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PRACTICE COMMENT

'Revalidation signals more GP support for practice nurses'

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Practice nurses need support from their employers to find time for training and CPD, especially now with the arrival of revalidation, says Janet Smith

The issues of not enough nursing hours or appointments for patients are perennial ones. In any GP surgery there is always a balance to be found between time spent directly with patients and time invested in staff training, sharing learning, and effective supervision and support. As registered nurses we are all practitioners in our own right and have a duty to keep ourselves updated and ensure patient safety, but this is not always easy.

Time is an issue and I am not the only practice nurse who regularly works through her lunch break because there is not enough time to get everything done during clinics. The numbers of nurses off with stress means that I am also not the only nurse that feels overwhelmed by the demands made on us: by our patients, our employers, by the Quality and Outcomes Framework, the Care Quality Commission, by the government and, coming next year, by revalidation.

The sheer amount of information that we need to know seems endless. I counted 103 policies in our practice’s shared folder, and this is before you consider legislation including the Mental Capacity Act, guidance from the National Institute for Health and Care Excellence, and ever-changing information on the many clinical areas that make up any practice nurse’s everyday work. It is enough to make your head explode. Without the support of your employer, keeping up with all of this is an impossible task.

Time and again the employment and training of nurses is seen as expenditure and not an investment and, with tight budgets, it is not surprising that some GPs cut back on training to save money. There is no clear career development path for practice nurses, so it can be difficult for us to negotiate training that GPs don’t see as value for (their) money. Practitioners in our own right we may be, but we are part of a multidisciplinary team that needs good leadership and investment in skills to be productive. The CQC rated the University Medical Centre at Reading as outstanding and in its report said “there was a culture of openness, transparency, continual learning and improvement” and it was committed “to providing high-quality patient care and provided good support and training to staff to facilitate this”. No doubt the staff in this practice are highly motivated to learn and give of their best in such a fantastic work environment.

Personally I am lucky as my surgery organises quarterly protected learning time for all the staff and is good at funding training. We also have a practice nurse group organised by the clinical commissioning group and coordinated by an enthusiastic nurse who ensures that the agenda covers issues relevant to our work.

Revalidation is scheduled for April 2016, and while many of us (me included) groan at the thought of even more hoops to jump through, there is no doubt that GPs are going to have to take supporting their practice nurses more seriously if they want them to be able to revalidate and so continue to be registered.

Janet Smith is practice nurse at Mortimer Medical Practice, Kingsland, Herefordshire.

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