Resources

There have been many renowned leaders throughout history. Alexander the Great. Cleopatra. Winston Churchill. Liz Truss… OK, maybe the last one is a bit of a stretch, but many civilizations have been defined by a single inspirational leader who was able to bend circumstances to their will.

To a much lesser extent, the same is true in any workplace. Someone has to make  decisions and drive strategies or ideas, otherwise nothing would get done. But what is it that makes a great leader? What qualities make people follow one person and not another? 

The Queen’s Nursing Institute (QNI) and the National Garden Scheme (NGS) have  announced five new gardens and health projects led by nurses taking place in 2023.

The five projects are all led by nurses working in community settings and seek to improve the health of local people. Many projects supported by the QNI go on to become part of
mainstream services. All this year’s projects will run until early 2024 when they will submit their final reports.

In an exceptionally challenging  labour market for healthcare workers, Leeds Community
Healthcare NHS Trust recruited over 100 local people for local jobs, reaching deep into communities to tap into a diverse talent pool and tackle unemployment. The trust innovated new ways to recruit, engaging with local people to overcome barriers in the
recruitment process.

In the UK, nursing remains a predominantly female profession, with only 11% of registered nurses identifying as male (www.nurses.co.uk/blog/stats-and-facts-uknursing-social-care-and-healthcare/). This disparity is even more pronounced in specialties focused on children and young people (Nursing and Midwifery Council,
2022). However, the University of Northampton has observed that there is growing recognition of the valuable contributions male nurses can make to the field, leading to efforts to increase their representation throughout the nursing workforce.

Use of technological-based solutions for healthcare specialities has become favourable worldwide and, in the author’s opinion, digital healthcare is revolutionising the medical arena.

Lower limb ulceration continues to be a common cause of suffering and its management places a significant burden on the NHS, with venous leg ulcers (VLUs) being the most common hard-to-heal wound in the UK. It is estimated that over one million patients in the UK have lower limb ulceration, of which 560,000 were categorised as VLUs at a cost of over £3 billion each year. Although self and shared care in chronic disease  management is not new, historically wound care and specifically lower limb management has been undertaken solely by healthcare professionals. This article outlines the results of implementing a lower limb wound pathway (Wounds UK, 2016), and a lower limb self-care delivery model measuring clinical outcomes and the impact on workforce pressures through limiting face-to-face healthcare professional contact up to one appointment every six weeks, when capacity and capability criteria are met. A suitability assessment was conducted and, when appropriate, patients were
managed using a self-care delivery model. Patient data were collected, anonymised and independently analysed, comparing time to healing against data on file from a previous audit using the lower limb wound pathway (Wounds UK, 2016). This highlighted VLUs in 84 of the 95 patients selected for the self-care model had healed by week 24 and a
further 10 patients had healed by week 42, with only one remaining patient reaching 42 weeks without healing. These results support the hypothesis that when suitable, patients with a VLU can self-care and deliver clinical effectiveness without compromise.

A chronic cough is often a symptom of respiratory illness, but it can be brought about by many factors, i.e. smoking, being female, abdominal obesity, low income, environmental factors, allergies, medication and increased age (Colak et al, 2017). Unfortunately, a frequent side-effect of chronic coughing is urinary incontinence (UI) — mainly stress
urinary incontinence (SUI). Although quite prevalent within this cohort of individuals, there seems to be little professional knowledge with regards to interventions to prevent or treat UI. This article looks at the causes of chronic coughing and how it impacts on UI. It also
identifies how professionals can recognise at-risk patients and start treatment options.

The UK has a population of approximately 11 million adults, 18.6% aged 65 and over (Centre for Ageing Better, 2022). Indeed, the demographic profile of the population of England and Wales and primary care records indicate that one in five people are over the age
of 65 in England (Office for National Statistics [ONS], 2018; Robards, 2020). The condition of frailty is more prevalent in the older person, and estimates provided by various studies suggest that 3% of people over the age of 65 in England have the condition (Clegg et al, 2016; Sinclair et al, 2021). Community nurse caseloads are representative of the ageing population of the UK and frailty has been recognised as a clinical condition of the older person (Leary and Bushe, 2022). Early detection of frailty by experienced nurse practitioners can assist in developing a management strategy for the patient in order to inhibit progression of the condition (Ruiz et al, 2020).

Due to its progressive nature, dementia is now the leading cause of death in England and Wales, so a palliative approach to care is beneficial because of its emphasis on supportive care. Many people with dementia also have other comorbid health conditions common
in older age, that in themselves may induce pain. However, people with dementia may have difficulty in understanding what they are feeling and in describing and locating the pain due to having issues with communicating their needs as their dementia progresses. This paper considers the recognition, assessment, treatment and management of pain in older people with dementia. It introduces the learner to what is known about the subject  and why it is important to know the person’s past history and previous ways of self-managing pain and discomfort using information gained from their family, carers and friends.

People experiencing homelessness are generally not seen in traditional models of intermediate care. An out-of-hospital care model for those experiencing homelessness has been established in Leeds. This offers good quality accommodation in community settings with a multidisciplinary team to assess people’s health and social care needs and offer step up or step down from hospital care. This has demonstrated a reduction in emergency department attendances and unplanned hospital stays, as well as an opportunity for people to be included in a home first model. Unexpected outcomes include a reduction in street sex work for the women who have been engaged on the project, less engagement with the criminal justice system, a place to facilitate prison releases, and an environment where end-oflife care can be delivered and achieve preferred place of death. Future investment is needed for out-of-hospital care to be an equitable offer in the city available to all.