A group of six primary care nurses talk to Kathy Oxtoby about what has got them through the Covid-19 pandemic, the positives they have taken from their experiences, and their hopes for the profession – and themselves – from now on. Is it possible to look on the bright side?
Camaraderie with colleagues, time out with family, wellbeing apps and long walks. These are just some of the ways nurses dealt with the difficulties of the past year.
After the challenges the first year of the pandemic, it was to be hoped that 2021 would be less traumatic. But the pressures from the impact of coronavirus continued, and the Omicron Covid variant wave made prospects for nursing even more uncertain. But nurses have taken away some positives too, from the success of the Covid-19 mass vaccination programmes and collaborations between practices, to the benefits of new technology, and a better understanding of mental health and wellbeing.
Here, nurses in primary care share what has got them through recent times, and some of the positives they have taken away.
‘General practice nurses should feel enormously proud’
Dr Crystal Oldman, chief executive, Queen’s Nursing Institute (QNI)
‘Services like the QNI’s TalktoUs phone line have been one of the great benefits for all nurses in the community and primary care. Trained listeners, Queen’s Nurses themselves, have been available to offer an empathetic ear and signpost people to other sources of support.
‘The QNI will continue to offer this – we are there for you and no nurse should be left to face personal or professional challenges alone.
‘Mental health and wellbeing at work has been talked about as never before, but we need to make sure that we are living the values and behaviours that we espouse, supporting all members of our teams, listening to them, taking their concerns seriously, and acting on them.
‘General practice nurses (GPNs) should feel enormously proud of the mass vaccination programmes that they have planned, led and delivered, while at the same time flexing to support people with a wide range of health conditions, in many cases using new technology that has enabled a step change in the way we see, treat and support patients.
‘I’d like to see greater recognition for GPNs and all nurses in the community, from health service leaders, politicians and the media. When they say, ‘people will be discharged home’ there needs to be an acknowledgement that care doesn’t end here – this is where it continues, with the support of the primary care team, the district nurses and their colleagues.
‘There can be a sense that care in the community happens as if by magic, that if you don’t name it, it doesn’t require more investment in staffing and other resources. As we know, the whole health and care system depends on the capacity, the willingness and the skill of our colleagues in the community and primary care. Without them, the intensive care wards, the emergency departments, and other high-profile services so beloved by our politicians and TV crews would simply be overwhelmed and unable to function.
‘We always say at the QNI that this is not a competition, all parts of the system are of equal value. But providing a little more recognition for the nursing work in the community and in primary care in 2022 would go a very long way to boost the morale of the workforce and support recruitment and retention of the fabulously talented nurses working in these services.’
‘Our adrenalin, grit and determination got us through’
Joyce Pickering, RCN GPN Forum Chair
‘Practice nurses are used to serious challenges like new vaccination programmes or new contracts. We’re used to change. But we weren’t used to change on the level we’ve seen during the pandemic. We really had to ramp up our existing skills.
‘We collaborated across the other practices in PCNs, sharing experiences and resources, and an unintended consequence of that was our network of contacts got bigger. There were more people to chat to if you were having a bad day and that was a real resource, especially at the start of 2021 when the vaccination programme started.
‘Our adrenalin, grit and determination also got us through. And there’s a lot of good will.
‘It helps to have friends that have nothing to do with healthcare who don’t ‘talk shop’. I’ve also been learning French – things can be a bit overwhelming at times so you need to have some diversion to reset your mind.
‘A positive I’ll take away from 2021 is how brilliant general practice nurses are, and I’m proud to be part of this profession.
‘There’s also been a willingness to adapt to new ways of working, like working from home. People just got on with it, and that’s a positive we’ll carry forward.
It’s also positive that nurses have been setting up networks – sharing good ideas and good practice that have now become the norm for us and are embedded in our work. Whatever happens next, we’ll keep pooling our ideas.
‘For the profession in 2022, practice nurses need investment in education, and resources. Additional roles within PCNs, such as physiotherapists, are funded by government, but nurses are not included. We need to get some parity and see some similar investment for general practice nursing. We feel we’re being left behind a bit.
‘My ambition is to complete my Masters. I feel passionately about practice nurse education and enjoy academia. And some family time as well would be nice.’
‘GPNs need to speak up, to be loud and proud’
Sue Nightingale, diabetes nurse practitioner, Croft Medical Centre, Solihull
‘On a professional level it’s the team I work with that got me through last year. We’re a large nursing team – from healthcare support works, healthcare assistants, nurses and ANPs, and as a nursing group we’ve supported each other – I’ve been able to go to my colleagues if I’m struggling with workload or general stresses.
‘I had Covid in 2020 and long Covid, so it’s been a difficult journey, both physically and emotionally. I used wellbeing apps like ShinyMind and had counselling because of the stresses around having Covid, and then trying to return to work to give 100 per cent when feeling about 50 per cent.
‘It’s helped to reduce my hours to two days a week. You have to practice what you preach – we tell our patients about selfcare and to ask for help and support. I’ve had to have that extra support and it’s been beneficial.
‘I’ve had to re-evaluate my life, to look at what’s most important to me – family first and then work. And I’ve prioritised my workload and what I enjoy the most, which is diabetes care.
