At the start of my adult nursing degree I was dead set that I wanted to work somewhere as challenging and gory as possible - in short A&E or theatres, however as the three years have progressed I have fallen more and more out of love with acute care nursing, so much so that I considered leaving the course in second year. Each placement I was faced with mentors who did not have ‘time for students’ and was often left to my own devices, working as a healthcare assistant more than a student nurse. As much as I loved this opportunity to get to know my patients and spend as much time with them as possible, I felt that my actual clinical skills were not as developed as I had hoped or imagined to be.
So you can imagine my delight when I found out my first placement of third year was in a General Practice - 8 weeks of regular hours, no shift work, no nights and no weekends. Pure bliss! Before even starting my placement I was contacted by the practice, asking if I had any off-duty requests and then with a detailed timetable of where I would be working for the entire 8 weeks, this was a stark contrast from ringing the wards and getting ‘Cassie who..?’ as well as often finding out my shifts only a week in advance. This gave me the opportunity to actually plan out the next two months of my life and have a proper ‘work-life’ balance, something that I had missed over the last 2 years of my nursing degree.
My first day I was greeted at reception, given a tour of the entire practice and got to spend time with each area of the practice including reception, care navigation and dispensary so that I got an entire feel of the practice and how it worked on my first day.
Throughout my placement I was encouraged to spend time with the entire MDT team, including the GP partners, the paramedic, nurse practitioner, assistant practitioner, HCA’s and of course the practice nurses.
No two days with the practice nurses were the same. We would go from seeing newborns for their immunisations to leg ulcers then to cervical smears. I was amazed by the variety of skills that the practice nurses had, their clinical skills surpassed those that I had seen in acute care. They worked much more autonomously, making clinical decisions regarding things such as wound management, chronic disease management and much more in-between. Although the chronic disease management decisions had to go through the doctors, this was often in partnership with the nurse and their clinical opinion.
I began to fall in love, the variety of patients that I would see on a day to day basis meant that I was literally caring for people ‘from the cradle to the grave’, I was able to promote health in a positive way, having time to speak to patients about their lifestyles and the small improvements that could be done. Finally all of the theory and clinical placements were clicking in to place. I had to use all of my clinical, communication and management skills each day, meaning that I was able to develop these further. Putting me in good stead for my final placement.
While I was on placement they had a position open for a Practice Nurse due to recent retirements. While I would have loved this position, I understood that they needed to employ somebody asap and so I didn’t even consider applying. However as my placement went on I was asked ‘where do you want to work when you qualify’ and people seemed shocked when I told them this placement had swayed me, I wanted to work in general practice. They then asked me if I would consider the position if the nurse practitioner put me forward, I was shocked and thrilled! I could not believe I would even be considered, let alone offered the position..this would not have happened without the entire practice support, rather than the usual ‘you can’t go straight into practice nursing, you need at least a years ward experience’ they understood and agreed..why go and work in a hospital when you have no plans to actually work there? Something the nurse practitioner knew too well, having gone straight in to Practice Nursing from qualifying, she was my biggest support and put me forward for the role, doing all the background work with the amazing assistant practitioner to ensure a plan was put in place until I qualify.
I have now accepted the role and cannot wait to start working there when I qualify- I truly feel like I have found my place and family in nursing, something that I had been missing from all previous placements. We are hopeful that I will be able to go back for my final management placement and then begin to go on specialist courses such as cytology(smears), child immunisations, phlebotomy and chronic disease management. These are all skills that I would not have if I had choose to work in the hospital,nor would I be as confident as an autonomous worker- having to make clinical decisions on a daily basis. In short as a practice nurse I will be doing things such as:
- Child and baby immunisations
- Travel vaccinations
- Cytology (smears)
- Wound management- Including leg ulcers
- Health promotion
- Vaccinations such as shingles, whooping cough, flu etc
- Telephone consultations
- Sexual Health
- Home/Nursing home visits
- Chronic condition reviews such as diabetes, CHD, Hypertension and Asthma
- Assisting in Minor Surgery
- Mental Health and Memory assessments
- A&E walk-ins such as burns, minor injuries and everything in-between!
- Continuity of patient care- seeing people from the start of life to the end.
This list is not exhaustive and each day a practice nurse is faced with something different. I have plans to continue developing my training and aim to eventually become a nurse practitioner.
Practice Nursing is my calling, that is something I am sure of. Despite the outdated view that it has ‘no career development’ or ‘somewhere nice to retire to’ I know that my future in nursing is bright, there is so much to learn, so many skills to develop and I cannot wait to get started.
Why would I ever want to work any where else?
If any one has any further questions about Practice Nursing or would like to know more then don’t hesitate to get in touch!