Im an Advanced Nurse Practitioner and whats the point

[Imhereyetagain]

Im an ANP in a GP surgery and I dont think the role is valued or appreciated. On the one hand patients moan that im not a Dr, and on the other Drs moan about the ANP job role existing. Im just so tired and bored of it all, and think about leaving.

My daily work is running an ANP emergency list, which really consists of any single, acute, undifferentiated problem. So things like chest infections, urine infections, simple dermataology issues, acute abdomens etc etc. I could go on but I think that illustrates my daily work fairly well. The more complex stuff goes to the duty GP.

Im just...tired.

I think every member of gp staff is tired.

The sad thing is I’ve met many great ANPs but really patients want and need doctors and the government should have funded doctors.

There should be a separate ANP service for exactly the things on your list.

It’s the blurring of boundaries that make for unhappy clinicians and patients.

Really sorry to hear you're feeling that way @Imhereyetagain
I know it doesn't mean much to you personally but I'm a huge fan of the ANP role and put great value on them, both personally and when I worked as a carer. Being able to see one for my LD & Dementia clients meant we could get them treatment much quicker than if we'd had to wait for a GP.

I kind of get the patients moaning that you're not a doctor, although they should be moaning to the surgery, not to you.

The ANP at my GP surgery is pretty hit and miss in terms of how much she can do, depending on the medical issue.

So sometimes it means needing a doctors appointment anyway, when it would've been easier to skip seeing her.

But it's not her fault, it's just the way it is. Even if you do tell the receptionist you'd rather see your GP.

I think it depends on the surgery. My DD1 is a GP and loves her ANP.. her diabetes specialist nurses and asthma nurses know way more on their subjects than she does :) and handle so many things
The Physician's Associates however no... their remit (and training) is insufficient and tend to cause more work not less.
They are all tired!
Find a better surgery!

It depends. The anp we used to have at our practice was brilliant and people used to request her over the GPS sometimes! However increasingly people are unable to have a proper discussion about their medical issues with a fully qualified doctor. There is no continuity of care and more focus on simply closing the requests on the online triage.

I really value the ANP role and I'm happy to see one. Ive always received decent and appropriate care.

Me too.

I would much much rather see an Advanced Nurse Practioner than a doctor. At our GPs the doctors are fairly unhelpful and don't listen. I actually get listened to by the ANPs.

I am doctor I think ANP are great for just the problems you describe, always happy to see one, especially for minor injuries in A&E you guys really know your stuff. Please don't give up- we need you❤

When I was in the UK I would always ask for an ANP, I found they actually listened and discussed the issue, rather than ignoring me, blaming every single thing on type one diabetes and providing zero helpful advice.

The ANP at my surgery is brilliant, we just don't need to see a GP for everything.

Sure there will be some ANPs that aren't brilliant but the same can be said for GPs.

ANPs are great! It does sound like you are no longer being challenged in your work though.

Is there an opportunity to run more specialised clinics where you can increase your skills?

Honestly i’ve worked with ANP/ nurse specialists for years and i think you are all truly amazing. Experience and education/knowledge with that nurses empathy is unmatched. I work with brilliant Nurse consultants too many doctors ( mainly old fashioned ones!) don’t like that role either.

Im happy to be seen by any Advanced nurse practitioner if i needed to be.

It’s very typical of the NHS that vital roles are under appreciated.

ANP’s can become a partner in the GP practice.

I get it though Nursing had a shelf life for me too, 10 years and I was out. Came back briefly for Covid and never again.

You will have loads of transferable skills. You are not trapped.

I think it sounds a daft idea all round. I'm not surprised there is dissatisfaction from both sides. The NHS is a disgrace.

Everyone in GP land is tired in fairness, it's a shit show with no sign of improving. Sorry you feel this way, it's a shame individuals are feeling devlaued and affected by the commentary on ACP roles, but have to say I do get it. Reality is there are unemployed GPs who can't secure jobs because of funding, yet there are roles with ringfenced money for roles such as yourself and PAs; wild really. Nursing is an amazing profession in its own right, and nurses play a vital role in primary care- but really what does an ANP offer in this case above a qualified doctor? Most people would rather see a doctor (unless for ongoing management of a specific medical issue such as asthma, diabetes, wound care) because medicine includes diagnosis. You say your patients are not complex, but you don't know what you don't know.

Before I get torn to shreds i am a nurse and love our profession, I'm proud to work as one but to pretend like there isn't an issue with the development of some roles to fill gaps that needn't exist isn't good either. It's like NAs, I'm appalled that they are being taken advantage of and used to basically fill nursing posts for less pay and with less training; i don't blame the individuals but the system. I can see why doctors get frustrated in a similar vein. There are also some (not all) ANPs who are scraping by the bare minimum of experience before doing their masters and it really shows.

There are plenty of other opportunities if this isn't working for you, the beauty of nursing is choice- I've working outside the NHS, had a spell completely out of healthcare and came back and have worked across all sorts of settings.

Thanks for that v.useful and insightful comment. Please do let us all know how it could all be done better for no increase in funding- oh is that you Wes ?

The general practice ANP at our surgery is wonderful. The specialist ANPs I have encountered at our hospital are too, and I occasionally work on a project with the most awesome nurse consultant.

I think you’ve been unjustly lumped in with the PAs in some people’s minds. They are concerned you aren’t qualified to see undifferentiated patients.

If the money wasn't ringfenced and partners could employ more GPs? Just a crazy idea i know.

The ANP at my surgery is lovely and I really appreciate being able to see her with DDs asthma as, frankly, she knows more than the GP and we can usually get to see her straight away when DD has a flare up.

i’ve seen a different ANP for things like UTI and again, all good. I genuinely don’t mind who I see as long as I get appropriate care and the ANPs seem to do a fantastic job.

i think you all do a great job, and I’m sorry you are not appreciated more.

I am sure this would help, but would it stop the NHS from " being a disgrace" ?whatever that actually means.

Oh no OP!
I get you but don’t give up!!

All that training, extra (bloody tough as nails) education and your time spent getting to where you are, you are an inspiration.

Although I don’t know you, I feel so SO proud of every ANP/ consultant nurse/nurse prescriber I know.

The likes of you are elevating the nursing profession above and beyond what we old nurses could ever have imagined.

You are very much appreciated and relied upon every day.

Excellent post.

I understand your points OP, but I think the bit about being bored due to the 'simple, undifferentiated patients' is quite telling. What would you like to be doing differently? And who is streaming them, reception? The symptoms you list may not be simple in cause.

Could a hospital position be more varied?

You responded to a poster saying about this particularly being a disgrace all round, ergo an answer to address it would be to not have had all sorts of funding tied to stipulations about which HCPs it could be spent on. It is disgraceful that this has been purposefully engineered this way.

i think its a brilliant role and its a shame you are not more valued. at our surgery if I have thrush uti's etc I don't bother asking for Dr I always ask for ANP. i am not sure if this is a new idea or just has been used more but i think a lot of people just have not got the idea of it so are sceptical and are still of the mindset if its not a Dr then nothing can be done. I think they are probably think of you more as a nurse who does blood tests flu jabs etc. i think you do a wonderful job