Your Primary Care Nursing Team.
The role of the nurse in the primary care setting has changed dramatically over the last 25 years. Gone are the days when they used to assist the doctor and run an appointments system making regular cups of tea and managing the home visit requests and out of hours also.
Todays modern NHS expects the nurse in primary care to be highly educated and experienced in not only the basics of care but must also manage patients with long term conditions such as diabetes and chronic obstructive pulmonary disease.
Nurses have taken on extensive further education in order to meet the requirements of the busy general practice and our nursing team are her to help deliver the care you expect at a high standard.
To help you understand the different levels of expertise within our team, we have decided to describe our individual nurse roles here at Shadwell Medical Centre.
Healthcare support practitioners
Our phlebotomist and health care assistant [HCA] support our registered nurses.
Neither of these roles requires a nursing qualification, but both roles require formal training in order to be safe and practice effectively within the primary care team.
Jan Hartmann has over 20 years experience as a phlebotomist and we are fortunate to have her in our team. She is an expert when taking blood and if any patient is anxious about this procedure, they can rest assured that Jan is extremely gentle and efficient. Jan works on a Monday, Tuesday and Wednesday so bloods can be taken throughout these days.
Treatment Room Nurse: an NMC registered nurse.
This role is usually suited to a nurse who is new to working in the primary care setting. It is a very different setting to secondary care. Very different skills are required to run a treatment room well.
The following are areas that the treatment room nurse can help patients with:
Assessing problems presented opportunistically by patients
Running well person clinics and health promotion programmes by providing a holistic assessment and lifestyle advice on diet, smoking, alcohol intake and exercise, with referral to appropriate agencies.
Offer advice about childhood and adult vaccinations
And ensure vaccines are administered under patient group directions/ Practice policy guidelines once adequate training completed.
- Vaccinations and medicines
- Safe sex
- Food hygiene
- Able to document consultations according to NMC guidelines
- Ensure all awareness of statutory and local clinical protection procedures, including systems of referral
- Ability to recognise signs and symptoms of child abuse
- Perform a holistic assessment of patients for ear irrigation, once the appropriate training completed
- Perform venepuncture according to local guidelines
- Provide a holistic approach to wound management and implement wound care in line with current evidence based guidelines
- Suture removal
- Perform Electrocardiograms - (ECG)
- Undertake ear care
- Able to recognise and manage anaphylaxis according to current UK guidelines
- Able to perform Cardio-pulmonary resuscitation according to current UK guidelines. Updates regularly provided
- Assist in the provision of minor surgery.
- Ability to obtain and document informed consent (either verbally or written)
- Ensure infection control guidelines are maintained.
- Ability to monitor and manage maintenance of stock and equipment to include refrigeration, single use equipment and general treatment room equipment and emergency equipment.
- Confidentiality of information gained at work must be preserved at all time
General Practice Nurse – an NMC registered nurse.
A general practice nurse [GPN] is a nurse who has skills to work in the treatment room and has undertaken further education to develop their role to meet the requirements of the practice in order to monitor patients with long-term conditions.
Carla Paniagua-Gutierrez has worked at Shadwell Medical Centre since 2008 and has all the skills of a treatment room nurse plus further training to manage patients with diabetes and chronic obstructive pulmonary disease [COPD] and asthma plus cardiovascular disease.
Carla works on a Wednesday and Thursday and can see patients requiring any of the treatment room skills plus the following:
C arla carries out regular diabetic, COPD, cardiovascular and asthma health checks. She attends regular educational updates to consolidate her knowledge, which ensures she is up to date with current practice and management of these patients.
Carla can perform spirometry (a lung function test) within the practice setting, which allows management of patients with respiratory conditions to be individualised, and appropriate treatment planned.
Carla can use the results of the spirometry test to help determine the cause of a patients's respiratory problem. Spirometry is also used to monitor respiratory patients. Information from the results of spirometry help Carla write individual management plans for our patients who are also part of the discussions around their care. Carla will seek advice from her colleagues if required.
Carla will check compliance with treatment and discuss the effect they are having on her patients, adopting a holistic patient centred approach.
Carla can recognise abnormalities in patients blood test results, spirometry readings or symptoms expressed by the patient.
Carla can identify the impact of treatment and implement or recommended changes as appropriate but will always seek advice from her colleagues if she has any doubts.
We have also been joined by a new Practice Nurse Helen Archer who came to us direct from the wards at Chapel Allerton Hospital.
Specialist Practitioner: a NMC registered nurse.
This role has developed to suit the requirements of general practice in 2016.
To help patients see the right clinician with the right skills at the right time, we employed a nurse to deliver a triage system for “emergency appointment” requests.
Denise Mellings joined the practice in October 2016 to do this. She works on a Monday, Tuesday and Friday and her role is to triage patients who feel they need to see a healthcare practitioner.
She has worked in General Practice for most of her career and is highly skilled to deliver this service as she did for her previous employer. Denise may be able to offer advice over the telephone or organise an appointment with a member of the clinical team.
She has trained to assess patients with minor illnesses, and as an independent nurse prescriber can rescribe suitable medicines, if appropriate, according to local guidelines .
The following are the types of minor illnesses that Denise can assess:
Earache, otitis media and otitis externa,
Diarrhoea and vomiting
Urinary tract infections (women, men and children)
Sore throat and tonsillitis
she helps the practice admin team to route electronic discharge letters to the appropriate clinician and act upon requests from our colleagues in secondary care when they have seen our patients and need a change in their management plan.
Having read the descriptions of all the nursing roles with Shadwell Medical Centre we hope you will understand that we all have different talents and expertise.
We work closely as a team for your benefit.
We are here to help and guide you.
|Dr Ian A Bargh - Managing Partner (m)|
MB, ChB (Manchester) MRCGP Fully Registered 1987. Honorary Senior Lecturer, Faculty of Medicine, University of Leeds.
|Dr Jeanette Turley - General Practitioner (Salaried GP) (f)|
|Dr A Grewal - General Practitioner (Locum) (m)|
MBBS (India 1980) FRCP FRCPS (Glasgow 1986) , LPCP CRCS LPCPS (Edinburgh/Glasgow 1987)