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My day: Working as a lead nurse in general practice

My day: Working as a lead nurse in general practice

Naomi Berry, who is the lead general practice nurse at Rooley Lane Medical Centre in Bradford after just three years in the profession, tells Mimi Launder about a day running clinics and supporting her nurse team

I get half an hour before my clinic starts to make a cup of tea, get the computer on, set everything up and check how the clinic is looking. I also review any urgent tasks or notifications. There has been an uptick in urgent requests recently as life returns to normal following the peak of the pandemic. For example, someone might need an urgent wound care appointment having delayed it due to Covid. It is my job to see where we can fit them in but we don’t always have the capacity, so I may have to send them to another clinic. We have been trying our best to see everyone, but our staff are exhausted. 

The first clinic starts. I have set clinics every week, each with a particular focus, such as asthma, babies, smear tests, ear irrigation or diabetes. During one clinic, a nurse might see 15 to 20 patients. I prefer to hold set clinics, as we get a better flow than if we mix them up. If I’m on a smear day, I’m on a smear day, and that’s what I’m doing. However, I do make sure that we see people in between appointments if it’s important.

I grab a much-needed 10-minute break after my first clinic. If there’s time, I’ll have another quick cup of tea. My next clinic takes me until midday, after which I spend half an hour checking the fridges, cleaning the room and disposing of waste. 

Each Thursday, as lead nurse, I also have an hour-long meeting at this time with the practice manager, partners, the IT manager and reception manager. It’s a great way to get a better understanding about the management side of the practice and have open discussions about issues such as uniforms or mask use. In these meetings, I make sure I stick up for the nurses, because I want them to be treated fairly.

I sometimes have lunch on my own and sometimes with others. It’s a good opportunity to catch up with team members, as the reception manager and IT manager often eat with us. Sometimes the doctors come too.

Before the afternoon clinics, I spend half an hour on admin, such as managing waiting lists and any tasks that come through over the lunch period. I also see if any stock needs to be put away and make sure I have enough immunisations for travel and babies, ordering more if I need to. I also pop to reception to say hello and let them know I’m here for the afternoon. 

I am also in charge of staffing rotas and notifications that impact our service. I look at open appointment slots and consider what type of clinical appointment to assign to them. You’ve got to be quite organised, because otherwise a clinician could be wasting half an hour with nothing to do. This week, I’ve had lots of staff sickness, so I’ve had to consider whether to rearrange appointments or squeeze them into another clinic. Sometimes I do have to cancel appointments, which can frustrate patients. I think a lot of the abuse we get is linked to the GP bashing in the press and social media during the pandemic.

I start seeing patients again. It’s always busy. For example, when giving prostate injections, the needle is huge so it can be tricky. If the patient is nervous, I allow them a bit of time and other patients have to wait. I take it at their pace – I’ll never kick a patient out. However, I do sometimes have to make a clinical judgement. If, say, a child will not sit still for a blood test, I might tell them that unless they do, they’ll have to go to hospital.

All day, every day, I’m also supporting nurses. They come into my clinic and ask for help. I make that time for them because they only come in when they need me, so I would never turn them away. Sometimes you just have that doubt and need another nurse’s opinion. I’m exactly the same. I’m fairly young, I’ve climbed the ladder quickly, and sometimes I sit there and think, ‘do I know what I’m doing?’ You do have those moments. You have to be confident in what you’re doing but it takes time. 

At this time on Wednesdays I have a meeting with all clinical staff. We talk about safeguarding, palliative care and anything else that needs to be discussed as a team. If I don’t have that, I’ll be in clinic until 2.15pm and then have another 10-minute break before returning to clinic. 

I shut my computer down and go home to my family. I tell all the nurses to leave at 4pm too. You can’t take work home because it stays with you. You need that cut-off point or your home life will suffer. I love my job, but we all need that break.

Profile: Naomi Berry

Location Rooley Lane Medical Centre, Bradford
Role Lead general practice nurse
Areas of responsibility Clinics: diabetes, coronary heart disease, COPD, spirometry and asthma. Advises patients on smoking, immunisations and travel
Hours worked 30 hours a week

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