People don't use Practice Nurses/ANPs enough

[TheMustressMhor]

I am always reading threads from people who cannot get GP appointments and I wonder why they don't book to see the Practice Nurse or Advanced Nurse Practitioner instead.

I know that these HCPs also have a long waiting list in many surgeries but they can and do diagnose and prescribe. They can also refer you on to the GP if necessary.

AIBU to think that most people do not understand the rold of the Practice Nurse/Advanced Nurse Practitioner and that their services are not used as much as they could be?

In my own practice there is a very competent ANP, one full-time GP and two part-time GPs.

There is also a Nurse available for dressings/smoking cessation clinics etc.

The ANP is the person I go to first with most problems.

The point you make is very valid.

The nurse can always tell you that you need to see the doctor and will refer you on.

PP suggested that ANPs are not as "qualified" as GPs - and of course they are not. But they are as qualified as ANPs should be and know their limitations.

The only time I have seen the ANP she refused to prescribe me antibiotics as she 'didn't think' I had tonsillitis (despite all the symptoms) but took a throat swab to appease me anyway. Results took a took (all this time I'm off work and still sick as a dog) and suprise su-fucking-prise I had tonsillitis!!! Took another week until I was well enough to go back to work. So because of her I was sicker and off work for longer than was necessary cos she wouldn't prescribe fucking antibiotics. So next time I absolutely will be refusing if offered.

Our surgery has one nurse and you wait about 6 weeks to sed her so that's why I don't make appointments!

I suffer with anxiety which is worse surrounding my health so if its something that is worrying me then I'll only want to see my own Dr. By this, i only want to see her as she understands me. But if its a general thing like a uti or flu then I'd quite happily see a nurse practitioner I don't see the need to see a dr in those circumstances

Getting a nurse appointment is harder than a gp at my docs. Can use online appointment booking and get same day appointment with a gp but if you want a vaccination or smear test the wait is literally weeks for a nurse.

I'm not aware of ANPs at my practice.

Unless pharmacists and nurses are given prescribing powers (maybe not for everything but simple antibiotics for straightforward infections for instance) it is pointless seeing them.

TBH our receptionist tends to try and get you to see the nurse more often - I have no issues with seeing the nurse, however one time she (the nurse) told me the next appointment had to be with the doctor (long term condition I presume you see the doctor every so often) when I rang to make that appointment the receptionist kept saying did I want to see the nurse, she's very qualified etc - and no matter how often I kept saying the nurse told me to see the doctor it didn't seem to go through

Several pharmacists and nurses have done prescribing courses so can prescribe

I’m happy to see whatever health professional can diagnose and treat my condition.

whenever i go to the pharmacist for the children, the pharmacist has always, without fail, told us we have needed to see the GP.

@ItsOnlyBloodyBread YABU a dr will have most likely refused antibiotics in that instance. I have been on my knees before with throat infections and been refused antibiotics by drs and rightly so. Antibiotic resistance is a real and very dangerous thing and I imagine hcp's have to follow very strict guidelines regarding prescribing.

Just to clarify, a practice nurse is different to a nurse practitioner. Practice nurses have the traditional vaccination, smears, asthma clinic etc. They are usually general trained nurses. An ANP/ACP are autonomous advanced practitioners who see most things you would see a GP for. They prescribe, diagnose, refer, and if hospital based, admit.

Imho the problems are not knowing who to see. Most of us dont have the time or patience especially when unwell to book one appointment to be told that they cant deal with the problem and you have to come back for a doctor's appointment.

The pharmacist is really busy 99% of the time. I would feel uncomfortable even asking for a private consultation. You are always guaranteed privacy at an appointment.
Maybe pharmacys need to be set up differently to accommodate this?

I dont care who I see as long as I can discuss the matter in private and they can help. I'm assuming most people have this attitude so just need more education on who to go to.

Thing is we do not have a nurse practitioner so need to see the GP or travel 30mins to wait in a walk in centre

In my case, I wont see them due to a bad experience: I gladly accepted an appointment with a nurse practitioner for (what I thought was) tonsillitis. Unfortunately it had developed to quincy and mine was particularly severe (surgeon brought in a load of students cos the hospital only see a couple of cases each year) and she sent me away with antibiotics despite me being unable to swallow saliva (I used her sink to spit in to instead) and struggling to breathe. i was in the hospital high dependency unit within 4 hours of being sent home from my GP practice. I totally trusted her judgement and my sister had to bully me in to seeking additional medical help. Routine stuff might be fine with an ANP, but if they can't recognise complications I won't see them.

On the other hand, I'm a big fan of pharmacists - only ever had good experiences and they can tell when over the counter meds will suffice and when I need to see a doctor.

We don't have a ANP and living in a large elderly area you have to book in weeks in advance to see the nurse. Even for the treatment room.

I've been pondering though over a mole that's turned black, will a nurse look an advise?

