 Hi everyone, my name is Claire Carmichael, I'm a newly qualified general practice nurse and I'm here today to tell you what to expect if you want to go into general practice nursing. So first things first, I'm just going to quickly do a brief overview of every single thing or not everything. This list is not limited to by no means at all but I'm just going to go through a quick list of things that you would do in your role as a general practice nurse just so you can get an overview firstly if you don't know that sort of thing. So you can sort of see the amount of variation in GP nursing and for this one, I'm going back to basics, I'm actually getting a part script for this because there's so much stuff that a GP nurse does, I physically just I don't want to miss anything on this vlog. Other clinics might be different because GP clinics do their own thing in a way so one GP might do minor injuries and minor surgery and that sort of thing whereas other ones might not do that sort of thing so yes this this list is not limited to and it might change between practices disclaimer first of all. Okay are you ready? So you will do hypertension clinics, diabetic clinics, asthma clinics, travel vaccines, flu vaccines, baby vaccines, ECGs, minor surgery like I said setting up an assistant the doctor with things like toenail removals or walk removals, new patient health checks, blood tests and results, mental health assessments, home visits, smear testing, slash cytology, sexual health and contraception, wound management, leg ulcer dressings, compression, management, things like that. A lot of health promotion and health prevention communicating as well with your team so the mental health services, your doctors, your receptionist pharmacists, phlebotomists, paramedics, there's all this like really good integrated team now in GP land. Calling patients as well to book in their appointments and follow-ups, telephone consultations, doing false prescriptions and assessments and frailty assessments as well, things like that on patients because you want to protect those patients and also safeguard and safeguarding as well so anything you see that you think oh you have to refer on to your safeguarding leads that's quite big as well especially if you're doing like things like baby aims or dealing with someone with dementia or learning disabilities you have to be really mindful of these sort of things in the background and you will also see a whole range of patients so you'll see from a pregnant lady to newborn baby all the way to the baby growing up, all the way to teens, all the way to adulthood, all the way to elderly and end of life or palliative care as well, you'll see a whole range of things and it's just amazing. So now I spoke about all the weird and wonderful things and amazing variety that a GP nurse does. I just want to talk about okay so what is expected of you as a nurse because there is a lot there, how are you going to learn all of that, what's expected as a newly qualified nurse as well going into that sort of thing, how are you going to get to know how to do everything if that makes sense so I'm just going to run through some little things for you. So as a new general practice nurse whether it's newly qualified or whether you've come from the hospital, acute sort of sector, intergeneral practice, you will have your induction when you go in and this can vary from place to place and person to person like for me because I'd had a general practice placement I knew the EMIS system already that we were working with and there was a lot of things that I could do already so I felt a lot more comfortable and confident to start my own clinic sooner whereas you might not have that, you might need a lot more shadowing, a lot more training and stuff like that so it's firstly it's about being open and honest and being comfortable and confident and competent in what you're doing, make sure you speak up if you're not confident to do something and make sure you get that extra training if you need it that's the most important thing going into general practice because at the end of day this is patient's lives, patient's safety and that's got to be at the forefront of your mind as well so yeah so just take it easy step by step and get that training just to start off. So the bits of training you'll have to start with is you'll have your normal induction fire safety, health and safety, information governance, all those little things you might get someone watching you if you're already doing bloods for example I already did bloods in sexual health so they just wanted me to just do a little refresher and do a competency thing sign off so I sat with the nurse and I did all the bloods and she signed me off to say I was confident to do that so just little things that you can do will have to go off on a competency list as well. Also for this there's the amazing Queens Nursing Institute or QNI for short their website I'll put the link below they've got an amazing general practice template it's just fantastic so have a look at that website there is a whole induction template specifically for GP which is what I printed off and I've gone by so it's really really good really helpful so just make sure you follow that as well and have a look at it. Next you will if you haven't got those skills already so if you can't do baby immunizations I can't do baby immunizations I never got trained at university so that's a separate course I have to do also smear tests I have the separate training for that so anyway there's a separate course called the fundamentals of primary care course and you go to uni like one or two days here and there just to learn those skills and then you take it back to your practice and then you implement them all so I start my primary care course in September I'm so excited it was put off it was due the