Resources

In July, Steph Lawrence MBE became the Queen’s Institute of Community Nursing (QICN) new chief executive, succeeding Dr Crystal Oldman CBE. Steph has been a nurse for more than 37 years, with the last 22 spent working in the community. She is both an adult and children’s trained general nurse, and a qualified district nurse. Steph is a Queen’s Nurse and fellow of the QICN and in 2022 was awarded an MBE for services to district nursing.

Steph was previously chief nurse at Leeds Community Healthcare NHS Trust and also spent three years at the Care Quality Commission as the national professional adviser for community services. She led the national trailblazer group for the district nurse apprenticeship standard, and co-chaired the clinical reference group for the national community nursing plan. She therefore brings a huge amount of experience and expertise to the QICN at a time when the NHS is adapting rapidly to meet new challenges

Like many skin conditions commonly encountered in primary care (e.g. dermatitis, psoriasis and acne vulgaris), hidradenitis suppurativa (HS) can be both difficult to spell and pronounce. HS can also be difficult to identify, despite being an inflammatory skin condition that affects as many people as psoriasis (Penzer Hick, 2022). As a consequence, it can sometimes take several years for patients to get a diagnosis; approximately 35% of people with HS reported it taking three to 10 years to be diagnosed (Nicolle, 2022).

To help address this by improving recognition of HS, JCN and GPN in partnership with Mediq, have produced a poster for clinicians to use in practice settings to raise awareness among both healthcare professionals (HCPs) and patients.

Good skin integrity is essential for overall health and wellbeing. The skin is the body’s first line of defence against external threats such as infection, injury, and fluid loss. Maintaining skin integrity is crucial, especially for patients in their own homes where skin observation may be less frequent than in in-patient settings. Any damage to the skin can increase the risk of complications, such as pressure ulcers, infection and skin tears. This article examines the importance of assessing risk and maintaining good skin integrity for patients, and explores the role of nurses in maintaining good skin health, outlining evidence-based interventions.

Lymphoedema is a chronic condition that can lead to pain, reduced mobility, and significant emotional and psychosocial burden. While standardised patient-reported outcome measures capture physical and psychological impacts, they may overlook important aspects of the lived experience. This service evaluation aimed to explore patient experiences of lymphoedema at first contact with the service by analysing open-text responses from LYMPROM© submitted to a single lymphoedema service, and to identify concerns not captured by fixed-response items. A retrospective thematic analysis was conducted on 229 anonymised open-text responses submitted via LYMPROM© for patients newly referred to the Swansea Bay University Health Board (SBUHB) lymphoedema service between November 2020 and December 2022. Data were analysed using Braun and Clarke’s six-phase framework, with coding and theme development undertaken collaboratively by three researchers to enhance rigour. Four overarching themes were identified: the burden of multiple comorbidities, disrupted sleep often linked to pain and discomfort, the emotional toll of lymphoedema, and behaviour changes related to social withdrawal and diminished confidence. Patient narratives revealed experiences not easily captured through structured assessment alone. The findings support the integration of narrative data to inform more holistic, person-centred care.

As lymphoedema prevalence continues to rise causing increasing demand for services, optimising patient self-management is vital. In the UK, lymphoedema treatment models have traditionally followed the ‘four cornerstones’ approach, including skin care, compression therapy, physical activity, and lymphatic drainage massage. These address the physical manifestations of lymphoedema yet neglect the psychological and emotional impact. Since the establishment of the psychology service within the Lymphoedema Wales Clinical Network (LWCN) in 2023, a more holistic model of care has been introduced into clinical practice. This development reflects a growing recognition of the psychological burden associated with lymphoedema and the need for integrated support services. The introduction of the lymphoedema COMPASS treatment model represents a significant advancement in routine care delivery, combining physical and psychological interventions to support patients to live as well as possible with lymphoedema. The COMPASS model is designed to place individuals at the centre of their care, promoting active engagement and self-management. It supports and encourages patients to take ownership of their condition, including the emotional and psychological challenges that often accompany lymphoedema.

The trial without catheter (TWOC) procedure aims to assess an individual’s ability to void effectively without the use of an indwelling urinary catheter. Prolonged catheterisation increases the risk of catheter-associated urinary tract infections (CAUTIs), sepsis, and hospital readmissions. Traditionally, TWOC procedures have been conducted in hospital settings, which can be costly, resourceintensive, and inconvenient for patients, particularly those with mobility issues or chronic conditions. This article evaluates the implementation of a commercial clinical nurse specialist (CNS)-led community-based TWOC service, highlighting its cost-effectiveness, improved patient outcomes, and positive patient experience. It aligns with national healthcare priorities, such as the NHS Long Term Plan, by promoting care closer to home, reducing hospital admissions, and optimising NHS resources. The findings support the case for expanding community-based urology services to enhance patientcentred care and achieve better health outcomes.

There continues to exist within society a taboo on discussing death and dying, an omission of which can lead to severe distress and anxiety, that can leave terminally ill patients fearful of dying. This paper extols the importance of nurses providing psychological, social and spiritual support at a time when patients may understandably be at their most vulnerable. While modern medicine clearly has a place in helping to reduce pain and anxiety, such interventions are not the only answer. Mindfulness-based interventions (MBIs) may also have a part to play. This paper also encourages nurses to seek an understanding of the concept of death cafés and how they can help people come together in a meaningful and supportive way. It concludes by encouraging nurses to develop a greater insight into such interventions, so that they are more able at least to discuss these with their patients.

Glaucoma is a serious eye condition, comprising a group of eye diseases, and is a leading cause of sight loss around the world. It has several forms, with primary open angle glaucoma (POAG) the most common. Glaucoma can affect people of all ages but is more prevalent among older adults. It is a progressive condition and has a huge impact on quality of life, affecting the person’s ability to continue to lead a normal life. This article focuses on glaucoma in adults, and provides information on symptoms, risk factors, diagnosis and treatment. The aim is to help nurses and non-medical prescribers to recognise and refer suspected cases, improving outcomes and quality of life for all those affected by this devastating disease.

In the last 80 years, the number of people in the UK with diabetes has risen from 200,000 to over four million (Nazarko, 2023). People with diabetes have at least double the risk of heart failure than the general population (Kenny and Abel, 2019), with American research indicating that 22% of people who have diabetes have heart failure (Pop-Busui et al, 2022). Most cases of heart failure are diagnosed in hospital, although 40% of people with heart failure have symptoms that the British Heart Foundation (BHF, 2025) comment ‘should have triggered an earlier assessment’. This article examines the link between diabetes and heart failure to update nurses working in primary care on who is at risk, when to suspect heart failure, as well as how it is diagnosed and treated.

Here, Allison Whitehorn tells her story of having cauda equina syndrome (CES) and the challenges and impact that the condition has had on her life. As a result, together with her husband, she has founded Cauda Equina Spinal Cord Injury (CESCI), a not for profit organisation to help provide education and support to others coming to terms with this devastating condition.