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Leanne Cook
THE lives led by drug abusers are often made even more desperate by painful, degrading leg ulcers that can remain inadequately diagnosed and treated for year after year. Now a radical new approach to the problem has been devised and piloted by a team that includes a specialist nurse who teaches at the University of Huddersfield.
The scheme operates in the Wakefield area but has now gained national recognition, for it was among the winners in the Royal College of Nursing’s Frontline Innovation Awards, held for the first time this year. The Chief Executive of the RCN, Dr Peter Carter, was impressed and aims to come to Yorkshire to see the project in action.
Addicts who inject drugs run a high risk of damaging their veins and developing leg ulcers. They are also at increased risk of deep vein thrombosis.
“A leg ulcer is often very painful, very smelly and leaks a good deal. All of this adds to social isolation,” says Leanne Cook, an expert on complex wounds, especially those that affect veins. She is a lecturer-practitioner in the University of Huddersfield’s School of Human and Health Sciences and employed as vascular nurse specialist by the Mid-Yorkshire Hospitals NHS Trust.
She adds that people with a history of drug dependency often lead such chaotic lives that it can be difficult for them to gain access to proper health care if they develop leg ulcers.
“Very often they have a history of being abusive and so they have been kicked out of their GP surgeries and no pharmacist is willing to supply them. So we decided to develop a pathway that took them out of all that,” says Leanne.
The award winners with RCN’s Dr Peter Carter. Leanne is pictured in the centre at
the back.
It is based around the Wakefield Integrated Substance Misuse Service, and one of the important innovations is that its nurses, whose expertise was often in mental health rather than wound care, have been trained to treat leg ulcers. In the past drug abusers would pay repeated visits to hospital A and E departments, but they now know to visit the Wakefield drugs team instead.
And the treatment they receive goes way beyond their ulcers. The nurses attached to the drugs team, in addition to their extra skills in wound management, are also trained to dispense help and advice over issues such as housing and problems with child care.
“The aim is to achieve reintegration into society, not just the treating of a leg ulcer,” says Leanne, who attended the RCN’s awards ceremony in London, alongside the Wakefield drugs team’s lead nurse Karen Jordan and well-being nurse Sheila Hayward.
The new pathway has been operational for a year and has dealt with about 50 patients. There have been some notable successes.
“One lady had suffered from ulcerations for nearly six years. When I saw her she never even came out of the house to collect her prescriptions or her methadone and she had two young children,” says Leanne. “We have managed to heal her and she now has gone the whole cycle and is a key worker within the Wakefield drugs team. She is educating future clients about her journey and that is a great inspiration.”
The new pathway itself is proving an inspiration and may now be adopted by prisons in the Wakefield area. If the RCN’s Dr Peter Carter makes a personal appraisal of the scheme, it could be the model for similar projects throughout the country.
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