Caring at night for people with multiple sclerosis

An evaluation of a multiple sclerosis liaison nurse

The workload and benefits of a new liaison nurse service for multiple sclerosis patients were assessed by retrospective examination of the nurse's records, interviews with patients and carers, and a postal questionnaire survey of general practitioners (GPs). The average number of contacts with 136 patients in two years was 14. Twenty-one to forty-four per cent of patients were referred to various therapists and 17% for respite care. Eighty-eight per cent of patients found the nurse helpful and 39-54% reported improved coping, mood, confidence and knowledge of multiple sclerosis (MS). Carers reported similar benefits. GPs found the nurse helpful with 66% of their patients, and she detected unrecognized disabilities in 23%. Twenty-three per cent of GPs learnt something about MS from her and 40% of GPs said they would purchase her service from their budget. Patients, carers and GPs felt that the service was helpful and that it improved patients' and families' psychological well-being, reduced GPs' workload and increased patients' and doctors' knowledge of the management of multiple sclerosis.

Improving terminal care at home: can district nurses act as catalysts?

District nurses from eight general practices in Devon attended a 3-day course on 'Improving terminal care for cancer patients at home'. The course was learner-centred. It was designed to motivate the nurses to introduce management changes aimed at improving terminal care in the practices in which they worked. Follow-up over 3 years showed that in each practice improved communication had taken place between the nurses and doctors. The doctors had greater understanding of the nurses' roles and skills.