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Home oxygen is widely used in the clinical management of patients with conditions that result in chronic breathlessness. It is often requested by patients and their families, particularly when they have been treated with oxygen during a hospital admission with an acute worsening of hypoxaemia. However, oxygen therapy at home is not an insignificant undertaking; it may be challenging for both patients and their families and carries a number of risks in terms of safety and clinical response to treatment. The British Thoracic Society (BTS) has published detailed evidence-based guidance for the assessment, prescription and follow-up of oxygen therapy in the home setting (Hardinge et al, 2015). This article addresses the main points of the guidance and considers the role of primary care health professionals, such as general practice nurses (GPNs), in supporting patients with chronic breathlessness and identifying those who might benefit from assessment for home oxygen therapy.

Prostate cancer is the most common cancer diagnosed in men in the United Kingdom (Cancer Research UK [CRUK], 2016). In 2013, there were 47,300 men diagnosed with prostate cancer. This amounts to 13% of all new cancers diagnosed in men. Furthermore, prostate cancer incidence has increased by 5% over the last ten years (CRUK, 2016). In 2014 there were 11,287 deaths due to prostate cancer, however 84% of men diagnosed with prostate cancer will survive 10 years or more (CRUK, 2016). This paper gives an overview of prostate cancer diagnosis and treatment and the role of general practice nurses (GPNs) in the care of men suspected of having prostate cancer and following treatment.

Here, Chris Loveridge reflects on a patient story where the focus slipped away from the patient resulting in a failure of care.

As nurses, one of the first things we are taught is how to communicate with patients. It is also important to look out for clues that might help to assess their condition. For example, in patients with breathlessness this could mean:

• Observing how they walk towards us, the degree of breathlessness
• Looking at their skin colour when they reach us — both at their hands as they greet us and their lips when they are talking
• Reaching across to reassure and feel the texture of their skin and perhaps even the radial pulse. Once taught, these skills are never forgotten and, added to a conversation, can encourage patients to relate how they feel, and thus, begin the process of history-taking.

Here, Denise Woodd, talks about her role as a trainer/ lecturer in leg ulceration and wound care in primary care.

WHAT IS A TYPICAL DAY?

I work independently so I plan my own schedule, but a clinical day would be seeing patients who have been referred to me with the nurse in their surgery in Portsmouth. We undertake a full holistic leg assessment, including Doppler together, agree the priorities of care, triage if needed, and refer on. Once the day is over, I come home and write the reports and recommendations for ongoing treatment, etc. Other days are carrying out education and training.

Undertaking a successful consultation with a child requires a particular set of skills. Children presenting to general practice vary enormously in age, development, disability, personality and clinical presentation, making each consultation unique. For the majority of cases, a parent or carer will be present, requiring the consultation to broaden out and become a triadic exchange of views, versus the traditional patient and practitioner dyad. This paper discusses techniques to optimise effective communication in a triadic consultation, that allows the child to present their concerns/ perspectives about their illness.

General practice nurses (GPNs) and GPs alike report high levels of stress and burnout, with the relentless demand for 10-minute appointments and reviews leaving both clinicians and patients dissatisfied. We have worked this way for so long, it is hard to imagine an alternative. Yet, there is one — and it is causing a quiet revolution across the country.

What is fascinating since the launch of the Journal of General Practice Nursing in May 2015, is that we have become increasingly aware of the demands that delivering skin and wound care places on community- and practice-based nurses.

The team of Eczema Outreach Scotland (EOS) has been working with families dealing with the day-to-day struggle of childhood eczema for over five years. Magali Redding, a West Lothian mother of three and voluntary sector professional, set up the group when her daughter asked tearfully: ‘why am I the only scratchy girl in the world?’ In between their precious clinic appointments, the family had been feeling increasingly frustrated and isolated in their battle with the impact of eczema on life.