Editorial Resources

Dermatological conditions are notoriously difficult to spell! Psoriasis with its silent ‘P’ and eczema without an ‘X’. But how about hidradenitis suppurativa (HS)? Hard to spell, hard to pronounce but, more importantly, really hard to be a patient with the condition.

The Asthma+Lung UK helpline takes more than 1,000 calls a month from people who are struggling with their asthma and need advice and support to manage their symptoms. Asthma is a common lung condition affecting 5.4 million people in the UK, and is more prevalent among women than men (https://ukdataservice.ac.uk). The charity’s recent analysis finds that women are, shockingly, almost twice as likely to die from an asthma attack than men (Asthma+Lung UK, 2022).

#AskAboutAsthma is an annual awareness campaign that takes place in September. Now in its sixth year, the campaign is about making simple changes to children and young people’s care that will make a big difference to how they experience their asthma. Primary care clinicians are critical to making these changes, with general practice nurses (GPNs) playing a vital role.

The National Paediatric Respiratory and Allergy Nurses Group (NPRANG) was formed 27 years ago as an asthma group for nurse specialists, with the first meeting taking place at Alder Hey Children’s Hospital, Liverpool. The group met annually before becoming part of the Royal College of Nursing’s (RCN) Respiratory Group when they had independent learning groups. However, when the learning groups within the RCN merged, NPRANG became an independent group with members from all fields of respiratory and allergy medicine.

Heart Failure (HF) already affects a million people in the UK. With 200,000 new cases annually, it is the fastest rising cardiovascular disease in the country (British Heart Foundation, 2022). And yet, the public and politicians are barely aware of this condition and the huge impact it has on people’s lives. At Pumping Marvellous, the UK’s only dedicated patient-led heart failure charity, we know too well what can happen when people are blindsided by HF, and how poorly understood it is. We also know how much can be achieved when people are educated and supported to manage their care.

It’s easy to worry about the things we might get wrong in our working lives and the level of consequences that could potentially follow, but what about focusing and celebrating what we get right (sometimes harder to see) and the potential for helping people achieve longer, healthier lives.

Last week at the end of a triage call a patient said, ‘thank you — I really feel you have listened to me’. The feedback meant a lot to me on a day when I was struggling a bit to keep ahead and helped me to stop for a moment and reflect on what our role in primary care is all about. It’s holistic, it’s often the patient’s first port of call and it’s important to the
people who reach out to us for help. Reading this issue’s ‘practice matters’ discussion about food insecurity, I have reflected further that it’s not just listening that we need to do, but rather use all of our senses to help us in our role and let us see the bigger picture that is required for good general practice consultations.

A friend told me at the beginning of the pandemic that she had made an active decision not to judge others and their behaviour and reaction to Covid-19. She would do her best to act responsibly, but would not question or worry about what others were doing. This seemed a good approach and I have tried to reflect on it when feeling annoyed about various examples of lack of adherence to the rules.

Here, Meg Burgess, specialist nurse at Prostate Cancer UK, talks about her role in providing a Fatigue Support Service by telephone, why it is needed, how it is structured, and the small changes that can help reduce the impact of fatigue on quality of life for men with prostate cancer. 

Around three in four men with prostate cancer (74%) will have fatigue at some point (Stone et al, 2000). For some it may be a short-term problem and manageable, for others it can be longer lasting and can affect quality of life.

As healthcare professionals, it can be a hard symptom to address as treatments or solutions may feel limited. Men say there is often little discussion about their fatigue with healthcare professionals and there may be differing perceptions of the impact of fatigue on quality of life (Sonn et al, 2009).

Since 2013, Prostate Cancer UK has provided a telephone fatigue support service to provide this much needed support.

Please click the link to read the full article.

With an adaptable and creative approach, we kept as much of our GPN work at the surgery going during the various lockdowns. Much of this has led to a more flexible service for our patients and certainly many respiratory reviews will continue to take place remotely (it was helpful to read how Jude Harford approaches remote paediatric asthma reviews in the journal, pp. 56–61).

This, however, has not prevented the colossal feeling of ‘catch up’ we are now experiencing. Our service is busier than ever, and many people bring extra problems which need signposting, rebooking, or managing within the consultation.

Managing stress is now an integral part of our role. Daily routines can help ensure we remember to be kind to ourselves as well as others. I often reflect on the importance of the simple routines I learnt about from the webinar held by Donna Booth (www.vitality-innersanctum.com). I make sure even in a hectic week that I still take time to enjoy nature, cook something nice or get some exercise.

As nurses we are committed to lifelong learning and, with this in mind, I found the ‘practice matters’ feature about learning styles very interesting to reflect upon from several perspectives: 

• How I help those I teach learn and how much I consider/discuss their learning styles 
• As a writer of educational modules and editor of this journal, how much do I think about different learning styles when bringing together educational content? I now plan to make a note of the styles and think about them in my planning and editing processes 
• What is my own learning style and how much of this is based on convenience (webinars/websites are much easier for me to access because life is busy, but I used to love attending a teaching day or even a conference) and how much is my core learning style?

I found the articles in this issue very helpful again. I think they do often have a conversational style as well as being packed with evidence and useful resources. I enjoyed expanding my understanding about heart failure, as this is often a factor when trying to understand what is causing a patient’s shortness of breath. It was also very useful to get a clear update on analgesic prescribing. I often find it’s the simple things like explaining why it’s better to take paracetamol regularly, rather than as required, that helps in people with chronic pain.

I hope you all find ways to use simple routines to relax and look after yourselves as summer begins to fade and we prepare ourselves for an uncertain winter. As a profession, we are known for our caring attitude and also our resourcefulness and resilience.

Jaqui Walker, editor-in-chief