Viewpoints Resources

The Queen’s Nursing Institute (QNI) is one of a number of charities that will receive additional support from the Covid-19 Healthcare Support Appeal (CHSA) this year. The funding allocated to the QNI will be used to support community nurses in financial need over the next 12 months. The new money from CHSA is specifically for nurses whose financial circumstances have been impacted by the pandemic and is one of several initiatives it is supporting across the voluntary sector.

Covid-19 has had a severe impact on everyone’s lives, but the past year has been exceptionally challenging for nurses and healthcare workers battling the pandemic on the frontline.

There are striking parallels between the experiences veterans faced in conflict to those which healthcare professionals continue to face in the fight against Covid-19. Any traumatic event — whether a global pandemic or experience of war — takes its emotional toll. Repeated exposure can overwhelm the nervous system and lead to burnout and trauma fatigue.

Hourglass is the only charity in the UK focused on the abuse of older people and safer ageing. The charity rebranded from Action on Elder Abuse in March 2020 and receives around 8,000 calls from those affected by older abuse throughout the year. Currently, Hourglass is calling for amendments to the Domestic Abuse Bill, so it better reflects the challenges and reality faced by older people throughout the UK. The seriousness and level of abuse taking place has been pulled into harsh focus by recent lockdowns. Hourglass wants to ensure that all victims, especially from older groups, receive the legal and

World Continence Week (WCW), taking place from 21–27 June, is an annual health campaign run by the World Federation for Incontinence and Pelvic Problems (WFIPP). The campaign highlights the impact that urinary incontinence can have on people’s lives and encourages sufferers to seek help to improve their quality of life.

Malnutrition (or undernutrition) affects at least three million people in the UK (1.3 million are over the age of 65), with 93% of these living in the community (British Association for Parenteral and Enteral Nutrition [BAPEN], 2018). Malnutrition has an estimated cost of £19.6 billion in England, with older adults (≥65 years) accounting for over 50% of this cost (Stratton et al, 2018). Malnutrition has adverse effects if unidentified and untreated.

A chronic leg ulcer is defined as a defect in the skin below the knee that has persisted for more than two weeks and shows no sign of healing after three or more months (NHS, 2019). Lower limb and leg ulcer management presents a number of global health challenges in terms of nursing resources, wound care dressings and high recurrence rates. Also, the persistence and recurrence of lower limb conditions can lead to physical and emotional distress for individuals and their families, contributing to depression, lack of esteem, self-neglect, social isolation and loss of income.

The nutritional consequences of Covid-19 are not yet fully understood, but knowledge from acute respiratory distress syndrome (ARDS) suggests that patients are likely to experience skeletal muscle dysfunction, which can persist for weeks to years (Files et al, 2015) and impede return to pre-illness status. Many of the signs and symptoms noted to frequently persist after acute Covid infection, such as breathlessness, fatigue, loss of smell and taste and inflammation, can impact oral intake and potentially worsen nutritional status (Arnold et al, 2020; Carfi et al, 2020; Doykov et al, 2020; Mandal et al, 2020; Sudre et al, 2020).

The last 12 months have highlighted the vital contribution that nurses have made in treating and caring for patients across the globe during the Covid-19 pandemic. At the same time, clinical research has been placed in the spotlight, as breakthroughs in treatments for, and protection against, Covid-19 have only been made possible due to pioneering and innovative clinical research trials. This dual focus on nurses and clinical research creates a real opportunity to highlight the research that nurses are undertaking within their own areas of clinical practice to raise the profile of research within the nursing profession.

The Covid-19 pandemic has put the UK health and care workforce under unprecedented pressure. For nurses, the pandemic has highlighted and exacerbated many issues that predated the pandemic, including inequalities, inadequate working conditions and chronically excessive workloads. The recent King’s Fund report, The Courage of Compassion: Supporting nurses and midwives to deliver highquality care, investigated the key changes to working environments of nursing and midwifery staff needed to enable them to flourish and thrive at work (West et al, 2020). This piece draws out some of the key findings from the research and asks what needs to be done to better support nursing staff working in the community, now and into the future.

In 2020, the Queen’s Nursing Institute (QNI) was funded by NHS England and NHS Improvement (NHSE/I) to create a resource to support nurses working in the community who are caring for people in recovery after being infected with Covid-19 — Living with Covid-19 (Long Covid) and Beyond (www.qni.org.uk/wp-content/ uploads/2020/12/Living-with-Covid- 19-Community-and-Primary-Care- Nursing-Resource.pdf).