Interstitial lung disease is a wide-ranging category of respiratory illness that includes many different lung conditions, such as interstitial pneumonia, idiopathic pulmonary fibrosis, non-specific interstitial pneumonitis and hypersensitivity pneumonitis. All interstitial lung diseases affect the interstitium, a delicate network of tissue that extends throughout the lungs and which supports the microscopic air sacs within the lungs (alveoli). Unfortunately, some forms of interstitial lung disease have a very poor prognosis, therefore it is important that community nurses are aware of the signs and symptoms of interstitial lung disease so that prompt referral, assessment and treatment can be started.
This article examines and summarises the role of nutrition and the dietitian in the final stages of palliative care. The recent publication of One chance to get it right (NHS England, 2014), highlighted the need for a change in the approach to food and drink, especially when caring for those patients who are at the end of life. There is a clear need for documentation and formulation of clear, patient-centred and effective care plans, as it is vital that food and drink are offered, as long as it remains safe and is not harmful to the patient.
JCN talks to those working in the community.
Dinah Latham is a retired community nurse from Buckinghamshire and author of Walking Forward, Looking Back a new novel about district nursing.
From watching whales off the Mexican coast to dealing with on-board norovirus outbreaks, the life of a cruise-ship nurse is rarely dull. Here, Gary de Beer explains what it is like to be part of an on-board medical team, which might have access to state-of-the-art equipment, but can be many miles out to sea...
JCN talks to those working in the community.
Soline Jerram, director of clinical quality and primary care, Brighton and Hove, Clinical Commissioning Group
In each issue of the Journal of Community Nursing we investigate a hot topic currently affecting our readers. Here, Jason Beckford-Ball looks at the latest plan for the future of the NHS in England and asks the question...
Every year there are seasonal spikes in infant hospital admissions for bronchiolitis, a common respiratory infection that affects vulnerable infants and usually occurs between November and March. Bronchiolitis is the most common cause of infant hospital admissions during the winter months and since 2004, admissions have increased by more than 50%.
End of life can be a frightening and uncertain time for patients and families and the role of the community nurse can be vital in easing this phase of life. This article outlines some of the issues that community nurses should be aware of when caring for a patient who is dying at home. It identifies the signs which signify that death is approaching, and explains the need for a change in care emphasis at this point. The author also outlines some key management aspects that can improve the quality of a patient’s death, including communication, care coordination, symptom and pain control, and support for nurses and carers.
The first part of this two-part series on breathlessness (JCN 28(5): 83–90) looked at the emotional and physical distress and social isolation caused by the condition for both patients and their families, as well as examining the assessment of the condition. Refractory breathlessness, i.e. that which persists even when measures to optimise the underlying condition have been implemented, is one of the most distressing symptoms experienced by patients with advanced life-limiting illnesses. This, the second part of the series, looks at how community nurses can successfully manage patients, including lifestyle changes, self-management, psychological therapy and pharmacology.
