Most research on resilience in healthcare systems such as the NHS is based on organisational crises, such as nurse shortages, an ageing workforce and financial restrictions. However, nursing can learn lessons from the past to consider how to become more resilient, particularly considering the 2020 COVID-19 pandemic. This article briefly looks at previous pandemics and disasters that have affected healthcare systems, as well as the 2020 COVID-19 pandemic, and considers how nurse leaders can support staff and show organisational resilience during such emergencies. The article also discusses how nurse leaders can develop their own resilience.

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hile SARS is increasing in pre valence throughout the world, there has not been a documented case of severe acute respiratory syndrome (SARS) in pregnancy until early 2003, when Sally* and her husband, Ken*, entered care at Holy Name Hospital in Teaneck, NJ, in March 2003. From March through July 2003, we cared for this complex patient, which required careful planning and communication not only among staff at Holy Name Hospital but with other health care experts including staff in Sally's obstetrician's office and experts at the local, state and national levels. This was the first known case of SARS in pregnancy in the U.S. As such, the health care providers who cared for Sally during this time became pioneers in the development of protocols with the New Jersey Department of Health (NJDOH) and the Centers for Disease Control and Prevention (CDC). As this patient was the only known pregnant SARS patient in the U.S., there was a critical need to balance patient privacy, confidentiality, general care needs and support with a worldwide need for knowledge about the outcomes from SARS infections. *not their real names Sally first entered Holy Name Hospital (HNH) on March 2, 2003, on the advice of her obstetrician via the Emergency Department (ED) complaining of an increase in "flu-like" symptoms. Sally was 20 weeks and 5 days pregnant. Sally's history included a recent trip to Hong Kong to visit her father. While there, she had contact with another relative who works in a health care facility that had reported a large number of cases of "unknown Chinese pneumonia." Upon return to New Jersey, her symptoms had worsened and she was admitted to HNH for medical treatment with a diagnosis of pneumonia. Antibiotic therapy using Timentin 3.1 gm every 6 hours and Zithromax 250 mg IV daily was initiated. Sally was placed on contact and airborne precautions on March 4, and overnight she became increasingly dyspneic, developing rales, decreased breath sounds and poor oxygen saturation. A chest x-ray showed progressive pulmonary infiltrates and on day 3 (March 5), she was transferred to the Intensive Care Unit (ICU) with a probable diagnosis of atypical pneumonia. Meanwhile, a discussion of suspected SARS had begun among her physicians, the infection control coordinator (ICC) and the infectious disease physician (ID). The New Jersey Department of Health and the CDC were notified on March 5 (day 3) by the ICC and the ID prior to the confirmation of SARS. Those agencies then became involved in her ongoing care.

Smoking continues to be the main preventable cause of death in the UK. Tobacco consumption causes a wide range of diseases and other adverse effects, including multiple types of cancer, chronic obstructive pulmonary disease, cardiovascular disease, pregnancy complications, cataracts and osteoporosis. The Government's vision to 'make every contact count' emphasises community nurses' responsibility and key potential to promote healthier living and behaviour. This article reviews the latest evidence on supporting smokers in practice and argues that nurses working in the community are ideally placed to record smoking status, give advice, encouragement and support, refer people to local smoking cessation services and offer pharmacological treatment.

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As chronic obstructive pulmonary disease (COPD) is one of the major causes of worldwide mortality, it is important to prevent, diagnose and manage it. COPD creates a huge burden on the NHS and has a significant impact on patients. This is a problem with the increase in morbidity and mortality rates. In primary care there is a lack of knowledge, under-use of quality-assured spirometry and under-diagnosis in about half of all cases. To be able to effectively diagnose, assess and manage COPD, health professionals must understand the physiology and aetiology of the disease. COPD is similar to asthma in its presentation and physiology but management of the condition can differ. The authors therefore looked at the similarities between the two conditions and what tests one can use to make a diagnosis of COPD.

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Recurrent urinary tract infection (UTI) is one of the most common reasons for long-term antibiotic use in frail older people, and these individuals often have non-symptomatic bacteriuria. This article reviews the literature and recommendations for the treatment of UTIs particularly in the older population (>65 years). It considers the question: is there an alternative for antibiotics for asymptomatic and non-symptomatic bacteriuria in older adults? D-mannose powder has been recommended for the treatment of UTIs, as when applied locally, it reduces the adherence of Escherichia coli. In one study, D-mannose was reviewed for the prophylaxis of recurrent UTIs in women, and the findings indicated that it may be useful for UTI prevention instead of prophylactic antibiotics. There is a lack of information about the efficacy of cranberry products combined with D-mannose in this regard, and this is an area for further research.