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.

You've given a good example for two things. A) why patients with complex health histories need to be seen by GPs, and B) of ANPs being used in a role they really shouldnt be in.

The support for APs and specialist nurses here seems to come with a form of GP bashing with people keen to bring up anecdotes of GP incompotence. I think there is a danger of people taking themselves into an NHS on the cheap because they feel they are being disrespectful by critiquing the roles of differing staff groups within healrhcare. I think you can be personally supportive of individuals working in a very difficult environment while simultaneously criticising health care governance and maybe a dangerous trend of addressing a GP shortage issue with other professionals

I personally think that they are now giving receptionists with no medical training way too much control over who sees who. Our rural surgery has an ANP who is fantastic as she also covers shifts in the out of hours unit at the county hospital and I prefer seeing her to a GP. But the new PA is an absolute waste of time as she can't prescribe, has to go off and get someone to sign a script and as I'm so allergic to most antibiotics, she had to bring a GP in to my last appointment - all of which I'd explained to the receptionist.

Not here, the GPS at my surgery are equally brilliant.

You seem to have an axe to grind.

There is an absolutely fantastic ANP at my GP. She does see the bigger picture both with physical issues and also mental/emotional stuff. Without going into the details a ten minute appointment with her last year has directly improved my son’s school attendance hugely because she could see the underlying mental problem. I did tell her that next time I saw her so I hope she realises how much she is appreciated.

I hope you get a break soon OP and a chance to recharge your batteries.

There isnt a shortage of GPs. There are GPs that cant get jobs because there isnt enough money.

I agree with you in a macro sense though - NHS healthcare governance is shocking.

There is NO shortage of available, fully trained GPs. There is a shortage of jobs, due to funding being given elsewhere. Want a doctor ? Then listen up because this year is set to see an unprecedented level of unemployed doctors. Trained by the NHS. But unable to get a job.

Madness. But sadly true.

ANPs are highly trained, but should not be first point of a diagnosis. You don't know what you don't know. And you either need 5 years Uni, 2 years foundation and 3+ years of specialist training to do the job of a GP. Or you don't. If you don't then doctors should be able to do the job after the initial 7 years.

@Imhereyetagain I think ANPs are awesome. They've helped me deal with a chronic condition for years. But needed a GP to sort out what was going wrong in the first place. The MDT is so important.

@Imhereyetagain OP:

"You seem confused between to the two roles, which is understandable to be fair. We are not Drs."

No. I can assure you. I am NOT confused at all. That's my whole point. I know they aren't Doctors.

The trouble is when the nhs infers and insinuates to patients that they are.

Plus, I was also told by staff he was a 'Consultant'. To me a Consultant is the top man. You get to see the registrar, then the Consultant.

This person is basically a nurse. Not an old fashioned top dog Consultant.

Our surgery has ANPs and I'm really grateful for them. It makes it much easier to be seen for standard ailments etc. and I'm really sorry that people make you feel not good enough

One's a nurse.
One's a doctor.
Different. You can't compare nurses training with doctors training.

I've found the ANPs and specialist nurses to be brilliant. So much knowledge and actually listen to you. I'd rather see an ANP than a doctor if it's for a specific problem.

It's difficult though. People of a certain age are used to seeing a GP first and a lot of us feel we are being fobbed off by the system. My MIL suffers with leg ulcers and saw a young paramedic at the GP surgery. The treatment she received was pretty awful. Paramedic inferred she was wasting their time but within a week or so she was under lower limb clinic as an emergency because the treatment she received from the GP surgery was so poor.

As a GP I think you have such an important role in delivering front line health care. Everyones skills together make for a great team. The NPs i work with are amazing and specialist nurses in hospitals are amazing.

I saw a clinical practitioner when my chronic illness was uncontrolled a couple of years ago. I was in pain during the night and hers was the only appointment available when I logged on to the practice in desperation. She was wonderful and saw me through until the hospital sorted out my medication and I recovered. No Dr could have done more.

