- 04 September 2020
- 18 min read
GP Nurses: What To Expect From Your JobSubscribe To Advice
GP Nurse, Claire Carmichael, gives an overview of what you can expect in your first role as a General Practice Nurse, what will be expected of you and why it’s such a fulfilling career choice.
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Hi everyone, my name's Claire Carmichael, I'm a newly qualified General Practice Nurse and I'm here today to tell you what to expect if you want to go into General Practice Nursing.
So first things first, I'm just going to quickly do a brief overview of every single thing, well not everything, this list is not limited to, by no means at all, but I'm just going to go through a quick list of things that you would do in your role as a General Practice Nurse.
Just so you can get an overview firstly, if you don't know that sort of thing.
Just so you can sort of see the amount of variation in GP nursing.
And for this one, I'm going back to basics.
I'm actually getting a part script for this because there's so much stuff that a GP Nurse does, I physically just, I don't want to miss anything on this vlog.
Other clinics might be different because GP clinics do their own thing in a way.
One GP might do minor injuries and minor surgery and that sort of thing, whereas, other bonds might not do that sort of thing.
What Do GP Nurses Do?
Okay, are you ready?
So you will do hypertension clinics, diabetic clinics, asthma clinics, travel vaccines, flu vaccines, baby vaccines, ECG's, minor surgery like I said, setting up and assisting the doctor with things like toenail removals or wart removals, new patient health checks, blood tests and results, mental health assessments, home visits, smear testing/cytology, sexual health and contraception, wound management, leg ulcer dressings, compression management, things like that.
A lot of health promotion and health prevention, communicating as well with your team to the mental health services, your doctors, your receptionist, pharmacist, phlebotomist, paramedics, there's all this really good integrated team now in GP land.
Calling patients as well to booking their appointments and follow-ups, telephone consultations, to enforce preventions and assessments and frailty assessments as well.
Things like that on patients, because you want to protect those patients and also safeguarding as well, so anything you see that you think, "Oh".
You have to refer onto your safeguarding leads.
That's quite big as well.
Especially if you're doing things like baby 'ims' or dealing with someone with dementia or learning disabilities, you have to be really mindful of these sorts of things in the background.
And you will also see a whole range of patients.
So, you'll see from a pregnant lady to new-born baby, all the way to the baby growing up, all the way to teens, all the way to adulthood, all the way to elderly and end of life or palliative care as well.
You'll see a whole range of things, and it's just amazing.
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What Is Expected Of GP Nurses?
Now I've spoken about all the weird and wonderful things and amazing variety that a GP Nurse does, I just want to talk about, okay, so what is expected of you as a nurse?
Because, there is a lot there.
How are you going to learn all of that?
What's expected that as a newly qualified nurse as well, going into that sort of thing, how are you going to get to know how to do everything?
If that makes sense.
So I'm just going to run through some little things for you.
As a new General Practice Nurse, whether it's newly qualified or whether you've come from the hospital, acute sort of sector into general practice, you will have your induction when you go in and this can vary from place to place and person to person, for me, because I'd had a general practice placement, I knew the EMIS system already that we were working with and there's a lot of things that could do already.
I felt a lot more comfortable and confident to start my own clinic sooner.
Whereas, you might not have that, you might need a lot more shadowing, a lot more training and stuff like that.
Firstly, it's about being open and honest and being comfortable and confident and competent in what you're doing.
Make sure you speak up if you're not confident to do something and make sure you get that extra training, if you need it, that's the most important thing going into general practice because at the end of the day, this is patients lives, patients safety, and that's got to be at the forefront of your mind as well.
So just take it easy step by step and get that training to start off.
What Extra Training Is Required Of GP Nurses?
The bits of training you'll have to start with is you have your normal induction, fire safety, health and safety, information governance, all those little things.
You might get someone watching you, if you're already doing bloods, for example, I already did bloods in sexual health, so they just wanted me to just do a little refresher and do a competency thing sign off.
I sat with the Nurse and I did all the bloods and she signed me off to say, I was competent to do that.
So just little things that you can do will have to go off on a competency list as well.
Also, for this there's the amazing Queens Nursing Institute or QNI for short, their website, I'll put the link below, they've got an amazing general practice template.
It's just fantastic so have a look at that website.
There is a whole induction template specifically for GP, which is what I printed off and I've gone by.
It's really, really good, really helpful.
Just make sure you follow that as well and have a look at it.
Next you will, if you haven't got those skills already, so if you can't do baby immunizations, I can't do baby immunizations, I never got trained that at a university, so that's a separate course I have to do, also smear tests, but I have the separate training for that.
