This month Hallam Medical, the nursing recruitment agency, celebrates its tenth anniversary, and over that time we have placed a lot of nurses in exciting new roles as well as developing our commitment to nurse education. During this period, there have also been a lot of changes in the wider NHS as well as in the world of community nursing. But, as we work in an ever-evolving environment, what changes can we expect in the future and, more importantly, are we actually ready for them?
Having co-founded Hallam Medical I have to say the past ten years have flown by, but despite it only being a decade, an awful lot has changed, in primary care in particular. Not only have the health needs of the general population altered significantly — witness the major growth in chronic conditions such as diabetes, heart disease and obesity for example — but the nursing profession as a whole has had to change, evolve and adapt to meet these new challenges.
Stroke is a major cause of mortality and lifelong disability, despite advances in diagnosis and treatment. The risk factors of stroke are well-known and many are modifiable through lifestyle adjustments, however, the incidence of first-time stroke is increasing year-on-year. Primary stroke prevention is an important health promotion issue and successful implementation could lead to a reduction in the incidence of stroke and relieve a costly burden to the NHS. Nurses play an important role in providing information and advice to patients in secondary prevention of stroke, and could play an equal role in primary prevention. Providing advice on lifestyle behaviours such as smoking, alcohol consumption, diet and exercise all fall under the remit of the nurse in health promotion and in secondary stroke care. By providing a primary prevention service, community nurses could work as case managers for a larger multidisciplinary team and provide prevention advice and treatment.
I realised very early on in my career that I was not destined to be a hospital nurse, so I messed around for a few years doing things other than nursing before landing a job as a community staff nurse.
The plan was to stay as a community nurse until my (very little) children grew up, but within 18 months I was on the district nursing course.
I became a district nursing sister, then a tissue viability nurse and then led a team of various specialist nurses while simultaneously working as a community research nurse. A few years ago I moved from clinical practice to teaching and research.
Candice Pellett OBE, Queen’s Nurse, is a transition project manager at the Queen’s Nursing Institute (QNI) in London. Candice received the OBE in 2014 for Services to Nursing and Healthcare.
Candice talks about her background in community practice.
Community nursing is becoming more stressful and some nurses are at risk of burnout. Angela Hall, a former district nurse and Macmillan clinical nurse specialist, explores what can be done...
Nina Turner, explains what her background in community practice is and what her typical days is like.
I work as the clinical manager of Rochester Prison within Oxleas NHS Foundation Trust with a fantastic caring team. I am a very proud prison nurse. Prison nursing is challenging and can be a difficult role, however, if you can work past this it is a very rewarding place to be...
Venous leg ulcers make up a considerable part of the community nurse’s workload and the gold standard treatment is multilayered compression bandaging applied to cleansed and debrided lower limbs. The author of this piece looks at the background to leg ulcer development; as well as how to assess patients and the principles of prevention. This article also examines the KTwo® bandaging system (Urgo Medical), which has a built-in pressure indicator to ensure that application is both consistent and effective. The make-up of the twolayer system makes it as effective as four-layer systems without the associated bulk, which means that patients find it easier to wear.
Heart failure is a common chronic condition and people living with it can have periods of relative stability as well as episodes where their symptoms worsen and they require hospital admission and treatment (Chun et al, 2012), such as intravenous (IV) diuretics. Traditionally, patients who failed to respond to an increase in oral diuretics have been admitted to hospital for IV diuretics. The British Heart Foundation (BHF) funded a two-year project in 10 NHS organisations across the UK to determine if delivering IV diuretics in the patient’s home or in a community by patients and carers (BHF, 2014).The programme was led by heart failure specialist nurses working within existing community heart failure teams and was built on existing evidence that, when compared to other heart failure patients, heart failure patients times less likely to be hospitalised (BHF, 2008). As IV diuretic services become embedded into existing services, community nurses have an important role to play in working in partnership with heart failure specialist nurses to support patients having challenges of delivering IV diuretics in the home.
Excessive exudate production interferes with wound healing and has a detrimental effect on patients’ quality of life. Exudate management is crucial as wounds need an optimum level of moisture so that they can heal. Superabsorbent dressings can handle extreme levels of exudate, prevent leakage and reduce the frequency of dressing changes, allowing people to live a more normal life unhindered by saturated dressings that constantly need to be changed. Community nurses will often need to treat chronic wounds and may consider using superabsorbent dressings. The article takes a look at Zetuvit® Plus (HARTMANN), a superabsorbent dressing that is used for superficial, heavily exuding acute or chronic wounds with the author examining its potential role as a wound care option in the community.
Sarah-Jayne Lawson is a registered nurse with ID MEDICAL and currently works as a community agency nurse.
