The Queen’s Nursing Institute (QNI) has published an updated resource for community nurses caring for patients with long Covid.
The updated resource has replaced a previous version that was commissioned by NHS England and NHS Improvement and published by the QNI in December 2020, when long Covid was emerging as a serious consequence of the pandemic, but was still poorly understood.
“It takes a long time to see any improvement to long Covid symptoms. It’s not a quick fix”
According to the latest figures from the Office for National Statistics (ONS), an estimated 2.1 million people in the UK were experiencing self-reported symptoms of long Covid as of 1 October 2022, nearly a quarter of whom have had the condition for at least two years.
Long Covid was most commonly reported by people aged 35-69, women, people living in more deprived areas, those working in social care, unemployed adults who were not looking for work, and people with another health condition or disability that reduces their mobility.
The most common symptom of long Covid was fatigue, reported by 70%. Other common symptoms include difficulty concentrating (45%), shortness of breath (42%) and muscle aches (42%), according to the ONS figures.
The updated QNI resource highlighted that long Covid is best considered as a multi-systemic condition and that nurses will need access to a multi-disciplinary team to ensure patients with the condition are getting the right support.
It set out the eight main areas that nurses should focus on when supporting patients still suffering symptoms more than four weeks after a Covid-19 infection. These are: mental health, wellbeing, education, physical health, self-care, spiritual care, patient finances and co-morbid conditions.
The resource suggested factors that should be considered during nursing assessments of each of these areas, the types of care and treatment approaches that could be appropriate, and included links to tools that may be of use.
Queen’s Nurse Maggi Bradley is a general practice nurse in West Lancashire who organised a video group clinic for patients with long Covid.
She welcomed the updated QNI resource and said it would be relevant to many community nurses managing patients with this complex condition that can require long term care.
“It takes a long time to see any improvement to long Covid symptoms. It’s not a quick fix,” she said.
She added that it was important for general practice nurses to have long Covid in mind when seeing patients, as many of the symptoms, including fatigue and brain fog, are similar to other conditions such as menopause and dementia.
“Very often someone will come in with something that is a long Covid symptom, so it’s really important to think about it,” she said. “You’ve got to always factor it in as part of your assessment of the patient.”
Ms Bradley, who is clinical nurse lead for the Sefton Training Hub, added that it was important for student nurses to learn about long Covid.
“This is going to be around for a long time,” she said.
Dr Alison Twycross, nurse academic and founder of the group Long Covid Nurses and Midwives UK, welcomed the new guidance, and particularly its inclusion of children and young people and how it highlighted the role of nurses in assessing those with the condition and signposting them.
However, she was “disappointed” that the aspect of long Covid the resource focused on “first” was mental health.
“While this may not have been intentional, it feeds into the perception among some parts of the health service that long Covid is primarily psychosomatic rather than mental health issues being caused by having an illness that severely impacts everyday life,” said Dr Twycross, who has had long Covid since 2020.
She stressed that guidance documents should also focus more so on addressing underlying causes of symptoms, rather than just on wellbeing and learning to live with it.
The updated QNI resource, titled Living with Long Covid A Community and Primary Care Nursing Resource was launched at the QNI’s annual conference in October.
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