Ninja Nurse: Charlene Sargeant

What makes you a Ninja Nurse?

Since starting at my practice 18 months ago, I have been involved in the restructuring of the service. My role as clinical lead for the nursing team is to manage the day-to-day aspects, but also to put in place clinical frameworks and processes for safe and effective patient care.

Some of the innovations to date include:

• A daily safety huddle, where we discuss unplanned admissions, complex patients, medication updates and home visits.
• Fortnightly clinical meetings.
• Weekly advanced nurse practitioner meetings.
• Bi-monthly nurses meetings.

There is a supervision structure in place for clinical staff to have supervision on a six-weekly basis. I have also developed an induction pack for all new starters from nurses to GPs, which has received positive feedback.

I am involved in the local college’s health academy, where teachers and practitioners come together to provide education and support for those wanting to come into healthcare.

As a result, I was named General Practice Nurse of the Year for my locality, and later went on to win the award for Yorkshire and the Humber.

The practice that I work at has recently been given a CQC rating of ‘good’ from ‘requires improvement’- everybody at the surgery should be incredibly proud of the hard work they’ve put in as we’ve come a long way.

Have you ever had to use your Ninja Nurse powers to rescue a GP?

Part of my role is to review all patients with diabetes, and due to my background in diabetes I am able to provide higher level of advice on their treatment.

On one occasion a 21-year-old patient attended the surgery with abdominal pain, and lethargy. I was sat in with the GP at that time for supervision. Due to the patient’s age and symptoms I asked if I could take some further history from them. At this time the patient also stated that they had lost weight, and was experiencing polyuria. I checked the patient’s blood glucose levels and they were 21mmol/l, with blood ketones of 2.3mmol/l. I supported the GP to diagnosis the patient with type 1 diabetes and treat and refer them as appropriate. But I think good teams always rescue each other!

Why do you think practice nurses are ‘ninjas’?

Practice nurses are often the first port of call for patents with a variety of conditions and needs. This may be for a long-term condition review, or for a minor illness.

Due to the role of the practice nurse continually evolving, they are able to diagnosis, treat and review patients with diverse needs, on both a physical and holistic level. As a result, we are able to support the GPs with complex and acute patients. Practice nurses have to have excellent listening and communication skills, and have the ability to problem solve on a one-to-one basis.

What would you like to see changed in order to increase appreciation for practice nursing?

I would like to see a greater awareness of the vast skills and services that practice nurses offer needs to be promoted. Patients need to be better informed of the services practice nurses can provide, and that they don’t always need to see a GP. Our skills also needed to be reflected in our pay. We need to celebrate practices nurses for their achievements!

Do you regularly work overtime or through your breaks – if so, please describe the circumstances and how often this occurs?

I often work through my breaks and help with service improvement in my own time. I have a large caseload of patients for long-term conditions, especially those with diabetes, for whom I need to provide regular follow-ups. For example, with titration of insulin doses for patients with diabetes. Furthermore, I provide a minor illness service, and like to be through in my consultations. I also have a great interest in the development of education within primary care and work within my organisation to establish and develop new ways of learning.

Describe any practice initiatives you are involved.

I have put in place a training structure with evidence-based competencies to enable practice nurses to have a robust development plan, and hope to take this structure forward to be utilised in all our practices. As part of the ANP educational meeting, we develop and implement patient information leaflets to enable us to standardise our care. One of my ongoing innovations is to have a practice-based carers group, which utilises care navigation and social prescribing to support carers young and older.

Are patients and other practice staff aware of with your initiatives?

I try to involve both patients and other staff in the changes I help implement at the surgery. I believe that it is vital to get input from all sides to ensure greater staff and patient satisfaction. Both staff and patients have a lot of experience and knowledge, which can be vital to ensure that change is successful – you never know what great ideas people bring to the table.

Would you encourage other nurses to move into general practice in 2018?

Yes, absolutely. The role of a practice nurse is ever growing and so diverse now. The opportunities to develop and extend skills and work autonomously are vast and are getting more readily available within primary care. The regular interaction and ability to build relationships with both patients and their families is also really rewarding. Come join the primary care team!