So anyway, there's a separate course called the Fundamentals of Primary Care course, and you go to Uni one or two days here and there just to learn those skills and then you take it back to your practice and then you implement them all.
I start my primary care course in September, I'm so excited. It was put off, it was due the start of the year, but unfortunately COVID and the pandemic hit, so it has been put off to September and it is actually part of it is online as well, which it's a bit sad, but it's okay, I know the reasons why.
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An Overview Of GP Training Courses
I'm just going to run through that really quickly with you.
You can sort of see what you're doing on your primary care course when that time comes for you as well.
This is my timetable that was printed off mind is through the Portsmouth campus.
This is where I'm doing all of mine, other campuses and other areas might be different.
They might edit it and tweak it slightly and you might be on a slightly different structure if that makes sense, but these are the things I'm doing.
So 23rd of September is my course overview, inductions and all of that.
Then I'm on the 6th, 7th, 20th, and 21st of October, so four days in October, I've got the history of general practice and clinical governance in primary care.
I've got infection control, portfolio assessment and overview, and then I go straight into cervical screening for the final two days in October.
And then November the 10th, 11th, 24th and 25th, four days again, I've got immunizations, immunizations again for two days, I've got wound care and leg ulcers for a day, and then I've got portfolio reviews and individual tutorials on one day, and then we go into December.
December the 8th and 9th, I have consultation and communicating with patients, impact of long-term conditions, and ear care.
And then we go to January, I know, January the 12th, 13th, 26th and 27th, four days again, so we've got a group seminar and introduction to essay, didn't expect to write an essay on this not going to lie.
That's level six and then level seven introduction essay again.
And then we have a reading day on the 13th, I'm assuming I'm going to knock out this essay in that day, maybe. And then on the 26th of January, we've got the skills lab for vena puncture, which is the blood testing, and interpreting the results, which I can't wait to do that side of it because at the minute I'm sort of learning online and trying to work out what's what.
And even though I can take blood, it's the results bit that, yeah, it gets me sometimes.
And then we've got sexual health.
And then February the 9th, 10th, 23rd and 24th, we've got integrated care, we've gotten to the introduction to the essay bit as well, part B apparently, health promotion, cardiovascular disease, and ECGs, common mental health presentations.
Yes, yes, yes
We need this in GP because we see so much of it, it's unreal.
Even on the wards if you're in the acute sector, you see a lot of mental health issues.
I'm so glad that, that's in there.
Dementia, child and adult safeguarding, which I've done a bit of that anyway.
Going into March 9th, 10th, 23rd and 24th of March we've got diabetes, aspirin COPD, accountability, managing HCAs.
I don't like the word managing HCAs, that sounds like I'm going to be like...
Maybe collaboration with HCAs would be a nice one.
Okay, individual tutorials again, assignment surgery.
Assignment surgery, no idea.
And then another reading day in April the 20th and then April the 21st is our last day.
So there's a review of the course, evaluation and wash up.
Learning On The Job
But yeah, so that is the overall of your course, so you're going to get all of those extra skills that you need to become a GP Nurse and the rest you're going to be learning on the job with the other Nurses as well.
Just sitting in and listening to other people's consultations as well, you might get chance to sit in with the doctors as well.
If you've got any extended people, like the phlebotomist might come to your surgery, I know a surgery that I did my placement on, they didn't really do the bloods as much, they had their own dedicated phlebotomist that came in and did all that.
That was actually really useful.
It took sort of the pressure, I think, off of the Nurse as well.
We have amazing HCAs where I'm working now, we've got two that do all of, mainly of the blood testing and one of them actually has taken on a lot more now.
So, she's doing a lot more wounds and leg ulcers and compression.
The HCAs are amazing, there's such a benefit to any setting anyway.
How The Hours Can Vary As A GP Nurse
Your hours as a GP Nurse.
Your hours might vary from place to place, because again, everywhere’s different.
It's really hard to pinpoint these things down in GP because everyone does something different clinic to clinic.
It's a little bit frustrating in that way but find the right clinic for you that's going to give you the best career development and choices and flexibility.
A lot of them are very flexible because they are based around family centred, and they're really, really nice like that, it is a nice community actually in GP land.
But anyway, the hours that I do, so I do four days a week, I used to do five days a week.
I used to do three long days and two short days, but then I felt, because it's quite a drive where I'm at, it's like 22 miles from my house.
I spoke to the management teams and I cut mine down into four days.
So now I do four long days, half eight to half six, and I have Thursdays and weekends off, which is amazing.
It's so nice, it's so much better to do it this way.
What To Realistically Expect In Your Practice
What realistically to expect in your practice as you're working, there's two sides to this story.
One side as a Practice Nurse.