‘I can appreciate the need to be more mindful about what others are going through. We often say “take care of yourself”, but we need to make sure people really are taking care and getting help.
‘In 2022, general practice nurses need to be heard. We’re a body of nurses who provided care throughout the pandemic and have been there for our patients. I’d like to see an uplift in the profile of general practice and community nurses alike.
‘I’d like the public and our colleagues to know what our role is. People ask “what does a GPN do?” We’re not here to mop the brows of GPs, we’re professional nurses providing high levels of care.
‘GPNs need to speak up, to be proud and loud, and deserve to be heard. And if we’re doing innovative things in practice we need to be proud of that, and let people know what we’re doing.
‘Personally, I’d like to continue getting better. I’d love all these long Covid symptoms to disappear.’
‘The spirit and commitment of my colleagues never ceases to amaze me’
Janet Thornley, strategic GPN lead for Bedford, Luton and Milton Keynes CCG
‘One aspect of my role is around professional development of practice nurses, workforce development, CPD and wellbeing. I have a lot of conversations with practice nurses about how they’re feeling and what they need, which I take into account when organising courses and CPD. I derive a great deal of satisfaction and pride in commissioning programmes for nurses.
‘I’m lucky to live in the countryside, so during last summer it was great to come home and unwind by sitting in the garden or taking the dogs for a walk. I also have support from my family. And I’ve kept a journal during the pandemic to put down my thoughts, which I’ve found cathartic.
‘A positive that’s come out of Covid for me, and many of my colleagues, is working in the vaccination hubs in our PCN. There was a real sense of camaraderie, and I gained a support network, and met new colleagues.
‘The spirit and commitment of my colleagues and their dedication never ceases to amaze me. Like some of my colleagues who gave vaccinations on Boxing Day.
‘Our patients been fantastic by and large, and they’ve been joyous and desperately grateful about being vaccinated – there’s been a real outpouring of support.
‘In 2022, I’d like to see Covid being more manageable for everybody. I’d like to see demands, challenges and pressures starting to reduce so people can start to take stock about what they have learned and what matters to them.
‘I’d like people to get some good downtime with their families, to really enjoy life and to have a life where Covid isn’t a word we say all the time every day.
‘I’ve booked two weeks off. I haven’t had two weeks together of annual leave since March 2020. I don’t know where I’m going yet, but it will be hot, sunny, and it’s marked in my diary.’
‘My hope is for a much clearer career pathway’
Jenny Aston, ANP, Granta Medical Practices, Cambridge
‘What got me through last year was going in to work. Being in the building we still had contact with colleagues so we were still working as a team. You could still talk to people to share thoughts, ideas and worries, and that was hugely beneficial.
‘It helped to be strict about taking breaks. It’s important to have a coffee and a chat to people. And having a garden and a dog also kept me going.
‘A positive I’ll take away from 2021 is telephone triage. It’s economical with time. But it needs to be done by people who are well trained, capable and competent and I don’t think it’s appropriate for nurses not trained to a high level to do it.
‘Adapting to doing training online where it’s a meaningful learning experience is a positive. I’ve also done a lot more meetings at home via Zoom and not having to waste half a day traveling has been hugely beneficial.
‘I’ve been involved with the GPN Career Framework due to be launched soon, so this year I’m looking forward to how it will help with the career development of nurses at all levels of general practice.
My hope is there will be a much clearer career pathway and therefore underlying training for nurses in general practice. I hope the Career Framework will be the stepping stone to reinvigorating general practice as a really great place to work, and that it will lead to the right training that’s fit for purpose.
‘We also need pay and terms of conditions to be reviewed in the light of the Career Framework so nurses feel valued.
‘I want to be able to smooth the way towards retirement, to do some effective succession planning in my work and to upskill the nurses around me so that I can feel I’ve left the profession in a better place.’
‘Having a really good team has helped me get through’
Naomi Berry, practice nurse, Rooley Lane Medical Centre, Bradford
‘I was newly qualified when the Covid-19 first hit. It’s been rough trying to learn new skills while dealing with a pandemic. But having a really good team has helped me get through. We’ve all supported each other all the way through the pandemic. We’ve had regular updates from everybody to make sure we were all okay.
‘We check in with each other and ask each other if there’s anything we need. And we have a WhatsApp group, which helps us to communicate as things can change very quickly, such as when Covid vaccinations started.
‘Personally, what helped to get through last year is making sure I had some time at home. When things were really hard I tried to make sure my other half knew what was going. If I was having a bad week we’d do something together, like going for a walk.
‘Working normal clinics and Covid vaccination clinics was like working more than seven days a week. So I made sure I had support at home. You can’t bottle things up – you’ve got to be open and honest and say how you’re feeling. At one point I thought: “I can’t do another Covid clinic”. I was struggling. So I had a break from them.
‘I also found SilverCloud to be a good programme for NHS staff, and it runs courses on stress and wellbeing.
‘We need a boost to team morale. Having more time to be able to group together for some practices would really benefit for them. We need to take that step back, look at staff members and ask: are they are they physically and mentally coping, and if not, what can we do?
‘For me, some normality would be nice. I love my job, it’s the best job ever, but some days are crazy busy. So I’d like a holiday. Christmas 2022 I’d like to be in Disneyland Paris to have some time with the family. It’s needed.’
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