Debbie Brown helps practice nurses to reach their full potential
Debbie Brown is London’s first nurse consultant in practice nursing and, after being appointed in September, she’s leading the way for others to follow in her footsteps.
Supporting other nurses is Ms Brown’s passion, and her role at Lewisham Clinical Commissioning Group allows her to do just that.
The Queen’s Nurse began working in Lewisham 36 years ago, training at Lewisham Hospital and working in a range of departments before entering practice nursing in 1998, where she found herself tackling misunderstandings about the field.
“There are lots of misconceptions that we have tea, change dressings and take blood pressure and that’s all we do,” Ms Brown says. “But there is career development in practice nursing. I think I’ve proved that in my transition.”
Her role as nurse consultant developed after Lewisham CCG performed an audit of district nurses, and Ms Brown decided to use the template devised by Professor Ami David to also evaluate practice nurses. What they found, she says, was a dearth of authority for practice nurses and disparities between their competencies and roles – findings that led to the nurse consultant position.
“I’m trying to support nurses, but it’s hard when I have no jurisdiction to go into a surgery and tell them what to pay”
“We saw that there was clearly a lack of leadership for practice nurses. Also, we have such diversity in competencies that the role of a nurse consultant would raise the profile of practice nurses.”
Now embracing her nurse consultant role, Ms Brown is able to provide some of that leadership. Much of the work in general practice is done by independent contractors, so she “cannot mandate or enforce anything” but can only “support and advise”.
Her lack of jurisdiction over those contractors can cause frustration, especially when it comes to pay. The absence of mandatory pay banding scales for practice nursing causes a “horrendous” variation in salaries, and she says she’s seen nurses leave their practices to go to others where the pay is higher.
“I’m trying to support nurses, but it’s hard when I have no jurisdiction to go into a surgery and tell them what to pay,” she explains.
She has developed the role to make that support invaluable and now sees herself partly as “a lynchpin”, and someone who can keep other nurses up to date on changes happening both locally and nationally.
”My job is to go out, find the evidence, look at policies and give everyone an update so they are informed.”
“I know all nurses are busy but because the practice nursing role has evolved enormously in the past five years, we haven’t got time to look through policies. My job is to go out, find the evidence, look at policies and give everyone an update so they are informed.”
It’s an important job, and one that she takes seriously, but that aspect of it isn’t necessarily her favourite. What she enjoys most is encouraging other nurses and “seeing them become more than they expected to be”.
“I love supporting the nursing workforce. I love seeing the nurses coming in, and then seeing their transition. To see them grow professionally and personally is the most rewarding part. I like helping people to grow and develop, to reach their full potential.”
And when they do this, Ms Brown feels that it has a ripple effect.
“If we can make a difference with the workforce, I believe it will help improve patient care. At the end of the day, we’re here for patients and to improve outcomes to keep people well and out of hospital.”
Despite those occasional road blocks, Ms Brown finds her “diverse” role satisfying, along with the new relationships she’s been able to build. She also hopes to continue encouraging others to develop their careers.
”I like helping people to grow and develop, to reach their full potential.”
“I want to ensure they have the competencies, skills and confidence to grow. We want to support staff so we can raise morale, and make sure the ones that are here want
to stay here.”
She also hopes the position of practice nurse consultant or equivalent is implemented in every CCG, to make sure “all practice nurses have the support any nurse working in a trust would have”.
And ultimately, everything does come back to patients and their care.
“It really is about supporting patients to remain healthy, and ensuring that every patient has the right care at the right time.”