Janette Morgan (above, left) was named Practice Nurse of the Year at the General Practice Awards 2022. Here, she tells Wiliam Hunter about longer appointments, green initiatives and including patients in decisions about their own health
Q: What was behind your decision to move from district nursing into general practice?
A: I wanted a change after 13 years in district nursing, and it was one of the best things I’ve ever done.
I love patient contact, and that was the key for me. Even though one-to-one time with a patient can be more limited in general practice, I’m lucky as I’ve got the support of the doctor to offer longer appointment times, especially when it comes to chronic disease.
With community nursing, it is about caring for those who already have a disease – in general practice it’s more about prevention. My community nursing skills, such as understanding disease and the disease process, have helped immensely with the transition. I’m now working to complete my independent nurse prescriber course.
Q: A highlight of your General Practice Awards entry was a green inhaler initiative. What was the inspiration behind that project?
A: The project aimed to reduce patients’ dependence on Ventolin, which is the main contributor to the carbon footprint of inhalers. It is also overused and less effective than other choices. After an audit of patients, we managed to reduce acute and repeat prescriptions of Ventolin by 60%.
In practice, I want to make a difference, not only to the patient’s health but to the wider planet. I’m vegan, and protecting the planet is important for me. When I saw this opportunity, I wanted to get involved. Our practice has almost 3,000 patients. I thought this project was a great start, and we could really make a difference.
Q: What was the response from the community like?
A: I’ve got quite good relationships with my patients, so I think that helped. I had to bring patients in to find out if they really were using Ventolin on a monthly basis or just automatically ordering it on repeat.
We needed to make sure they understood what was happening and took it all on board. After that I never had any problems and the uptake was fantastic.
It’s about health literacy; ensuring patients have the information to make decisions about their health is vitally important.
Q: How do you keep up a good relationship with patients?
A: At the end of the day it’s not about me, it’s about the patient. And while I’ve got guidelines to follow, it’s about giving individualised care and the patient has to be at the forefront of that.
A lot of people tend to follow the guidelines as a framework. But the guidelines don’t take into account the differences between patients.
To include patients in decision making is key. Look at how their lives work and their social circumstances. There’s no point giving a medicine three times a day, say, if that patient can’t take it at lunchtime because of work.
I’m also interested in promoting healthy living. For example, tackling obesity in the community is about looking at a patient’s lifestyle and suggesting changes that suit them. Cost-of-living issues mean it’s important to find changes that won’t hurt their budget.
Simple things like avoiding processed food or recommending frozen vegetables and bulk cooking can really help. But again, it’s not a case of me saying ‘you’ve got to do this’; it’s a joint decision with the patient.
By working this way our practice has already seen a 2% reduction in obesity rates over a pretty short time.
Q: How do you cope with a growing workload and time pressure?
A: Time is a big factor. As I said, I’m fortunate that the practice allows longer appointments because you can’t address everything in 10 minutes.
If you are pressed for time, healthy lifestyle advice or respiratory technique can be a good thing to focus on, but the key is asking the patient what they want. It’s listening and finding out what’s really concerning them.
That approach can lead to a bit of trouble with timings, but I feel I’ve got to address everything. If something happened to that patient I wouldn’t be happy with myself.
Q: And finally, what was it like to be named Practice Nurse of the Year?
A: I feel totally honoured. I have never been nominated for any awards, and this has been an amazing experience – one that I will never forget and certainly the highlight of my career.
The General Practice Awards are run by Nursing in Practice’s publisher Cogora. Look out for the opportunity to nominate or enter for the 2023 awards.