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Practice nurses deserve investment from their employers

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16 December, 2013

There were some great speakers at the Chief Nursing Officer’s Summit a couple of weeks ago, and delegates left with plenty of food for thought, advice on how to tackle NHS priorities, and new networks of mutual support developed over the two days. Even in the best conferences, often the most valuable aspect for delegates is the opportunity to meet peers, share experiences and ideas and mull over the latest challenges.

One of the sessions at the summit involved a panel that included Professor Steve Field, former Chairman of the Royal College of General Practitioners and Chairman of the Department of Health’s National Inclusion Health Board. He has spent much of the last year visiting GP practices, and said one of his major concerns was professional development for practice nurses.

Prof Field said many practice nurses find it difficult to access CPD – the worst case he came across was a nurse who had received no training or education in over 20 years. Of course, like all practitioners on the NMC register, practice nurses are required to keep up to date, and we must hope that the nurse Prof Field mentioned had undertaken some independent study. But surely the GPs employing the nurse should be expected to fund some training?

The role of the practice nurse today would be unrecognisable to one practising 20 years ago. These nurses now shoulder a huge amount of responsibility, and most of the new tasks they have taken on have increased practice incomes. Aren’t they worthy of investment? And more to the point, don’t patients deserve well-trained practice nurses?

The problem for these nurses is that they are all employed by small businesses. Some of these recognise their nurses’ value and ensure they are supported in developing their careers. Unfortunately, others simply pile on the responsibilities and either expect their nurses to organise and fund their own training or don’t even bother to ensure they are undertaking any.

Working in small organisations can be isolating, with few or no peers for mutual support, while many practices have rigid hierarchies that make it difficult for nurses to assert themselves. After all, their line manager is also likely to be their employer.

As more care is moved out of the acute sector it becomes increasingly urgent to ensure that practice nurses receive appropriate training and education. Like delegates at the CNO summit, they would also find opportunities to meet their peers invaluable. Clinical commissioning groups need to take this issue seriously, and require all GP practices to offer their nurses access to professional development and peer support. These nurses have enabled their practices to transform and profitability to expand. It’s time they were given the recognition and investment they deserve.

Readers' comments (3)

  • My own practice is great for paying for me and giving paid extra time but many of the practice nurses I teach have to pay for training themselves AND take annual leave. How shocking is that? Very common I am sad to say. Can you imagine if that was the case for teachers or police officers or firefighters? Immediate down tools and strike I would imagine. We must all try to stick up for ourselves more.

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  • ‘The problem for these nurses is that they are all employed by small businesses. Some of these recognise their nurses’ value and ensure they are supported in developing their careers. Unfortunately, others simply pile on the responsibilities and either expect their nurses to organise and fund their own training or don’t even bother to ensure they are undertaking any’.
    This comment really describes my situation and I pretty sure there must be many Practice Nurses out there who are in a similar situation.
    Where I work, I fulfil the role of a Nurse Practitioner/ Nurse prescriber - I believe that there are various guidelines (Good practice in prescribing and managing medicines and devices 2013, GMC) that ‘cover’ GPs to allow this situation to continue.
    Time and money are in short supply in the NHS and especially so within General Practice.
    If GPs can have you carry out what they need you to, without you having the qualification then why on earth would they put you through the appropriate training?
    I have given up asking my GPs for me to do my Nurse Prescriber Training – apparently ‘they don’t think there is a need’; a colleague also said that the GPs have noted which of us ‘are coming up to retirement in the next few years’, so there appears to be an ageist agenda as well.
    So I operate in ‘no-man’s land’ – I try to be as safe as possible and am trying to stop doing what I am not qualified to do – all without the support and guidance of my GPs.
    Perhaps if GPs were obliged to train up their staff who are presently fulfilling the role of Nurse Practitioner or Nurse prescriber then this would address the situation.

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  • The problem I have constantly been confronted with in trying to access nurse prescribing has been to "ask your employer". This attitude even blocks the practice nurses like myself who try to access training independently.

    I have paid for my own training and gained experience in some areas in excess of the GP who employ me, but I feel I am on the same roundabout where, like a little girl, I have to ask the GP or even worse my "line manager" a practice manager who has little clue what practice nursing is from that of a HCA.

    It is really important that nurses in the future can professionally develop WITHOUT support of their employer by external means, that way at least those of who are self motivated can escape the awful employment circumstances and either work autonomously or move on to an employer who supports us.

    My employers archaic attitude has ruined my ambition and potential.

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