SPNA Conference Reports 2006

Review of Nursing in the Community

Alison Jarvis is Project Officer seconded to the Scottish Executive to undertake the Community Nursing Review in Scotland which is being taken forward as an action point from the new policy for NHS Scotland, Delivering for Health.

The review will record what nurses do well in providing modern care for the people of Scotland and make recommendations for the future delivery of nursing services in the community.  Alison outlined a possible draft of a team mix which included a local community nurse (LCN) who would co-ordinate care with Health Care Assistants, Staff Nurses, Specialist Nurses, Advanced Nurse Practitioners and Consultant Nurses.  There was a national conference in March and a consensus conference in May but it was clear that many Practice Nurses present were unaware of the Review and felt that there were more questions than answers—see evaluation comments.  There is a website to view:  www.scotland.gov.uk/topics/health/care/communitynursing/homepage

It is hoped that the final draft will be presented at the end of June 2006.

Obesity in Scotland: why diets, doctors and denial won’t work:

Dr Neil Hamlet Locum Consultant in Public Health Medicine and Ms Fiona Crawford, Public Health Programme Manager

The next session was very entertaining, informative and well received - a scenario evolved between two Public Health experts playing ‘Socrates’ and ‘Panacea’ who illustrated that we're stuck with the metabolic and behavioural legacy of our evolutionary history.  Human beings are naturally susceptible to becoming obese when food is readily available and life is not physically demanding, although some people are more susceptible than others.  Obesity is more common in the UK than in most other European countries, the proportion of children who are overweight is rising and Scottish children and adults are more likely to be obese than their English counterparts.  The potential for this epidemic to spread rapidly was graphically illustrated in a series of slides showing the speed with which obesity has increased among adults in the United States.  It became clear that we need to understand how we arrived at this situation and begin to change the fundamental economic and social rules by which we produce and consume food in order to know what needs to be done at a societal level in order to change it.

Access the website for further information:

www.obesescotland.org.uk

Sexuality and the pulmonary patient: Sharon Haggerty (Assistant Director of Nursing and Clinical Excellence, Hartlepool PCT)

Sharon began her talk by explaining that it would be fun, and intended to be fun, and certainly many of her comments, quotes and pictures made us all roll with laughter.   My favourite of her quotes came from Jane Mansfield:

“Men want women to be pink, helpless and do a lot of deep breathing” (cue the emphysematous patient!).

However, behind the laughter was a serious message about the importance of addressing our patients’ concerns regarding their sexuality.   To do this requires nurses to be prepared to discuss sex with patients, to keep an open mind and not ‘label’ people mentally as probably not concerned with their sex lives, and to offer advice and support where appropriate.

Sharon cited American research which found that, whilst 26% of men and 24% of women over 75 reported they still had intercourse at least once a week, only 34% of people with COPD claimed to have no limitation to their sex lives.   The cause of sexual problems for people with breathing difficulties are many, including fear of failure, anxiety, low self-esteem, depression, coughing bouts, and an alteration of their relationships with partners to one of dependant and carer.   Sharon suggested a number of practical strategies for enabling patients to improve their sex lives, including a guide of suitable positions for intercourse and how to recover afterwards. Her advice has been published in leaflet form, a copy of which is available from the SPNA (this can be photocopied and distributed providing Sharon’s details are not removed from the back of the flyer).

Travel Health Update : Margaret Umeed (Practice Nurse with special interest in Travel Health)

Margaret presented the final talk and concentrated on the problems of Rabies, Yellow Fever and Chikungunya infections and some vaccines whilst encouraging all Practice Nurses to access the Health Protection Scotland website Travax on www.travax.nhs.uk/ which is updated daily and provides an enormous amount of relevant material.

We were given insight into Rabies infection which is present worldwide except in the UK, parts of Scandinavia, Japan, Oceania, Antarctica, Australia, NZ, Malta and some Caribbean islands.   It can be transmitted to humans in several ways, but most commonly via the bite of an infected domestic dog.

Rabies, if left untreated, will always cause death.   If travellers have never been immunized against rabies and receive a suspect bite, vaccination should be initiated within 24-48 hours.   Recent recommendations in England to enable continuation of a Yellow Fever centre will ultimately be initiated in Scotland requiring an annual half day training but without an administration charge unlike south of the border.

Chikungunya is a mosquito-borne viral infection first reported in Feb 2006 which is affecting areas  in the south-west Indian Ocean as well as cases also now being reported from India.   Several European countries have reported returning travellers importing the infection.   As there is no vaccine available and no treatment, apart from anti-inflammatories and analgesics, avoidance of mosquito bites is the only reliable means of prevention.   Those who may be at increased risk include pregnant women, those with immune system problems either due to illness or treatment and those who have a severe chronic illness.

This was an excellent presentation which was well received and healthy discussion ensued resulting in increased knowledge on some current travel health issues.