/leisure activities (Heidari, 2011).
A treat-to-target strategy aims to achieve remission or low disease activity by up-titrating medication from the point of diagnosis, thus minimising the impact of the disease (National Institute for Health and Care Excellence [NICE], 2018).This strategy only works
if patients take the prescribed medication. The nurse’s role is vital in supporting patients’ understanding of the medications and advising on how to manage side-effects.

The number of people with dementia is expected to increase with a consequential effect on the wellbeing of families and increasing pressure on an already over-burdened health and social care system. Risk factors for dementia, both modifiable and non-modifiable,
if appropriately understood and identified are amenable to management and amelioration. Community and primary care nurses are in an ideal position to support the reduction and management of risk pre and post dementia diagnosis. Using a case study, this paper highlights some of the issues in identifying, assessing and managing risk in a person with an existing diagnosis of dementia and their family/carer. The potential for dementia-related risks to escalate can have a much wider impact on a family unit if not appropriately identified, managed and mitigated against. 

In 2019, South Warwickshire NHS Foundation Trust implemented a pilot scheme to create place-based teams (PBTs) across the community under its leadership. These were to align themselves to the newly formed, geographically located, primary care networks
(NHS England, 2019), and renamed integrated care systems (NHS White Paper, 2021). Their implementation and leadership was, as a result, devolved to these individual localities. In part, the drive behind this initiative was to address many of the social
challenges that patients face, such as social isolation, anxiety and mental health problems — situations that often lead patients to consult general practitioners and healthcare professionals, even when there are alternative interventions that would serve their needs more effectively. This article outlines how the setting up and implementation of a PBT, and its success in meeting patient needs, is attributed to a number of key elements and the committed organisational leadership and involvement of all those involved.