Compassionate leadership in district nursing: a case study of a complex wound

Fear of malignant fungating wounds

BACKGROUND

The poor prognosis and clinical presentation of malignant fungating wounds (MFWs) can lead to service users experiencing various dimensions of fear.

AIM

This article encourages district nurses (DNs) to explore the psychological factors associated with MFWs in the community setting.

METHOD

The reviewed literature discusses DN practice, with supplementary sources utilised to provide a wider perspective on the multifaceted nature of the subject.

FINDINGS

Guidelines advocate that DNs should promptly initiate dialogue to address fears, establish trust and enable service users with MFWs to express concerns, thus facilitating a holistic provision of care. It is crucial to leverage the multidisciplinary team and engage with other agencies to provide support for service users. Effective leadership qualities play a vital role in initiating practice changes that ultimately benefit service users, while also considering clinical governance aspects.

Diabetic leg and foot ulcers: how district nurses can promote wound healing through blood glucose control

Diabetes is a chronic and often life-long condition that is a consequence of the blood glucose level being too high (National Institute for Health and Clinical Excellence (NICE), 2019). Diabetes covers a range of conditions such as type 1 diabetes, type 2 diabetes and gestational diabetes. It has been well documented that uncontrolled blood glucose levels can lead to further circulatory damage, which impedes the wound healing process and often results in chronic wounds that do not heal. This article uses data collected from an audit and explores how district nursing teams can improve wound healing for those living at home with diabetic ulcers (DUs) by regularly monitoring blood glucose levels. This is followed by a discussion on how district nurses can support their team to adapt best practice, and the benefits of regularly checking blood glucose levels, even for service users that manage their diabetes with diet or oral medication. The article also explores how the multidisciplinary team can be accessed and used efficiently and how leadership skills can improve service user care and safety.