What I do at work: general practice nurse

Describe your role in a sentence.

I’m skilled in all areas of general practice and nursing – my role encompasses a bit of everything including responsibility for all aspects of chronic disease management, patients who have learning disabilities, and new respiratory diagnosis.

What motivates you?

Reducing health inequality is something I’m very passionate about. I’m based in a deprived area of Newcastle upon Tyne and work at a food bank once a month offering a one-stop health care shop. I’m there to help and use the contact to assist a range of other issues – there’s often an element of health education and preventive care.

How did you get here?

I celebrated 20 years in nursing last year. After completing a diploma in adult nursing, I started my career in acute general medicine and toxicology before moving to general practice nursing 14 years ago. I then completed Clinical Skills (Level 6) followed by Non-Medical Prescribing (Level 6), and more recently Enhancing the Diagnostic and Management of Respiratory Disease (Level 7). I’ve also worked at a respiratory hub, COVID-19 vaccination centres, and as a specialist practice nurse adviser for the Care Quality Commission.

Why nursing?

I left school with no direction and then my nana became unwell, needing palliative care. I was shocked by the care she received. But instead of being upset about it, I decided to become a nurse.

What are 5 things you do in an average week?

Lead a team, manage chronic disease, diagnose respiratory diseases, lead the learning disability annual review clinic, and diagnose and prescribe – or not – as appropriate.

What things do you do that other nursing staff don’t?

I have responsibility for all the new respiratory diagnoses within the practice and also diagnose and prescribe in all areas of chronic disease and many areas of acute illness. Most recently I launched a local cervical screening campaign to improve our attendance figures. I also sit within the management team, driving change to improve patient experience.

A lot of people have this traditional belief they need to see a doctor within the practice for any and all issues, but it’s not true.

Any specialist equipment?

I review results of fractional exhaled nitric oxide (FeNo) tests to guide respiratory diagnosis. This measures the levels of nitric oxide in your breath. A high level of nitric oxide when you breathe out can be a sign of inflamed airways and could indicate the probability of asthma. I’m a huge advocate for the benefits this machine can bring and how it can improve the accuracy of a diagnosis.

I regularly interpret results from a spirometer, which is used to help diagnose asthma and chronic obstructive pulmonary disease (COPD).

What are 5 key qualities a nurse needs to do this job?

Self-awareness, empathy, innovation, flexibility and communication skills.

What’s most challenging?

Demand for appointments and patient expectations, addressing cultural differences in health systems, and breaking down barriers to health, including language, poverty and education.

The same-day appointment system where patients need to call at 8.30am really frustrates me. Some vulnerable patients aren’t able to access this, so are missing out on the care they need.

And most rewarding?

Managing the holistic needs of patients, helping to make them better, and promoting prevention to help improve patient outcomes and potentially save lives. Like hospital nursing, in general practice nursing you’re still saving lives, you’re just doing it in a different way.

What would you say to someone who was looking into doing the same role as yourself?

I absolutely love my job and wouldn’t change anything about it. General practice nursing is an exciting, rewarding career.

What needs to change for general practice nursing?

I am fortunate to feel valued in my role, but I know many other general practice nurses can feel undervalued at times. Because most of us are employed directly by our practice, our pay, terms and conditions can vary dramatically. We need to see pay and terms and conditions standardised and at least the equivalent of Agenda for Change, with terms and conditions recognised as equally important as pay.

There also needs to be reassurance we won’t be replaced by pharmacists and nursing associates in future, and goalposts need to stop moving in terms of our credentials – for example ‘nurse practitioner’, ‘advanced nurse practitioner’, and ‘advanced clinical practitioner’, with training requirements prioritised and identified at appraisals.

Our voice needs greater representation: many primary care networks still don’t have a nurse as part of their management team and this can make general practice nurses feel undervalued.