start of the year but unfortunately Covid and the pandemic here so it has been put off to September and it is actually part of it is online as well which it's a bit sad but it's okay I know the reasons why so yes anyway I've got my template for my course I know what I'll be learning what I'm doing so I'm just gonna run through that really quickly with you so you can sort of see what you're doing on your primary care course when that time comes for you as well so this is my timetable that I've printed off mine is through the Portsmouth campus so this is where I'm doing all of mine other campuses and other areas might be different they might edit it and tweak it slightly and you might be on a slightly different structure if that makes sense but these are the things I'm doing so 23rd of September is my course overview inductions and all of that then I'm on the 6th 7th 20th and 21st of October so four days in October I've got the history of general practice and clinical governance in primary care I've got infection control portfolio assessment and overview and then I've go straight into cervical screening for the final two days in October and then November the 10th 11th 24th and 25th four days again I've got immunizations immunizations again for two days I've got wound care and leg ulcers for a day and then I've got portfolio reviews and individual tutorials on one day and then we're going to December so December the 8th and 9th I have consultation and communicating with patients impact of long-term conditions and ear care yes and then we're going to January I know January the 12th 13th 26 and 27th 40s again so we've got a group seminar and introduction to essay didn't expect to write an essay on this I'm not that's level 6 and then level 7 introduction essay again and then we have a reading day on the 13th yay I'm assuming I'm going to knock out this essay in that day maybe and then on the 26th of January you've got the skills lab for venopuncture which is the blood testing and interpreting the results which I can't wait to do that side of it because at the minute I'm sort of learning online and trying to work out what's what and even though I can take blood it's the results bit that yeah it gets me sometimes and then we've got sexual health and then February the 9th 10th 23rd and 24th we've got integrate integrated care we've got another introduction to the essay bit as well pop be apparently health promotion cardiovascular disease and ECG's common mental health presentations yes yes yes we need this in GP because we see so much of it it's unreal even on the wards if you're in the acute sector you see a lot of mental health issues and so I'm so glad that that's in there and dementia child and adult safeguarding which have done a bit of that anyway diabetes well that's March sorry going into March 9th and 10th 23rd and 24th of March we've got diabetes asthma and COPD accountability managing HCA's I don't know the word managing HCA's that sounds like I'm gonna be like maybe collaboration with HCA's would be a nice one okay individual tutorials again assignment surgery no idea and then another reading day in April the 20th and then April the 21st is our last day so there's a review of the course evaluation and wash up I hope they don't mean washing your hands because that should be at the start but yeah so that is the overall of your course so you're gonna get all of those extra skills that you need to become a GP nurse and the rest you're gonna be learning on the job with other nurses as well so yeah just sitting in and listening to other people's consultations as well you might get a chance to sit in with the doctors as well if you've got any extended people like the phlebotomists might come to your surgery I know a surgery that I did my placement on and they didn't really do the bloods as much they had their own dedicated phlebotomists that came in and did all that so that was actually really useful it took sort of the pressure I think off of the nurse as well so yeah but we have amazing HCA's where I'm working now we've got two that do all of mainly of the blood testing and one of them actually is taking on a lot more now so she's doing a lot more wounds and leg ulcers and compression she's doing amazing she can do some things that I can't even do yet it's hilarious I love it the HCA's are amazing there's such a benefit to any setting anyway your hours as a GP nurse so your hours might vary from place to place because again everywhere is different it's really hard to pinpoint these things down in GP because everyone does something different clinic-to-clinic it's a little bit frustrating in that way but find the right clinic for you that's going to give you the best career development and choices and flexibility a lot of them are very flexible because they are based around like family-centered and they're really really nice like that it is a nice community actually in GP but anyway the hours that I do so I do four days a week I used to do five days a week so I used to do three long days and two short days but then I felt because it's quite a drive where I'm at it's like 20 kilometers from my house so I spoke to the management teams and I cut mine down into four days so now I do four long days half eight to half six and I have Thursdays and weekends off which is amazing it's so nice it's so much better to do it this way the best thing to do is if you're looking at GP and look at their website and see what hours to open because that will give you a rough idea to what hours you might be doing so what realistically to expect like in your practice as you're working there's two sides to this story so one side as a practice nurse I feel wow like so overwhelmed some days because I'm so busy I've got so much to do I've got so much to remember I've got so much to document and you've only got a