Resources

Here, Callum Metcalfe-O’Shea, advanced nurse practitioner diabetes specialist and co-chair for the Norfolk Health Professionals Diabetes Forum, provides the last part in the diabetes digest series with an outlook on the future of care provision for diabetes in primary care settings. This article explores the current data on diabetes, acknowledging the change in future therapies and the role of diabetes technology in advancing care. The role of the GPN is also examined to highlight the need to recognise their involvement in supporting high quality care.

Stressors in life often seem to have a habit of coming all in one go. Before the summer holidays I felt tired out emotionally and physically and that I was being bombarded with a constant stream of issues at home and at work to problem solve and manage. No sooner was one issue sorted and another two swept in to take its place. I like to be busy and enjoy a challenge, but I felt over stimulated and exhausted. At the same time a rather negative voice had set up shop in my head, I was not making enough time to look after myself and was looking with envy at my university friend posting pictures of her sunny lunch dates now she has taken early retirement.

Ever felt that you were working alone with no one to turn to? Or that your caseload was getting on top of you, and you just wanted to let off steam?

We’ve all been there at some point in our careers and while nursing is all about caring for others, it’s sometimes easy to wonder who is caring for us.

Getting support from your colleagues is a crucial part of working as a nurse, where long hours and the demands of patient care can mean that managing stress is not always easy. In acute hospitals, the number and accessibility of colleagues on any shift means that support is never far away. But in general practice, many of you spend a significant portion of your working day alone and it’s not always obvious who you should turn to after a distressing episode of care, or even if you’ve just had a rough day.

Here, Dr Nick Jenkins, senior DVLA doctor, explains why they are hoping to gather evidence on topics such as legal obligations, medical licensing rules in other countries, growing prevalence of drivers with multiple medical conditions, as well as advancements

Vaping is often seen as a less-harmful alternative to smoking cigarettes, and while this may be true in some respects, it is not without its dangers. Understanding how this relatively new phenomenon of vaping could develop into a health concern and even an addiction was of real importance to the author’s team at the UK Addiction Treatment (UKAT) Group, hence the launch of an addiction prevalence survey towards the end of 2022.

The Queen’s Nursing Institute (QNI) annual conference takes place online from 2–5 October and is the UK’s leading event for community nursing. Thanks to its sponsors and donations, the conference is free for all registered and student nurses to attend. The theme of this year’s conference is, ‘In the Spotlight — Nurses Leading Care in People’s Homes and Communities’.

For many nurses working in general practice, chronic obstructive pulmonary disease (COPD) is a familiar condition. From carrying out annual reviews to supporting people living with the symptoms of cough, phlegm, breathlessness and managing their effect on day-to-day living, most general practice nurses (GPNs) will have some experience of supporting people living with COPD. Increasingly, though, GPNs are having to consider comorbidities as part of the review, as for many people living with COPD, this will be just one of the long-term conditions they have already been diagnosed with or of which they will be at risk. In this article, the relationship between COPD and other long-term conditions will be highlighted, along with recommendations about how to identify and manage comorbidities in order to holistically optimise outcomes.

Heart failure (HF) is a clinical syndrome distinguished by the inadequate pumping of the heart. It represents a prolonged condition that impacts approximately one million individuals in the UK, a figure surpassing the toll of other ailments such as cancers and strokes. Recognising symptoms like fatigue, fluid retention, and breathlessness can often present a challenge, given that patients may be asymptomatic, and these symptoms are not always specific to heart failure. The utilisation of a simple blood test, such as NT-pro BNP, followed by advanced diagnostics like echocardiography and magnetic resonance imaging (MRI) scans, hold pivotal importance for achieving timely diagnosis, implementing targeted therapies, reducing mortality rates, reducing hospital admissions, and decelerating the progression of the disease. Simultaneously, this approach works towards enhancing the quality of life for patients and reducing health inequality gaps. The recent 25in25 summit convened by the British Society for Heart Failure (BSH) brought together stakeholders from other countries to discuss and address HF mortality rates. This resulted in the participants collaboratively formulating and signing a declaration with the aim of reducing HF mortality in the first year after diagnosis by 25% within the next 25 years.

Group clinics were one of 10 high impact actions for primary care in 2016. In randomised controlled studies, they improve self-management of type two diabetes and demonstrate positive impacts on: key biometrics, knowledge of diabetes, quality of life, patient-initiated behaviour changes and empowerment. These changes sustain in those from low-income underserved communities. They also improve adherence with quality and outcomes framework standards, reduce A&E visits among vulnerable people with diabetes, and build trust between clinicians and patients. There is evidence that group clinics improve access, reduce waiting times and free up clinician time. They are especially well suited to general practice nursing’s caseload. Introducing group clinics upskills nurses and the whole primary care team, and return joy and autonomy to nursing through deeper connections with patients and by providing the opportunity for nurses to reimagine and revitalise repetitive chronic disease reviews. This is highly motivating and supports retention. Their time has come.