Resources

‘What exactly does a general practice nurse (GPN) do?’ Does that question sound familiar to you? It is one that has been frequently posed to me throughout my career as a GPN and my initial reply would inevitably be ‘Where do I start?’

The role is huge, diverse and continually evolving and can be a very rewarding career choice. However, there are myths and misconceptions that circulate which can serve to deflect nurses away.

The devastating impact that Long Covid can have on people’s lives is plain to see, with long waiting times and lack of support potentially making the experience of having Long Covid
even harder.

There are estimated to be 900,000 people withdementia in the UK and indications are that this will increase to one million people by 2025 and two million by 2051 (Wittenberg et al, 2019). While dementia is associated with old age, there are approximately 42,500 people under the age of 65 years old diagnosed with young onset dementia (Sandilyan and Dening, 2019). Due to the progressive nature and neurodegeneration of dementia, it is now the leading cause of death in England and Wales, accounting for 12.5% of all deaths registered in 2019 (Office for National Statistics [ONS], 2020).

In a position statement issued by the British Society for Heart Failure (BSH, 2021), the author said that keeping heart failure specialist services intact would:
... mitigate the significant risk to those living with heart failure and prevent unnecessary pressure on other healthcare providers. The pandemic has already taught us that we need to maintain service provision for this highly vulnerable cohort.’
A statement which has hit home as cases of Covid-19, fuelled by the latest variant, continue to rise.

This article explores why we should adapt assessment of leg ulceration to be more mindful of the presence of lymphoedema. If clinicians can change the assessment process and begin to treat leg ucleration with a lymphatic component differently to venous oedema, this, in turn, can potentially reduce complications such as toe, foot and knee oedema. The introduction of simple changes in documentation and additional training can lead to improved outcomes for patients as well as potential cost savings for healthcare providers.

There are many different causes of liver disease and current estimates suggest that as many as one in 10 people have problems with their liver at some time in their life (Foundation for Liver Research, 2020). Perhaps most worrying is the fact that incidence of liver disease is increasing, with the number of deaths reported to have increased by 400% since 1970 (British Liver Trust, 2020). Most liver diseases are asymptomatic early on, frequently resulting in late diagnosis, potentially leading to a higher risk of poor outcomes. Many of the well-known liver diseases are preventable and this article, which covers fatty liver disease, hepatitis A, B and C and liver cancer, hopes to raise awareness of risk factors, recognition, causes and treatment of these conditions, and give general practice nurses (GPNs) and non-medical prescribers more confidence when caring for patients with these illnesses.

Pelvic organ prolapse (POP) and urinary incontinence (UI) are common problems experienced by women of all ages. With the publication of Seizing the opportunity to improve patient care: Pelvic floor services in 2021 and beyond (Pelvic Floor Society, 2021) comes recognition of how common pelvic floor disorders are, but how little investment
has been put into these services. Such publications highlight the need for services to be provided which encourage women to come forward to be assessed and treated. This article, the second in a two-part series, discusses conservative treatments for UI and POP, which should be considered as first-line options where possible (National Institute
for Health and Care Excellence [NICE], 2021) and are easily started in primary care.

It has been reported that one in 500 people in the UK are living with a stoma (Colostomy UK, 2022) and nearly threequarters of people with a stoma experience skin problems. Therefore, skin assessment, prompt identification of risk and preventing skin problems is the cornerstone of peristomal skin care. This article introduces common peristomal
complications, focusing on the assessment and prevention of two distinct groups of peristomal skin damage; peristomal moisture-associated skin damage (PMASD), one of the types of moisture-associated skin damage (MASD), and medical adhesive-related skin injuries (MARSI).

In 2006, the National Institute for Health and Care Excellence (NICE) released the landmark guidance on nutrition, ‘Nutrition support in adults: oral nutrition support, enteral tube feeding and parenteral nutrition’ (NICE, 2006). At the heart of NICE guidance and quality standards is the aim to integrate research into practice and reduce gaps between recommended and actual practice. However, successful implementation is dependent on national and local action. To facilitate the implementation of the NICE clinical guidance (CG32), a national multidisciplinary expert panel was convened to explore and develop strategies that would overcome barriers to implementation of the NICE guidance, facilitate access to practical tools, and enhance knowledge to improve the management of disease-related malnutrition in the community. The collaborative work undertaken by the panel, in conjunction with major stakeholders, led to the development of the ‘Managing Adult Malnutrition in the Community’ materials. This article reviews the work of both the initial panel in 2012 and subsequent expert panels, that have delivered and continue to develop resources for nurses and the wider multidisciplinary team to assist in tackling malnutrition, which affects up to three million people in the UK at any time (Elia and Russell, 2009), especially that which arises as a consequence of illness and long-term medical conditions having an impact on appetite and the ability to eat and drink.

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.