General Practice Nurse (GPN)

What does a typical week look like?

Monday, I attend my GPN course. I mainly do clinics Tuesday to Friday within the surgery such as baby immunisations, chronic disease management, women’s health, ECGs, bloods.

I also work with our community care coordination team within the surgery. I worked with them one day a week when I was doing my level 4 and then when I qualified I’ve come back to clinic and if there's only one of them in, I will help out, we'll do home visits for housebound and care homes.

What has the primary care pathway looked like for you?

I started here in primary care six years ago, within 12 months I'd gone on to my Level 4 in higher education, completed that, then successfully got a place at Bangor to do my nursing part time supported through primary care. I qualified in January and got a practice nurse job back here, started my GPN in March and will finish in July. It’s been a full on few years, I thought “right, I'm going to do it!” and I've worked my way up and coming towards the end now.

It's always something I wanted to do because I started very young at 16 in a care home and worked there for a few years there. Then I went on to working in the hospital, did three years then I went to Community resource team before the opportunity for primary care came up. I've gone full circle, secondary care, community and now primary care.

What has the GPN programme enabled you to do that you couldn’t in a different model?

It has been really good doing the GPN and it's given me that bit more confidence that I needed coming back into surgery. Because I've worked my way up from being a healthcare to now being a practise nurse, it was a bit of a jump. I am nearly six months qualified now and I'm really comfortable in what I'm doing. It's given me more knowledge, even though I've done the odd session and training, the GPN course just gives you that bit more.

When I first qualified in January, I'd gone on contraception training and travel health training so starting the GPN module I thought “oh, I've done this training, it's going to be a bit repetitive” but it's really not. Each module has been so interesting because we've had a doctor or a guest speaker in to discuss it. Sometimes it's just reading modules. But there's always articles and things that back it up and the other practise nurses reflect on it. It just gives you that that bit more of “okay am I doing things right” or “oh, she does it that way, so maybe I can”.

It's all through Bangor so every Monday morning, we'll have a meeting for half an hour, see how last week's work went, she'll tell us what we've got to do for this week. We’ll have an online session on different topics, last week it was contraception in the morning and dementia in the afternoon. We've had topics from asthma, to diabetes and sexual health then out of all the topics, you pick eight and write a 300 word blog on each. It's a bit like a reflection, if you've dealt with that in clinic, just reflect on it or if not, find some evidence that supports it.

I've got an exam, then it's competencies to get signed off within the surgery. The team here have supported me through everything, they still support me now through the GPN programme, I've got set days where I've been doing my smears training and there's always someone there to support me, which made a massive difference. I've got my lead nurse; she supports me massively in house.

I'm more than happy with everything and where we're up to. I can't fault my experience from my level 4 through to my GPN. My manager, my lead nurse and nursing team, they've all supported me here. I've thoroughly enjoyed it.

What could we have done differently to make it a better experience?

It's been it's been great. The staff at Bangor have been really supportive, my colleagues here have been really supportive. I'm quite lucky that I've gone straight into it from uni, I'm still in that way of the academic writing and the reading all the resources but it is a lot to take in sometimes. Whereas my colleague was in primary care as a registered nurse for six months, and then did the GPN. She found it a little bit better because she already had the basic understanding.

What has been your greatest area of learning from primary care?

That's hard, because I've learnt so much in such a short period of time, I can't say any one of them. I can't say I know exactly what I'm doing and I'm best at any one of them, I've gradually got through them all. I think my most interesting has been contraception and smears, also travel health, which I've learnt to do since starting.

Overall I just think people don't understand how busy primary care is and that's always so frustrating. You go on a surgical ward, you deal with surgical patients. You go into primary care and you've got somebody coming in for diabetes, which then has a leg ulcer, which then relates into their blood pressure being really high, they haven’t had a smear for 10 years. Actually, there's so much to learn in primary care. I love my job. I love primary care, but people don't realise how hard primary care can be.

What does it mean to you to work in primary care? 

It's just giving the patients the satisfaction of their basic care needs being met. When they're coming into primary care a lot of it is their chronic disease management and sometimes they're not very compliant. But if they know you're there and you're going to support them and you're going to make sure that everything's okay and their tablets are all right, they'll keep coming back for the reviews that they need.

It's just building that rapport; I've built a rapport with many patients now because we do have some that come in quite often. We've had a couple that wouldn't turn up and I've seen them and they've come back for me. It's letting them trust you, knowing that you're going to be there. It's hard in primary care, you come in to see a doctor, it's a different doctor every time you come in and it does get frustrating. But knowing as a practice nurse that I can build that rapport with the patients, I just think I can provide the best effective care. From my point of view, yes, it's challenging, but I like to just make sure that patients have been heard.

What are the 3 key skills essential to your role?

Chronic disease management is probably one of the forefront of what we do most within primary care, women's health, contraception and smears is another. It's just your general care of every person that comes through, even if they're coming in for a blood test. Sometimes they just need that five minutes to chat to somebody.

Learning disabilities is pretty close to my heart since coming back to primary care. I worked with patients on the wards and within primary care prior to doing my nurse training. I went on to some learning disability training not so long ago and I’m learning disability champion for my GP surgery now. I tend to do the learning disability health checks and sometimes you do need that little bit of extra time with them, but you don't see the person because they’ve got this learning disability, you see the person for who they are.

Long term, what could make primary care continue to be attractive to you?

I think I've always liked primary care, the chronic disease management. When you're in community, you don't really get to see that side of it, it's more the personal care and mobility and things. But if I knew then what I know now, I'd probably have been able to support them better.

It was a colleague that had come here first and asked if I would like to join the team. There's not very many jobs available in primary care so when the opportunity come, I was definitely going to take it.

What do you aspire to in future? 

I'll stay as a practice nurse and probably look at my prescribing in the future and then go from there. But for now I'll be happy to finish my GPN programme and get all my competencies signed off. I'm on track and I'm doing it, I just want to achieve what I can.