We don’t have one so no choice

The waiting time for the practice nurses at our surgery is 2 or 3 times longer than the wait to see a GP.... The GP's run a 'duty doctor' rota which works really well and seems to keep their appointment book turning over whereas the nurses are rushed off their feet

No ANPs (or ACPs rather as it isn't just nurses now) at my GP practice.
I work with a lot of them though so would very happily see one if it was an option.

if a pharmacist says you need to see a GP - then you REALLY do

That isn’t quite true, I’m afraid (I’m a GP).

All summer my surgeries have been full of people with insect bites that ‘the pharmacist said was infected and needed antibiotics’.

Virtually zero were actually infected...

I've been pondering though over a mole that's turned black, will a nurse look an advise?

Please see a GP as soon as possible. That wouldn’t be something an ANP could really deal with.

Can I have an example of something that and ANP cannot do and would hawb8to refer to GP?

I have a pretty complex set of medical conditions and I have found nurses are very good at single issues but when it comes to dealing with an interaction with another condition then they are not so good.

I have found diabetes nurses to be amazing, very knowledgeable about meds and other treatments while GPs now have very limited knowledge and if you ever ask them about medication they just tell you to talk to the nurse.

My practice have also got a full time pharmacist now who is also good, she has phoned me a couple of times to discuss prescriptions. My psychiatrist was raging after she phoned him angry because of the way he was changing my doses of mood stabilisers and the fact he he gives me prescriptions direct instead of going through the GP.

I'm extremely lucky with my medical centre. It has, alongside roughly 8 GPS, 4 practice nurses, an ANP, SNP and a clinical pharmacist.
That's without phlebotomists, physios, diabetes & asthma nurses and HCAs.
No matter what your ailment you'll find someone who can see and help you.
No need to book an appointment with a GP just for a prescription/med review/test results...

My previous surgery had all of 4 GPs, 1 prescribing nurse and 1 practice nurse.

ANPs are fantastic and have helped me a lot more than certain GPs, it's just a shame that not everyone has the same opportunity to see one.

@itsonlybloodybread - "tonsillitis" actually only describes a set of symptoms primarily inflamed tonsils. And it (and most types of sore throat) IS usually viral in cause which antibiotics are of no use to. Our overuse of antibiotics is causing HUGE issues as I'm sure you're aware. So it is now fairly standard practice to test throats BEFORE prescribing quite possibly unnecessary antibiotics.

However as a frequent sufferer myself I do (quite literally!) feel your pain. It's usually viral in cause but I have noticed myself that if it developed in a particular way I know and have had confirmed on several of these occasions that the cause is bacterial. I have learned to make an appointment ASAP when I feel that symptom (it's a very specific sharp pain on one side before the sore throat properly develops) and get a swab taken so that I can get the antibiotics ASAP.

It's a horrible thing to have and ime certainly more than "just" a sore throat, but I mostly use home remedies to treat the symptoms and they do help.

There are also natural things that have antibiotic properties - garlic, honey, ginger and clove all have natural antibiotic properties - that is why hot lemon with honey and ginger can help such ailments. Top tip much easier to peel ginger with a spoon - sounds nuts but works!

"Unless pharmacists and nurses are given prescribing powers (maybe not for everything but simple antibiotics for straightforward infections for instance) it is pointless seeing them." Do you think hcps are mere dispensers then? They can do so much more if you have a good one.

"I have a pretty complex set of medical conditions and I have found nurses are very good at single issues but when it comes to dealing with an interaction with another condition then they are not so good."
To be fair myself and particularly dd (she has a disability that affects every body system in some way) have had THIS issue with far too many gp's!

Not least because the time pressures mean the "one appointment one issue" culture means often interrelated things causing dd difficulties are misdiagnosed or missed altogether!

My current GP is fabulous but I've had some real shockers!!

I've been offered the Nurse so often as there are never any Dr appts, but every time, I was told you need to see the Dr. So I don't say yes any more. All the next 2weeks Dr appts are: "only released by the system every Wed" & taken within the hour. It doesn't seem very efficient to me.

My practice doesn’t have an ANP or a practice nurse, just GPs but we are not in the UK.

Our surgery diverts you to a phone call from an ANP in the first instance. My experience wasn’t great when I was calling about taking some medication while pregnant. I’d already tried not to bother the GP surgery by going to the pharmacy and trying what was licenced in pregnancy, was told to consult GP if it didn’t work.
The ANP just read out the guidelines on the box to me and when I asked to speak to a GP she said ‘it depends if you want to take a risk with your baby’ then when I was still asking to speak with a GP she hung up the phone on me.
Got a call back a couple of hours later from a GP who gave me some great advice, advised me of risks and current evidence with that medication without giving me a guilt trip, and prescribed something that fixed my problem.
So based on that only experience I have found pharmacists and GPs more helpful.