Introduction

Musculoskeletal disorders are the most common causes of disability in developed countries throughout the world. Musculoskeletal disorders consists of the many rheumatological conditions and also trauma and other injuries that affect the musculoskeletal system. In the UK a significant rheumatic disease affects one in seven of the population. Arthritis, which is severe inflammation of the joints, is one of the leading causes of disability causing intense pain, restricted movement and in some cases disfigurement. The two most common forms of arthritis are rheumatoid arthritis and osteoarthritis.

Rheumatology nursing is one of the fastest growing specialities in the profession. Although there have always been nurses caring for patients with rheumatological conditions, the recognition of rheumatology as a distinct nursing specialty dates from 1981. The complex needs of patients with rheumatological conditions demand that nurses in the specialty need to have mastery of a range of nursing skills. Primary among these is the ability of nurses to work as partners with the patients and their families at various stages of their illness and to maintain the cohesiveness of the partnership in the face of shortage of staff and changes in the organisation of care delivery.

Rheumatic diseases are chronic conditions and the nature of the disease is that patients require different types of nursing input at different times. The nursing input can vary from the very essentials of nursing care such as help with the activities of daily living, pain management, maintaining tissue viability and patient education to highly technical activities such as intra-articular injections and the management of intravenous infusions. The recent changes in service delivery in the NHS has resulted in a shift from acute services to community services and in many trusts the majority of rheumatology patients are seen in the outpatients department and the community. These changes in the location of service delivery have led to development in the type of service delivered and many of these changes have led to developments in nursing roles.

In the Leeds Teaching Hospital Acute Trust patients with musculoskeletal disorders are treated mainly by the rheumatology or the orthopaedic services. Patients with rheumatology conditions may also have shared care by multiple specialist consultants in cardiology, dermatology, respiratory, renal etc.