In a national first, Counties Manukau Health has created the role of community dermatology and infectious diseases nurse specialist.
Kusum Narayan works in their own homes with adult patients experiencing complex recurrent skin conditions, to help prevent their readmission to hospital.
The newly created role sits under general medicine and was developed with input from dermatologists and infectious diseases specialists. This is the first time a community nurse role has combined dermatology and infectious diseases.
Mrs Narayan says she sees conditions of complex eczema and recurrent cellulitis. Her role is to help educate people on the best ways to handle their skin condition, including how and when to apply topical treatment.
Because the nurse specialist role is community focussed, Mrs Narayan is able to see first-hand the challenging circumstances of some patients, and the way these contribute to their complex skin conditions.
“It’s not just cellulitis that I’m seeing. It’s not just eczema. You see first-hand the challenges some of these people are facing,” she says, noting there are over 2000 skin conditions in existence.
“There are a whole range of things going on with their lives,” Mrs Narayan says, adding factors which impact on patients’ health may range from poor health literacy, financial hardship, unemployment, social, family, and relationship issues to patients not taking their medication.
She says she is also able to explore more innovative multi-disciplinary ways to assist these patients, calling on other services such as the patient’s GP, practice nurse, Fanau Ola community case managers and district nurses, as well as family members or care givers.
Mrs Narayan says that in an acute setting (in hospital) the focus is on stabilising the patient, whereas there is more time to look into underlying causes within community based treatment.
“Also I don’t think the patient always takes in the information that you are giving them when they are in an acute environment,” she says.
“Working with and alongside patients in the community, and understanding their individual situations has provided me with insight and deeper understanding of my new role.”
Currently, all referrals made to the clinical nurse specialist are either via the dermatology or infectious diseases team.
Consultant dermatologist Paul Jarrett says Mrs Narayan’s appointment is a welcome one.
“Kusum has already begun to positively impact the lives of patients with complex skin conditions in the South Auckland community,” Dr Jarrett says.