I feel, wow, so overwhelmed some days because I'm so busy, I've got so much to do, I've got so much to remember, I've got so much document and you've only got a short space of time between each patient to do everything in.
You do feel very busy, very like, "Oh my God, oh my God, oh my God".
However, you do get into a nice flow and a nice routine.
Unless, something goes wrong.
If something goes wrong, then all your patients are going to be waiting in the waiting room.
But that's okay, again it's about communication as well with your patients.
So if you're running behind, if something's happened, get reception or go out yourself and just say, "I'm really sorry, something's happened, there is a bit of a delay, I'm really sorry".
And do you know what, that's the main thing I've found with patients, they just want to know what's going on.
They want to know why they're sat there for 20 minutes waiting for their Nurse when their appointment was 20 minutes ago, and they haven't seen anyone coming out your room.
They think that you're just sat there.
It's really, really important to just be open and honest with your patients and communicate with them because that's where it sorts of starts going wrong, that's when patients start to complain to a reception, that's when they write complaints and referrals and all sorts goes on.
So yeah, so just be mindful of that.
Then you have the positive next side, it's so rewarding, it's such an amazing career and you will go home thinking, "Do you know what, yes, I did the best for my patients today, I really helped that patient today. I prevented a stroke. I prevented a heart attack. I prevented sepsis. I've really helped this person in their mental health crisis, and they've gone out of here smiling instead of crying when they come in".
You're going to feel just this amazing, overwhelming sense of, "Wow, what have I done today? This is amazing".
And it's those days that just make all of the difference. And you just think, "Yes, this is why I've come into this role".
But at the same time, it is hard work, you really have to be dedicated to this role.
You have to be confident in your abilities.
You have to be open and honest.
But above all it is amazing.
What To Expect From Your Patients
I've spoken about expectations in your practice and I briefly spoke about patients getting a little bit miffed.
This is expectations, what it's really like dealing with the public.
And again, it's such a variety.
Some patients are really lovely, really understanding, they'll be just, they won't want to bother you at all, but actually they really need it.
I've had patients with things happen to them and I'm just sat there like:
"Why haven't you told me this? Why haven't you said this?"
And they go, "I don't want to bother you".
I was like, "But you need to bother me because you could be having a heart attack, you could be having a stroke, you could be up having DBTs".
Whatever's going on in that person's life.
These are the people that never say anything.
And then you've got other patients who want everything and beyond, and they can't understand why you can't do it for them because you're a Nurse, you should know this, or you should do this.
And you're just like, "I literally can only do so much".
And nothing you do will be enough for the odd person, I have to say the odd person, because that's not realistically everybody, it is just the one or two people.
That's just the way they are, that's them as a person, that's what they're expecting, they've got high expectations of Nurses and doctors.
Maybe they haven't been treated well in past by healthcare profession.
So, they've got this different side to things.
You just have to be mindful that that person might be going through a lot.
They might be going through things that you don't know about, so it's about respecting them, even though they're not very nice sometimes, it's about respecting them, being your best self for that person and still treating them as a person.
However, if someone is getting physically aggressive or verbally aggressive, no, don't stand for that.
Because I think as Nurses, we think, "Oh, we have to treat everybody".
But if someone's coming at you attacking you verbally, no, that's not okay.
If you let them get away with that behaviour, they're going to be like that time and time again.
They're going to keep doing it.
So, you need to just, obviously professionally and politely, and to say:
"Do you know what? This isn't acceptable. I'm here to help you, I'm not here to get verbally abused or whatever. Continue this you'll be out and off the books. So, it's your choice".
No one in healthcare should ever be verbally or physically abused.
Luckily, it's been okay at our place, it's been all right.
What It’s Like To Be A GP Nurse
So just as a final overall round thing, what to expect as the GP Nurse.
Overall, do you know what, it's a very different set into the acute setting.
You will notice the change like that, like in an instant you'll be like, "Whoa, this is a whole different culture. This is a whole different breed of Nurses. This is a whole different breed of management".
And overall, I think, this is just my own personal opinion from when I was on my placement to this placement to other GP Nurses that speak to, overall, it's an amazing place to be.
And the way things are managed are so much better, and the way that people communicate with each other is so much better, and GP Nurses are so much better.
Everything just is so much better for me.
However, that might not be for you.
It's about finding what you really want as well in life.
If GP's not for you, then that's okay.
Find your speciality because as long as you're happy, that's all that matters.
GP for me and many, many Nurses, it's amazing and it's a long fulfilling career ahead of you.
So yeah, good luck guys.
Let me know in the comments your thoughts on becoming a GP Nurse and what I've said about what to expect - let's chat there!
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