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.
For the first time, the Queen’s Nursing Institute’s (QNI’s) annual conference was a two-day event, with a range of speakers on the twin themes of inspiring quality and success in nursing and on shaping the future of the nursing workforce. The speakers — from England, Wales and Northern Ireland — spoke about the various challenges facing the nursing workforce and some of the new initiatives that are being introduced to address them.
Technology is all around us and while it enables us to do things that were not possible in the past, I still talk to nurses around the country who have very different levels of professional engagement with it.
The UK has one of the highest death rates from asthma in Europe (Global Asthma Network, 2014). Every day three people die from asthma, two-thirds of these deaths are preventable (Asthma UK, n.d.). Why asthma still kills: The National Review of Asthma Deaths. Confidential Enquiry Report (NRAD) was published in 2014 by the Royal College of Physicians (RCP). It is the largest worldwide study looking into why people die from asthma and the first to adopt a UK-wide focus. The NRAD identified that only a fifth of people with asthma are receiving all the basic elements of asthma care which could help them manage their asthma effectively and reduce their risk of experiencing an asthma attack. It provided valuable insights and clear practical recommendations which, if implemented, could improve care and reduce the number of asthma deaths (RCP 2014).
Four million — or one in 16 — adults in the UK have diabetes (whether or not they are aware of it), and this figure is predicted to increase to an estimated five million by 2025 (Diabetes UK, 2015). The majority have type 2 diabetes and the focus of this article will be on the role of general practice nurses (GPNs) in managing type 2 diabetes, although an overview of pre-diabetes, type 1 diabetes, gestational and steroid-induced diabetes will be provided. The author will also discuss the best current dietary advice that GPNs can provide for patients so that they can manage their own diabetes, as well as looking at the support available for GPNs to facilitate self-care in their day-to-day practice.
Atopic eczema is a common dry skin condition, and, as with any dry skin condition, emollients are a fundamental aspect of care. With so much choice there can be uncertainty around which product to use. Choosing one product over another can create confusion for both healthcare professionals and patients. This paper looks at emollients, the products available, how to use them and the current evidence and research relating to emollient use for atopic eczema. The reader is also directed to additional resources to support clinical practice.
The second in this two-part series on migrane focuses on how to treat patients to reduce disability and improve quality of life. Expectation is an important driver to treatment and patients and healthcare professionals should be ‘on the same page’. Unfortunately, this is not always true. Packard (1979) found in his study that doctors thought patients wanted pain relief (96%), medication (68%) and explanation (68%), but what patients actually wanted was explanation (77%), pain relief (69%) and a neurological investigation (31%). Ineffective communication leads to dissatisfaction with care and poor adherence to treatment in headache patients (Cottrell et al, 2002). Therefore, it is essential that patients are involved in the decision-making process when deciding on treatment.
Obesity and its consequences, such as diabetes and cardiovascular disease (CVD), have significant health and NHS cost implications. Relatively small reductions in weight (around 5–10%) have clinically important benefits (Pietrzykowska, 2016), but long-term weight loss maintenance is challenging. Behaviour change interventions have been identified as key for use in weight loss by authorities such as the National Institute for Health and Care Excellence (NICE, 2014). In particular, motivational interviewing (MI) — a form of behaviour change — has been identified as a successful approach to changing health behaviours (Rollnick and Miller, 2013).There is an abundance of evidence showing that just telling people what to do does not work as a way to change patients’ behaviour in order to achieve health gains (NICE, 2014). Furthermore, there is emerging evidence that MI does work and leads to long-term health gains. This article provides an overview of MI to help general practice nurses (GPNs) in their day-to-day practice.
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