23 January 2018

06 September 2024

In the second part of our Monitoring matters series, Callum Metcalfe-O’Shea, advanced nurse practitioner and UK professional lead for long-term conditions with the Royal College of Nursing (RCN), discusses the role of weight management in relation to long-term conditions. For the purpose of this article, again the term long-term conditions will cover type 2 diabetes, asthma, chronic obstructive pulmonary disease (COPD), autoimmune
rheumatic diseases and inflammatory bowel disease (Crohn’s/colitis). With advances and changes in how weight is addressed in general practice, this article highlights key issues faced and helps general practice nurses (GPNs) to recognise the value they play in supporting patients in their healthcare journey. Treatment options are also considered when appropriate in condition-related areas only.

01 March 2021

In primary care, there is a lack of understanding and awareness among some clinicians regarding mental health issues that military veterans experience. The aim of the project outlined here was to identify military veterans in one primary care centre, screen them for anxiety and depression, and offer them the most appropriate treatment and support. An emotional health check template was used to identify military veterans for anxiety and depression. Training was also offered to staff in the practice and appropriate services were identified and listed on a leaflet. By the end of the project, the number of military veterans identified in the practice had increased from 19 to 200, 45 with a diagnosis of depression and five with post-traumatic stress disorder (PTSD). Only four veterans were offered emotional health checks during the project period due to restrictions in place for the COVID-19 pandemic. This article shows how the process of identifying military veterans and developing a system of screening for depression and anxiety as well as introducing new staff training has been effective. Adding missing elements to the template will improve follow-up and evaluation in the future.

09 July 2015

Long-term conditions: seasonal allergic rhinitis.

Allergic rhinitis (AR) is a common disorder which has a major impact on the lives of sufferers and families. Although currently there is no cure for this disease, a variety of therapeutic interventions can alleviate the symptoms. It is important that general practice nurses (GPNs) are able to differentiate allergic and non-allergic rhinitis (NAR) from viral upper respiratory tract infections (URTIs) in order to best manage their patients. It is also necessary to ask appropriate questions of those patients attending for asthma review, as they may have unrecognised and untreated disease. Familiarity with the range of medications and their administration is advocated. Patients with troublesome, non- responding symptoms need to be referred, as do those with red flag signs.

01 June 2021

Online events, such as webinars and the GPN Facebook Live ones, have become a regular feature in my life now, and it does make balancing both home and work commitments easier. Rather than needing to take an afternoon, evening or even a day or two out of normal commitments, we can just disappear for an hour or so and access a multitude of training at quite literally a press of the ‘join’ button. Meeting people face-to-face is great, but online events are convenient and accessible for today’s busy life.

My favourite webinar recently was one called ‘Just how stressed are you?’ I signed up for it as I was aware life was running at a fast pace with stressors flying in at me from every angle. Donna Booth’s calm, authoritative voice spoke clearly over the webinar, helping me to work out where it was all going a bit astray and to find simple ways to recognise this and adjust. Taking her audience through a careful explanation of what stress is and the different responses we can have to it; fight, flight, freeze and fawn (fawn was new to me, but described as those times when you try to please everyone, which is tricky because you can’t in fact please everyone). Donna explained that we all have an invisible stress bucket and that while some stress is good for us, if the bucket is constantly slopping over with too much we will eventually run into difficulty. To remedy this, we need to make some space for self-care in our lives; small, simple routines that help us relax. It doesn’t need to take long, but building simple relaxing routines back into life can be effective. This awareness has helped to make me more relaxed and my stress bucket is no longer set to overflow. To learn more about Donna, visit: www.vitality-retreat.com.

This issue of GPN has some helpful respiratory articles with Laura King, clinical nurse specialist for children’s asthma, exploring the importance of the post-asthma attack 48-hour review and Karen Heslop Marshall, a nurse consultant, who has written a thought-provoking article about COPD, CBT and self-management. This article has stimulated me to look at including resources for mental well-being, as well as COPD symptom control, within self-management plans. Carol Stonham, a respiratory senior nurse practitioner, encourages us to consider the environmental impact of respiratory healthcare, looking at everything from inhaler choice to how people access their appointments.

The NMC are working on a review to modernise general practice standards and are currently seeking consultation on this. In her editorial, Professor Geraldine Walters CBE, executive director of professional practice at the NMC, explains some of the changes within the new draft specialist standards and encourages us all to get involved with the consultation process.

I hope you enjoy this issue and wish you all a warm and relaxing summer and, as Donna teaches on her courses, remember, self-care is NEVER selfish.

Jaqui Walker, editor-in-chief

01 June 2021

Chronic obstructive pulmonary disease (COPD) is a term often used for two common incurable lung conditions, chronic bronchitis and emphysema. Breathlessness is the main symptom experienced by patients, which can be frightening and patients can develop symptoms of anxiety, panic, low mood and depression. General practice nurses (GPNs) are ideally placed to address these symptoms. This article describes the importance of considering psychological well-being to improve self-management in COPD and how cognitive behavioural therapy (CBT) techniques can be used to assess and manage the psychological impact of breathlessness. Addressing mental health is a key area to improve self-management in COPD and research has found that respiratory nurses were able to learn and deliver CBT techniques to patients with COPD and improve symptoms of anxiety and depression, as well as quality of life, while also reducing use of healthcare resources (Heslop-Marshall et al, 2018). GPNs can likewise improve self-management by incorporating CBT techniques.

02 October 2017

Supporting patients with COPD to self-care. 

By 2030, chronic obstructive pulmonary disease (COPD) is projected to be the third leading cause of death worldwide (World Health Organization [WHO], 2016). Within the UK, it is estimated that around three million people are living with COPD in England alone, with two million of these unaware that they are living with the condition (Department of Health [DH], 2012).

It is the fifth biggest killer in the UK overall, causing about 30,000 deaths each year (DH, 2011). The condition itself is associated with considerable disability, impaired quality of life and high utilisation of healthcare resources.

19 June 2020

The terms sexually transmitted diseases and sexually transmitted infections (STIs) are used to cover a number of individual conditions that vary in their presentation, treatment, management and risk, and severity of complications. Statistics indicate that the prevalence of some diseases is rising, while others are falling. Yet, in spite of these findings, in 2017 there were 422,147 new diagnoses of STIs made in England alone (Public Health England [PHE], 2018). Current data shows that young people experience the highest diagnosis rates, thought to be likely due to more frequent rates of partner change among younger adults, with females more likely to be diagnosed than males (PHE, 2018). Early detection and treatment is key if complications and avoidance of spread are to be achieved. Given the incidence of some STIs, it is likely that general practice nurses (GPNs) and GPs will be approached by patients asking for help and advice. This article gives an overview of some of the more common STIs, with the aim of improving knowledge and confidence in this area of clinical practice.

05 September 2022

07 October 2020

The recent Covid-19 pandemic has reinforced the need for health care to be delivered in a different way to enable the NHS to be fit for purpose and continue to provide high levels of health care at an affordable cost. One way of doing this is to utilise the benefits of shared care, a concept that is not new, but has not yet been fully embraced. This encourages sharing the responsibility of delivering care in a variety of ways. Wound care is one area that provides general practice nurses (GPNs) with a significant opportunity for patients to be involved in their own care. This can even include wounds producing a high volume of wound exudate, if an appropriate dressing is selected which gives the patient confidence that it will work, despite the unpredictable nature of chronic wounds. Patients need a package of information to reinforce the verbal education given to ensure that they know how to carry out their care, and what to do in the event of a problem or change in wound status. Virtual clinics, which have been especially useful during the recent pandemic, are also an option to replace some face-to-face contact.