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Debate: Should practice nurses do more to promote their image?

Practice nursing is regularly misrepresented by the general public and media - so Nursing in Practice asked whether GPNs should be doing more to promote their own image.

YES – Delia Clarke: Practice nurses must take responsibility for how they are perceived.

Since I started as a practice nurse in 1991, I have seen the profile of practice nurses rise from practically nothing to a recognisable level - but it is not happening fast enough.  

Most patients and many nurses from other roles still do not fully understand the duties of the GPN. For example, someone undergoing a cervical cytology test may not realise their nurse is also qualified to undertake long-term condition reviews including COPD, asthma, diabetes, heart disease along with childhood immunisations and travel clinics. Such wide-ranging expertise requires a high level of education and continuous training updates.  

Look at this list of activities and see how many you are responsible for squeezing in between seeing patients: stock control and cleaning, referral, blood results, patient letters, patient forms, hospital letters, medication reviews, prescription requests, meetings, teaching, management, educating yourself, emails and even occasionally using the loo.  

You may be surprised to know this list was written by a GP describing some of what they get done between appointments. Think about what you do from this list and beyond it, and then ask yourself why it is not more widely known that GPNs do all of this too.  

I believe it is easy to forget that we are unique in caring for people from the cradle to the grave. Therefore, we need to believe that we deserve the same level of respect as any other role within the clinical profession.  

A team survives by each member respecting one another’s role. General practice is a team and although there may be a senior leader within that team, we are all leaders in our own right. So, it saddens me to still hear comments about practice websites not individually naming nursing or listing their skills and qualifications. 

We must address this as individuals by raising our own profile within our teams and engaging with our localities and neighbourhoods to work together towards the same aim. This can also be done as a collective through forums, groups and working parties. Each one of us must take the lead on this to ensure that the momentum we are building does not slow down.  

In my area of Greater Manchester, we are very privileged to have a lead nurse in primary care who has and continues to showcase the role of GPNs. I am pleased to say that we are also moving towards a more cohesive national plan to encourage a better understanding of the complexities of the GPN role.  

But questions remain. Do we need an advertising campaign and a public relations officer to promote our professional role?  And should articles like this be published in non-nursing journals or are we worried we might be criticised for ‘blowing our own trumpet’? I will risk it - will you?  

Delia Clarke is a GPN partner at Premier Health Team. 

NO – Debbie Fletcher:  Practice nurses already do an amazing job promoting their role.  

I was instantly drawn to the role of the practice nurse when I was a student nurse in the 1980s. Whether it was the working hours or the health promotion and preventative role that appealed, I am still yet to decide. But back then, I and many others were guilty of viewing it as an easy role done by nurses who were ready for retirement and at the end of their career pathway.  

Now 30 years into my nursing career and after almost 16 years as a practice nurse, I believe that this is where I find the most enjoyment and job satisfaction. I also feel the role and the view of it has developed greatly due to changing perception among employers, public demand and the delivery of care now being directed towards primary care.  

At some point in our lives, we will have an appointment with the practice nurse, especially as we age and require chronic disease management. Due to providing amazing outcomes for patients, I feel the role speaks for itself. A good experience with the practice nurse also encourages further attendance from the patient themselves and other patients, as they are more likely to encourage their friends and family to attend.  

Many practice nurses work as the only nurse within a GP setting but are encouraged by peers to attend local practice nurse forums to gain peer support, vital updates, as well as hints and tips to improve. Social media is also a great advocate in the promotion of the practice nurse role with advice and support for prospective practice nurses just a click away.  

Funding available locally by the CCGs has allowed many practice nurses to gain qualifications in prescribing, as well as other areas of expertise relevant to the role – whereas I was of the generation where many practice nurses did not have the funds to even contemplate working towards a degree. Now many of us are qualified to degree level and have the aspiration to progress further.  

Government recognition, such as in the Five Year Forward View and the General Practice Nursing Workforce Development Plan, has ensured that the practice nurse post is now much more developed. This has increased student nurse placements with the knock-on effect of encouraging many newly qualified nurses to pursue practice nursing at the beginning of their working lives, having experienced first-hand our first-class passion, care and support.  

No two days are the same in my job. It is a challenging and diverse role and I feel that every day is a day to learn. I am nowhere near the end of my career. I work more hours now than I ever have because I am passionate about my job and want the attendee to experience primary care as I would expect to experience it. If I can make a positive impact on an individual - be it a patient, relative or colleague - then I feel that It’s worthwhile doing what I do.  

Practice nursing is already well-promoted through social media and face-to-face as an ever-developing role. Since I started 30 years ago, it has already come leaps and bounds. I will continue to recommend it to anyone who enjoys learning, being challenged and doesn't want to risk stagnation.

Debbie Fletcher is a practice nurse at Whittaker Medical Centre.

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