Journal of General Practice Nursing Article
Journal of General Practice Nursing, Volume 1, Number 4, November/December 2015 pg 66
What is a typical day for you?
A typical day for us is just like any other general practice nurse (GPN). We have a variety of clinics that consist of treatment room duties such as baby immunisations, ear irrigation, smears, dressings and also chronic disease management. Sarah also holds minor illness clinics. We also have admin time where we organise visits and complete tasks sent regarding patient queries.
Do you have one practice experience that has taught you something valuable?
Not one experience in particular, but I would suggest to question everything! Primary care funding is being reduced and this will have an impact on staffing levels so we need to do things differently. When I first started in general practice there were systems in place where the patient would come back several times, now we try to have more time allocated to each patient so that the patient doesn’t have to keep returning. Think about the procedures and systems that are taking place in a GP practice — is that just the way it has always been? Could work be delegated to admin or HCAs to free up nurse time?
Where did your passion for respiratory care come from?
I started as a nursing cadet when I was 18 and my first placement was an assessment unit. I couldn’t believe that too much oxygen could kill someone. I became fascinated with chronic obstructive pulmonary disease (COPD) and my love of respiratory grew from there. Sarah had a placement as a student nurse on a respiratory ward and this is where she developed her passion. Then, we later completed respiratory diplomas when we moved into primary care nursing.
What were the main drivers for setting up the Leeds respiratory network?
We decided to set up the Leeds Respiratory Network for two reasons. First, working as a GPN can be quite isolating and lonely. I work in a small practice and there is no one to discuss patients or share ideas with. Second, we found from looking at data that Leeds was one of the worst places in the country for respiratory outcomes. From discussions, we realised that there was a great deal of variation in general practice, for example, training given, time allowed for reviews, etc. So, we wanted to try and reduce some of this variation through education. We organise evening educational meetings and also a full respiratory event with inspirational national speakers. We use social media to disseminate information, with twitter, facebook and blog accounts. We also send out emails to people, as new guidance and resources become available. We have tried to create a sense of community with our mailing list, and people email questions that we send out to the rest of the network.
What are your plans for the future?
Setting up the network has led to us forming a social enterprise called ‘Respiratory Care Solutions’. From discussion we were having at grass roots to commissioning level, we realised that there was a gap in the market. There is already a shortage of nurses and this will become worse over the next few years as more GPNs retire. We would like to become a kind of nursing agency that only provides respiratory care, for example, if a practice needs extra help with reviewing their respiratory patients. In addition, we can provide support to GPNs by shadowing their clinics. We hope that in the future, clinical commissioning groups (CCGs) will commission our service.
What advice would you give a GPN Who Was considering setting up a network?
Just do it! It hasn’t taken up too much of our time, but it has really helped us to establish links at both local and national level. We are fortunate that we are affiliated with the Primary Care Respiratory Society UK (PCRSUK), which has put us in touch with appropriate people from its groups throughout the country. PCRS-UK also has an excellent leadership programme that members of the society can attend for free twice a year. We have developed personally and grown in confidence from attending these events. At the leaders event we have also learnt non-clinical skills that we have used to set up the social enterprise, such as project management, business knowledge and how to obtain data to make the case for change. If someone wanted to set up a diabetes network, for instance, find a colleague to work with so you can share the workload and bounce ideas off each other.
How do you see primary care developing in the next five years?
I think primary care will look totally different in five years with co-commissioning and the new federations. The Five Year Forward View will also change the look of primary care with the integration of services. These are exciting times for nurses to be innovative and use their knowledge to fill the gaps in service. Setting up the social enterprise has not been too difficult, and we have received grants and business support from UnLtd (a provider of support to social entrepreneurs in the UK) and Leeds Community Foundation, so it has not been financially taxing on us as individuals.