Practice nursing

[Rarily]

Can anyone let me know how they find working as a practice nurse? I've been in a management position over the last few years but am looking into returning to more clinical practice. Some of my local practices are open to applicants who don't have practice nursing experience. I'd be keen to progress to independent prescribing etc. How do you find the job? (The thought of childhood vaccinations terrifies me) and is the work varied and interesting? Thanks:)

I've been a practice nurse for nearly 16 years. I love the variety, the relationships you build with your 'regulars' and the true cradle to grave nursing. I like the fact I am an independent practitioner managing my own clinics yet have the support of my nursing team colleagues. I also like not working nights, BHs and weekends as it suits my family's needs.

I don't like the crap pay, (expect a significant pay drop from where you are now, especially if you are Band 6 or higher), the bullshit handed down from 'on high' (ie the NHS/government targets). Promotion is limited, the prescribing course is expensive and very intensive so GPs are reluctant to invest in you to do it especially if they have a nurse practitioner already prescribing. Practices vary hugely in their training opportunities and support. I've met many nurses on courses that are woefully unsupported by their practices, self funding training and doing it in their own time. Their GPs often expect them to work outside their remit. Patients can be hugely demanding and have very unrealistic expectations of what primary care can provide.

Having said all that I much prefer primary care to secondary care and can't imagine doing anything else.

Thanks Sidge. Can you let me know the proportion of types of work you do in a standard week? I'm keen on chronic disease management, less keen on bloods and vacs!

CDM only when qualified, usually with diploma level in asthma, COPD, CHD and/or diabetes. Some practices will get their nurses doing chronic disease clinics without the training or courses but I personally wouldn't and haven't done this. It's massively complex and ticking a box for QOF just isn't good enough even though the docs may expect it.

Bloods depends on your local provision - my surgery has a daily phlebotomy clinic so I don't do many bloods, just enough to keep my hand in. However I worked in a surgery doing maternity cover where the first hour of my clinic each day was bloods!

It's very varied and depends whether you'll be a treatment room nurse which tends to be the more routine stuff eg dressings, suture and clip removal, ear washouts, BP checks, health promotion, pill checks, ulcer dressings, vaccinations. Or a practice nurse which tends to involve more CDM, all contraception, cervical cytology, dopplers, triage and minor illness assessment, baby immunisations, travel health.

There is no one way for practice nursing, it all depends on the practice and the GPs. You're employed by them and not the NHS so they call the shots. What they will ask of you depends on their current team set up and their requirements. Good luck!

Thanks Sidge that's really helpful. Have to say the part that puts me off is being employed by GPs. Doctor's management of nurses seems to have increased over the years (with the clinical nurse specialists etc) whilst what was nursing is now done by HCAs....

Rarily , there is a good forum for practice nurses
practicenursing.co.uk

its very informative about issues in the practice nursing world , I'm a community nurse and find it really good for tvn topics .

I have found in primary care that nursing is still done by the registered nurses. Of course it can vary but HCSWs tend to do very 'minor' stuff. Ours does housekeeping type stuff, technical tasks such as BPs and ECGs (but no interpretation) and assists with diabetic clinic and leg washes etc.

We are managed by a lead nurse, the GPs don't get involved with day to day nursing management.