Ninja Nurse: Nicola Milne

What makes you a Ninja Nurse? 

My passion relating to the delivery of optimal and equitable diabetes care to all those at risk of or living with diabetes is what drives me in my role as a practice nurse with a special interest and makes me a Ninja Nurse.

I am very keen to reduce variation in care and promote accessible education to all healthcare professionals in primary care.

Within my practice, in addition to my general practice nursing roles, I take the lead for the delivery of diabetes care to just under 700 patients and have lead on various projects relating to the prevention of diabetes, diabetes and kidney disease and diabetes and pre-conception care, which have won national awards and have been presented both nationally and internationally.

Within my locality there has been little provision for practice nurse education in diabetes so with colleague support I took the initiative to develop a bottom-up approach to education and established a Practice Nurse Diabetes Group, which meets bi-monthly with the aim of enhancing diabetes education.

The group has steadily grown to include members from other localities and other professions to include pharmacists and health care assistants. It has an agenda set by participants to facilitate meeting their needs.

Nationally, I now sit on three diabetes committees and the editorial boards of two diabetes journals to provide a practice nurse voice and promote the importance of the role of the practice nurse in the delivery of diabetes care.

As a member of Diabetes UK (DUK) I have been part of the working groups for information prescriptions, which are a great resource for people with diabetes and all healthcare professionals alike.

As Vice Chair of the DUK Professional Conference Organising Committee I worked with the chair, GP Dr Paul Newman and the Healthcare Professional Engagement Team to deliver a Stand Alone Primary Care Day aimed at ‘Getting the Essential Right’. This day was the first of its kind at the Conference and marks a positive forward step in recognising the vital contribution of Primary Care HCP in the delivery of diabetes care. This is something that I hope to replicate as chair for the programme content organisation of the 2019 Conference in Liverpool.

My other contributions to diabetes education include authoring several published articles and CPD Modules and being actively involved in the Primary Care Diabetes Society Education sub-group.

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

My role has always been to work within teams and as much as my knowledge and experience has often rescued GPs and indeed other healthcare professionals, their knowledge and experience has equally rescued me!

I am very fortunate to work with a great GP, Dr Naresh Kanumilli, who has shared my interest in diabetes and who has been just as keen to champion the great work done by practice nurses and the vital need for GPs, practice nurses, healthcare assistants, pharmacists and receptionists to all work as one team.

Why do you think practice nurses are ‘ninjas’?

The difficulty for practice nurses is that our work is so varied and we are often working in isolation. This creates great challenges but we overcome them and reliably deliver for our patients and colleagues.

Yes, we are Ninja Nurses and we believe in doing our best through commitment and hard work.

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

In my experience, patients are extremely appreciative of practice nurses and generally so are our GP colleagues.

The NHS does however need to give greater recognition to our role and formalise training, rate of pay and career progression. Hopefully the 10 Point Plan for practice nurses in England and other similar initiatives across the home nations will go some way to achieving this.

Do you regularly work overtime or through your breaks?

All my local and national roles are undertaken in my own time. I regularly use annual leave to attend meetings and conferences (over two weeks’ worth last year) but the feeling that I am contributing to improved education and giving a voice for practice nurses is a rewarding one.

Are patients and other practice staff aware of your initiatives?

Many of our patients are aware of the varied roles that I undertake and many express their increased confidence in having a nurse caring for them with such a knowledge base.

I was very honoured when several of my patients and colleagues put my name forward to be a Queens’ nurse in recognition of the additional work I undertake outside my normal role.

We have undertaken various projects within ourpractice to look at ways to improve care and patients have always been willing to participate and I thank them for all the support and feedback they have given with such projects.

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

I would encourage other nurses to move into general practice because I feel that it is a great role!

You are privileged to be able to look after generations of families and this can really build trust and make a positive impact on their wellbeing.

The continuity of care aspect of the role allows for the establishment of an effective healthcare relationship as you travel with the patient on their health care journey and work together to set individualised goals and strive to achieve the best outcomes.

There is scope within general practice to become specialist in a particular area and with specialist input you can save many patients the need to be referred into secondary care, which often means trips to hospitals and impacts on travel, work and lack of continuity of care.

Over the 16 years that I have worked within general practice the diabetes expertise that we have been able to deliver has resulted in greatly reduced referrals to secondary care.