Just out of curiosity what did you move on to if you don’t mind saying?

The ANP at my GP’s surgery is certainly appreciated and respected. A couple of years ago I had a series of different medical issues all manifesting at the same time I was seeing hospital consultants, optician, ANP and GP in all cases I was seeing the best person for each issue and I was extremely happy with all the NHS care I received. I know the lead of our GP surgery through community work and I mentioned to him how amazing the ANP was and he said that he agreed and that other patients had made a point of telling the surgery as well.
It’s not always see one or the other in my experience one time more recently I was given an appointment with the ANP and she realised that she really needed to double check something with a GP she asked if I minded waiting ( not at all) and she got one of the GP’s to see me straight away, they confirmed what the ANP had thought so no extra waiting for a GP appointment.

I'm really sorry you're feeling down about things, OP. I don't normally support medical professionals on here, as I've had such appallingly shit experiences with 99/100 of them. But, over the 2 years we've been forced to deal with countless nurses, consultants, trainees etc., the one and only shining light was an ANP we saw in one of the hospitals. I regret she was only ever on one shift. She was the most knowledgeable, empathetic and seemingly best trained of literally everyone else we have ever had any interaction with. She was patient centric, took pain problems seriously and had them investigated (which literally no Dr has ever done for us), made recommendations to make procedures easier, knew how shitty some of the services could be and made sure absolutely everything was written down, so they couldn't weasle out of doing what was required. She was amazing. I'm sorry people don't understand the level of training you have and don't value the service you provide.

Yes ANPs are generally much more helpful. Also I like the practice physio that you go to where appropriate. They are much more knowledgeable about backs and joints than the GPs.

The ANPs at my local surgery practice are brilliant and they took fantastic care of me when I had scalding hot potato water on my foot - note to self, don't cook in bare feet! Keep up the fantastic and vital work x

To be honest, I appreciate being able to get a quick same-day appointment with ANP rather than having to do the 8am phone call lottery to try and get a GP appointment. DS developed an ear infection over Christmas and we were able to phone at lunchtime on 27th and get an appointment with ANP and antibiotics later that afternoon....

I have great respect for ANPs especially those who have extra training in a specialism such as diabetes or asthma. They are highly experienced and well trained and in no way comparable to the current PA role or some of the other ACP permutations. I've seen them myself for a number of things and had nothing but good treatment.

Having said that, I do have concerns about them seeing undifferentiated patients due to a shortage of GPs. Some years ago, my DH saw one twice with a non healing painless mouth ulcer. He was twice sent away with mouthwash and then insisted on seeing his GP, who immediately sent him for the biopsy that confirmed squamous cell carcinoma. The (small) delay didn't affect the outcome I believe, it was over a couple or 3 weeks and I blame noone. However after his death I spoke to his GP (also mine) who said that he immediately knew what it was.

I feel that the training doctors undertake in diagnostics is important and does set them apart from other, equally valuable health professionals, which ANPs are.

There is no shortage of GPs. There is a shortage of jobs. Some qualified doctors are driving Ubers or stacking shelves in Tesco to pay their bills. They'd rather be a GP. We need them, but they are not funded.
Same with hospital doctors. Lots trained by the NHS have no jobs. Employ them, cut waiting times, cut waiting lists. They are v often cheaper than the alternatives being employed. Doctors earn LESS than PAs for the first 8+ years.

Why the shortage of jobs? Is it because of a false economy of hiring cheaper less qualified staff which is a real worry. Having GP practises privately managed means that primary care boards are looking primarily at the fiance so the CEO and directors have healthy payouts. Makes sense if you are running a business to hire the cheapest staff?

I have no issues seeing ANP's. I saw one for a stomach problem, she ordered tests and subsequently referred me to the hospital. The doctor would have just done exactly the same, no need to see a GP at all.

Or rejig those words to say "GPs want more than their surgery can afford to pay them"