And how does that make you feel? A Practice Nurse’s view.
When I was a teenager, I went to see my local Practice Nurse for some routine testing. I marvelled at how kind she was, at how she seemed to listen to me and how effortlessly empathetic she was. From a superficial level as a patient, you see a caring person who is helping you in that moment with something specific. However, what you don’t see is the holistic view that they are taking. They are looking at your general wellbeing, your tone, listening intently for any signs that you may need extra help.
So when I joined Practice Nursing, I didn’t know that there was a much bigger picture to look at, a wider perspective that you may miss if you don’t look carefully. From my time as a Practice Nurse, the majority of patients that I saw needed more help than they were expressing, and often they had some sort of chronic or underlying condition. My role was to assess how I could best help this patient in the limited time I had, which often was in the area of 10 minutes. I found that the numbers of people who were smoking, avoiding cervical screening, and those with larger BMI’s were increasing.
This is where my interest in public health was born. I wanted to find out how I could stop this, or at least help with education on these subjects to decrease the prevalence and therefore improve people’s general health and wellbeing. This all would have a positive impact not only on the person and the wider community.
The follow up programmes for these types of chronic conditions or lifestyle choices were lacking. There were so many people who hadn’t had their smoking or drinking habits noted down in several years, and there was no protocol in place to audit this. There was a similar issue with cervical screening, where a lot of women were declining the procedure with no auditing in place for the practice.
In my 4th year as a Practice Nurse I took on a new role in a new surgery as Head of Diabetes, which was daunting as it was previously run by the lead GP of the surgery who had around 40 years experience in the field. I took it in my stride and tried to assess how I could best help the surgery, as they were concerned about QOF (Quality Outcome Frameworks) but I was concerned about the patients, the rising HBA1c levels and the lack of time during consultations to cover the full scope of the issue. I had a meeting with the lead GP and discussed this with him, explaining that if we spent more time with the patient to fully explain the disease, diet and exercise then the outcomes were more likely to be positive. In the end the GP decided to keep the short consultation times due to lack of nurses and time constraints.
This all left me feeling very deflated, like no matter how much I tried to make a difference, I was only able to make a difference on a very superficial level. I was able to help my patients once they got to the point of having a chronic disease, however, I wanted to help them before that. I wanted to be able to educate and help on a wider level, and make a difference to the lives of many people across the UK and beyond. I initially saw Practice Nursing as a treatment based career, however, it has led me to see that much more can be done for preventative healthcare.
