Resources

Chronic breathlessness is very difficult to live with. It has widespread effects on both patients and those who care for them. And yet there are many ways that people can learn to cope with it, including using breathing techniques, adopting comfortable positions and using handheld fans and mobility aids. General practice nurses (GPNs) and other healthcare professionals have a vital role in helping people to manage their breathlessness. First, GPNs should acknowledge that breathlessness is difficult to live with and tell their patients that it is right that they have raised it as an issue to be addressed. Then, they can help patients to learn to manage their breathlessness and guide them to other sources of information and support. Some healthcare professionals find it hard to talk about breathlessness, but if they can help patients to see that it is an expected symptom, which is manageable, this could have a huge effect on their lives and help them to learn to live well with the condition.

Asthma is one of the most common long-term conditions (LTC) in the world. The UK has one of the highest prevalence rates of asthma worldwide, with asthma-related deaths continuing to rise each year. Supported self-management is imperative to enable people with asthma to live well. Low levels of self-management are linked to increased cost,
faster disease progression, early mortality, and increased multimorbidity (NHS England, 2024). This article highlights how primary care nurses, such as general practice nurses (GPNs), are well placed to support people living with asthma to self-manage their condition through the use of motivational interviewing and personalised asthma action plans (PAAPs), using a case study to demonstrate learning.

Anaemia is a common condition occurring worldwide. There are several different forms of anaemia, with iron deficiency anaemia (IDA) and anaemia of chronic disease (ACD) being two of the most prevalent types. Both have similar symptoms but are associated with different causes. Differentiating between the two types and confirming the diagnosis can be a difficult process. This article gives an insight into these two diseases, providing nurses and nonmedical prescribers with an understanding of assessment, diagnosis and treatment.

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.