Resources

The purpose of this article is not to discuss the pathophysiology of pain in detail, but to focus on the clinical importance of assessing and managing leg ulcer pain. Effective pain management is crucial for improving patient comfort, promoting wound healing and improving overall quality of life. The article explores how to assess pain, including the importance of understanding a patient’s pain experience, use of pain scales, and distinguishing between different types of pain. It also discusses pharmacological approaches to pain relief and offers suggestions as to how healthcare professionals can minimise pain during dressing changes, a frequent source of distress for patients with leg ulcers.

The mental health and wellbeing of children and young people (CYP) is an area of growing concern, with many experiencing challenges that do not meet the threshold for specialist services but still requiring support. General practice nurses (GPNs) regularly come across young people in their line of work, and those who feel comfortable doing so may be well-positioned to provide some support in this area — be it opportunistically if mental health concerns are identified as part of another presentation, or as the focus of a consultation. Building on the discussion of assessment and referral processes in a previous article (Al-Yassin, 2024), this piece explores practical strategies for supporting CYP with mental health concerns. It describes the widely adopted THRIVE Framework and how the role of the GPN fits into this with a focus on the ‘thriving’ and ‘getting advice’ quadrants. This article introduces for the first time the 6S technique, including stigma reduction, simple explanations, self-help, signposting, support and safety netting, and provides comprehensive resources and signposting to guide both new and experienced GPNs in supporting the mental health of CYP.

Despite advances in wound care, treatment of lower limb ulceration remains suboptimal, with poor outcomes often attributed to inadequate diagnosis, failure to follow evidence-based practice, and variations in care delivery. These shortcomings result in delayed healing, reduced quality of life (QoL), and a significant economic burden on healthcare systems. Compression therapy is the recommended treatment for venous ulcers and ulcers with mixed aetiology, however there are some individuals who may not respond to compression alone or who are unsuitable due to arterial status. Recent advances in adjunctive therapies, such as the geko® device, offer promising results for these patients. This muscle pump activation (MPA) device activates the calf and foot muscle pumps, increasing venous, arterial and microvascular blood flow. This article examines the impact of leg ulceration on healthcare services and patient outcomes, while exploring the potential of the geko® device to improve healing rates and reduce associated costs.

Endometriosis has a profound effect on quality of life of around one in ten women in the UK, mostly due to the pain and inflammation it causes. A diagnosis may not be immediate as the condition can mimic other problems, including irritable bowel syndrome (IBS). By the time women have had a diagnosis, they are often desperate to try any treatment offered, frequently by non-qualified healthcare professionals. This article looks at evidence for and against certain diets and supplements offered for treating endometriosis and concludes that those that may work are ones that possibly help to reduce inflammation. More research is needed on how to help women with this condition, but the author warns that it probably will not be with certain supplements or diets that exclude certain foods, but rather with a holistic whole diet and lifestyle approach.

General practice nursing is unique in both its skill set and employment. The knowledge and skills required to be a GPN are not taught in pre-registration nursing courses, nor are they evident in other areas of nursing. GPNs perform varied and important roles with increasing responsibility. However, training for this role can be inconsistent, as individual GPNs negotiate it at practice level. This inconsistency has been highlighted in several reports. To address this, the Cheshire and Merseyside Training Hub has developed a one-year preceptorship course for new GPNs. The training is structured, uniform, and accredited by a university. The Hub also provides support from experienced GPNs. While the course has been successful, it has not been without challenges. Future efforts should focus on navigating these challenges and reconsidering the employment framework for GPNs to ensure consistent education.

It is exciting to see a growing editorial board for our journal, and we are fortunate to have some excellent clinicians with wide and varied experience to help inform our content and direction as we move into 2025. The December issue reflects this with a range of articles
including advanced clinical decisionmaking, patient safety, and clinical articles on the rare but important disease bullous pemphigoid, gout and dietary changes, asthma, and managing urinary tract infections (UTIs) in men.

We’ve all been there. That ‘leave it to me’ moment when frustration gets the better of us and we decide that we’d rather finish a task ourselves than let someone else ‘help’.

We might be trying to teach a patient to self-catheterise or educating them on how to monitor their blood glucose levels, but sometimes, whether it’s through tiredness, others’ lack of ability, or simply not having the time, it can seem easier to finish the job yourself than to watch someone else struggle.

Asthma is the most common longterm condition in children and young people (CYP),  affecting one in 11 five to 18 year olds (Asthma + Lung UK, 2024a). That is around three in every classroom. Most cases are mild to moderate and, in most children, a few  simple interventions can vastly reduce asthma symptoms and risk of attack (Bush and  Fleming, 2015; British Thoracic Society/Scottish Intercollegiate Guidelines network  [BTS/SIGN], 2019; Levy, 2020; National Institute for Health and Care Excellence  NICE], 2021). The awareness campaign, #AskAboutAsthma, was established to encourage  everyone seeing CYP with asthma to have these interventions front and centre of their minds.

Compression bandaging can present a challenge to healthcare professionals. Some clinicians may not have the necessary skills and training to safely and competently apply it, while others may be using it but not in accordance with the evidence base. As clinicians, it is
our responsibility to make sure that our knowledge and skills are up to date so that we can deliver evidence-based care to patients and do no harm (Abu-Baker et al, 2021). The NHS Long Term Plan emphasised the importance of placing the patient at the heart of their care with their experiences, needs and preferences considered when developing a care plan
with them (NHS England, 2019).

Sjögren’s syndrome. Never heard of it? No, neither had I. In fact, a nurse I spoke to only a few weeks ago hadn’t either.

Sjögren’s syndrome (hereafter known as Sjögren’s) is a chronic autoimmune disorder of unknown origin (Carsons and Patel, 2023), which attacks the secretory glands that produce fluid for the eyes, mouth, skin, gastrointestinal and genital tract resulting in decreased 
fluid production (Lackner et al, 2017). Essentially however, the condition has the potential to affect virtually any organ system leading to extreme clinical symptoms (Negrini et al, 2022), the impact of which can be severely debilitating.