Resources

Nutrition and hydration are vital components of successful wound management. Malnutrition is associated with a delay or failure of the wound healing process and this article discusses the macro and micronutrient requirement of each stage of the wound healing process. Holistic wound assessment, including assessment of nutrition and hydration, plays a significant part in successful wound management, in partnership with controlling exudate with appropriate wound care products.

Cervical cancer is the fourth most common cancer in women worldwide, with around 311,000 women dying of the disease in 2018 (World Health Organization [WHO], 2020). In the UK, cervical cancer accounts for approximately 870 deaths each year. Effective primary (human papilloma virus [HPV] vaccination) and secondary (screening and treating precancerous lesions) strategies are therefore paramount in preventing unnecessary mortality, especially given that cervical cancers are one of the most successfully treated if caught early (WHO, 2020). Obtaining an adequate sample during cervical screening is of the utmost importance to ensure early histological changes are detected. Whether lubrication should be used during the screening process is a contentious issue, since contamination of the sample with lubricant can mean that vital histological changes are missed, thereby putting women at risk. This also needs to be balanced with women’s comfort, since an uncomfortable experience may lead to women failing to attend for future screening. This article looks at the current literature available, with recommendations for further research.

As the NHS and general practice changes, the authors raise questions about of one of the fundamental human responses we all can have to each other. This article looks at the dynamics and impact of listening in health care for nurses and staff. The close relationship between active listening and safe, lawful and ethical health care are explored. It combines current academic doctoral work, wider research, practical experience and psychological thinking on how listening is a conduit of care and humanity. The article shares stories, research and observation to ask what communicative listening looks like, why it matters, and how we practice this powerful skill. The authors come from different and complementary backgrounds, bringing together a wealth of experience and knowledge to challenge and explore the concept and practice of listening.

Lockdown, as a result of the current health crisis, has demonstrated the risks that social isolation can have on physical and mental wellbeing. Social isolation and loneliness in the UK are rising, with nine million adults reported to be lonely and little chance of this changing once full restrictions are lifted post lockdown. While four million of this group are elderly, the remaining five million come from a diverse range of age and social groups, highlighting the diversity of this complex problem. To address the challenges loneliness produces, a multifaceted approach needs to be taken to find solutions and tools to help those working in primary care support the most vulnerable patients. Digital technology, in particular virtual reality (VR), may be one area that could provide some answers.

Cannabis has been around for millennia and is a popular recreational drug. A recent survey found that it is the most frequently used substance in the 16–59-year age group (Home Office, 2018). Recently, it has been approved for medicinal purposes and the National Institute for Health and Care Excellence (NICE, 2019) has published guidance for specialist medical staff on prescribing cannabis. There have been studies on the potential beneficial effects of cannabis on pain, particularly in conditions such as multiple sclerosis and terminal cancer (Calignano et al, 1998; Russo, 2008; Whiting et al, 2015). There have also been publications on the use of cannabis in some dermatological conditions (Whiting et al, 2015), but very little published evidence on how or whether cannabis impacts on wound healing. With the widespread use of cannabis, it is likely that healthcare professionals will care for cannabis users who also have wounds. This article discusses some of the current available evidence to establish if and how cannabis may affect the wound healing process in order to advise patients on how to optimise wound healing.

Eczema, also known as dermatitis, is a very common skin condition. There are several different types of eczema, affecting people throughout their lifespan. General practice nurses (GPNs) will see children and adults with eczema regularly and they are well placed to assess, manage and support them. Eczema is a chronic conditon and can have devasting effects on quality of life and mental health. GPNs can play an important role in supporting patients with eczema and their families in understanding how to self-manage this long-term conditon and help with coping strategies. This article outlines eczema as a long-term condition and provides practical advice for GPNs on assessment and treatment in primary care. Psychological effects and intervention and referral guidelines for eczema are also discussed.

The first piece of this two-part series explored the context for leadership in general practice nursing, our role as leaders, and perceived barriers to nurses fully utilising their leadership potential in the general practice setting. Here, Jaqui Walker, general practice nurse/advanced nurse practitioner (GPN/ANP), Falkirk, explores why we should lead, who can lead, leadership styles and behaviours for ANP/GPNs, and how to develop leaders. Written from the political setting of Scotland, this article is applicable to nurses across the four nations of the UK and suggests, as part of our leadership skills, we should all make ourselves aware of the context within which we work.

In each issue of the Journal of General Practice Nursing, we investigate a topic currently affecting our readers. Here, Kate Upton, representative for Nursing Professions on the Crisis, Disaster and Trauma Psychology Section of the British Psychological Society, looks at - Recognising compassion fatigue and protecting wellbeing.

It seems that the focus for many is now on potential Covid-19 vaccines, with people understandably seeing a potential end in sight to the current pandemic. It is worth celebrating the pivotal role that general practice nurses (GPNs) already play in delivering vaccine programmes to people throughout their lives. The majority of vaccine programmes in the UK are delivered in primary care or wider community settings, and GPNs are crucial to the successful delivery of these. Although most of the vaccines in the routine schedule (Public Health England [PHE], 2020a) are recommended to infants and children to provide protection against infections as soon as possible, vaccines remain necessary for people at all stages of their lives. Indeed, for many vaccines, people are never too old to have them. Thus, it is essential for nurses in general practice to make sure adults at all ages are protected throughout their lives.