short space of time between each patient to do everything in so you do feel very busy very like oh my god oh my god oh my god however you do get into a nice flow and a nice routine unless something goes wrong if something goes wrong then all your patients are gonna be waiting in the waiting room but that's okay it's again it's about communication as well with your patient so if you're running behind something's happened get reception or go out yourself and just say I'm really sorry something's happened there is a bit of a delay I'm really sorry and you know what that's the main thing I've found with patients they just want to know what's going on they want to know why they sat there for 20 minutes waiting for their nurse when their appointment was 20 minutes ago and they haven't seen anyone coming out your room so they think that you're just sat there it's really really important to just be open and honest with your patients and communicate with them because that's where it sort of starts going wrong that's when patients start to complain to a reception that's when they write complaints and referrals and all sorts goes on so yeah so just be mindful of that so then you have the positive next side it's so rewarding it's such an amazing career and you will go homes and kids you know what yes I did the best for my patients today I really helped that patient today I prevented a stroke I prevented a heart attack I prevented sepsis I've really helped this person in their mental health crisis and they've gone out of here smiling instead of crying when they come in you're gonna feel this over just this amazing overwhelming sense of wow what have I done today this is amazing and it's those days that just make all of the difference and you just think yes this is why I've come into this role but at the same time it is hard work you really have to be dedicated to this role you have to be confident in your abilities you have to be open and honest you have to speak to your colleagues and always seek help if you need it if you need backup and you need to call people in and your team will always support you you just need to ask for the help but above all it is amazing so I've spoke about expectations in your practice and I briefly spoke about patients getting a little bit miffed so this is expectations what's what it's really like dealing with the public and again it's such a variety some patients are really lovely really understanding there'll be just they won't want to bother you at all but actually they really need it so I've had patients with things happen to them and I'm just sat there like why haven't you told me this why haven't you said this and I go I didn't want bother you I was like but you need to bother me because you could be having a heart attack you could be having a stroke you could be having dbt's whatever's gone on in that person's life these are the people that never say anything and then you've got other patients who want everything and beyond and they can't understand why you can't do it for them because you're a nurse you should know this or you should do this and you're just like I literally can only do so much and nothing you do will be enough for the odd person I have to say the odd person because that's not realistically everybody that it is just the one or two people and that's just the way they are that's their them as a person that's what they're expecting they've got high expectations of nurses and doctors maybe they haven't been treated well in the past by health care profession so they've got this different side to things so you just have to be mindful that that person might be going through a lot they might be going through things that you don't know about so it's about respecting them even though they're not very nice sometimes it's about respecting them being your your best self for that person and still treating them as a person however if someone is getting physically aggressive or verbally aggressive no don't stand for that because I think as nurses we think oh we have to treat everybody and you know but if someone's coming at you attacking you verbally no that's not okay and if you let them get away with that behavior they're going to be like that time and time again and they're going to keep doing it so you need to just obviously professionally and politely and just say you know what this isn't acceptable I'm here to help you I'm not here to get verbally abused or whatever continue this you'll be out and off the books so it's your choice someone in health care should ever be verbally or physically abused luckily it's been okay at our place it's been alright but yes it's just it's just more of a reminder to people just you don't have to put up with that just make sure you give them a professional little warning and the gentle stop that so just as a final overall round thing what to expect as a GP nurse overall do you know what it's a very different setting to the acute setting you will notice the change like that like in an instant you'll be like whoa this is like a whole different culture this is a whole different breed of nurses this is a whole different breed of management and overall I think this is just my own personal opinion from when I was on my placement to this placement to other JP nurses that I speak to overall it's an amazing place to be and the way things are managed are so much better and the way that people communicate with each other is so much better and GP nurses are so much better like everything just is so much better for me however that might not be for you so it's about finding what you really want as well in life if GP's not for you then that's okay find your specialty because as long as you're happy that's all that matters GP for me and many many nurses it's amazing and it's a long fulfilling career ahead of you so yeah good luck guys