Practice Nursing-What are we going to do?
With more nurses leaving the UK each year than arriving from abroad, there are staff shortages across the profession and this is acutely felt in primary care. Additionally, an impending retirement is coming, with many older nurses in primary and community care. We urgently need to draw more student and newly qualified nurses to pursue a career in general practice, and training is key to this.
90% of all patient contacts occur within general practice and practice nursing is a great chance for nurses to work at the heart of the community, with exposure to a widespread and diverse case load and the chance to make a difference to the outcomes of patients.
In 2009, just 16% of practice nurses work full-time with 82% working part-time and 1% occasional/various hours or part of a job share.
The Department of Health said that in 2013 there were 14,943 full-time equivalent GP practice nurses, compared with 14,695 in 2012, a 1.7% increase.
In a recent survey 86% of practice nurses spent their time in clinical activity compared to 69% of other nurses. Just 16% of practice nurses work full time.
What do practice nurses do? This is a question I am often asked. The truth is it varies from practice to practice and nurses to nurse. Some practice nurses are doing very skilled and specialist roles such as diabetic clinics, asthma and COPD clinics. Very often they are the ones who will alter the patients treatment according to their clinical findings and diagnosis. Practice nurses are skilled in childhood and travel immunisation. However, some are doing duties that Health Care Assistants (who are trained) can do.
I have often found whilst talking with practice nurses that they feel threatened by the HCA role. That’s somehow the HCA is taking over their roles. This is simply not true. Its important to understand that resources are scarce and we must be mindful of matching every team member to their abilities and tasks for which they are trained. It is in fact freeing up the practice nurses to be able to take on more specialist roles using their skills and abilities. However, we must acknowledge the importance of training and regular updates, which are essential.
With nurse revalidation due in 2015 practice nurses will need to demonstrate competence and skills that are relevant for the roles they undertake. Every nurse and midwife will be required to confirm they:
- Continue to remain fit to practise.
- Have met the requirements for practice and continuing professional development.
- Have sought and received third party feedback which has informed their reflection on their practice. This feedback could be from patients, carers, students (for educators) or peers.
- Have sought and received third party confirmation that they are fit to practise. A third party (likely to be a manager, another registrant or a supervisor) will need to confirm that the nurse or midwife is adhering to the Code and standards, and is fit to practise.
So we must provide a career framework in general practice so nurses of today and the future can easily access careers in general practice. We must do this now as there are many practice nurses due to retire in the next 2-3 years.
MA, BSc, RGN, PGCert, INP,ANP
Annie Barr Associates