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PATIENTS

Unit Five
Career development from a patient’s perspective

Key Messages

Once you have read this Unit, you should have an understanding of:

  • how general practice nurses (GPNs) can move from one role to another as their career progresses
  • how patient’s constructive feedback can help a GPN’s career development.

GPNs are an expanding sector of the NHS workforce. All GPNs are qualified nurses. This means that, at the very minimum, they have completed a 3-year training programme in general adult nursing to gain a qualification of a registered nurse and will be registered with the Nursing and Midwifery Council (NMC) (www.nmc-uk.org). The training programme will have included education in both hospital and community settings.

The vast majority of GPNs will also have undertaken further study in order to equip them with the skills that are required in general practice. This additional study may comprise:

  • degree programmes or higher degrees (Master’s)
  • specific university modules (eg diabetes management)
  • study days hosted by the local primary care trust (PCT) or a pharmaceutical company.

Standards of education for GPNs

All registered nurses are required to re-register with the NMC every 3 years. In order to be re-registered, nurses need to achieve a minimum set of standards relating to their post-basic education and practice.1

These standards are:

  • nurses must undertake and record professional development relevant to their area of work for a minimum of 5 days every 3 years before they can re-register
  • nurses must have worked (in some type of nursing) for at least 750 hours within a continous 3-year period or, if not, they must attend a ‘return to practice’ course before they can re-register to work.

The NMC is entitled to see the nurse's personal portfolio of professional development at any time. These standards ensure that nurses keep up-to-date with education and training relating to their area of work. In practice, most nurses far exceed these basic requirements.

Most nurses will appreciate that the general public want to be assured of their competence, particularly when nurses are working in expanded roles and undertaking work that was previously done by the GP. They therefore will not object to you asking about their qualifications and the extra study that they have done.

General practice nursing as a career

After entering general practice nursing, there are a variety of routes that nurses can follow according to their interest and expertise. GPNs may apply for new, more senior posts, as they become more experienced and acquire more qualifications. However, patient feedback is equally important to their career development. All GPNs will appreciate hearing about their performance from patients, so that they can learn from this. Sometimes, if performance is not good, and comments are negative, this can be difficult to deliver direct to the GPN who may become defensive. In this case it is probably better to discuss your views with the practice manager.

When you are giving feedback on a GPN's performance, try to do it in a constructive way so that it is easy to see how they can improve. Similarly, if you are praising a GPN, offer feedback that states exactly why you found them so helpful - was it the information they gave, the way they understood your perspective, or the way they listened to your problem? As all nurses are required to keep professional portfolios, they may appreciate a written comment that they can include within this to demonstrate ways in which they have helped patients effectively.

To access general information on different types of GPN roles and the skills they encompass, see
Tool – Varying roles within general practice nursing .

New GPNs

Nurses who are new to general practice nursing may have come from a variety of nursing backgrounds (eg working in a hospital setting, or other branches of community nursing). There is no mandatory course for nurses to undertake to work in general practice. However, the practice or PCTs should offer them an induction programme, which may include a course of formal study and mentorship.

Experienced GPNs

The majority of GPNs who have worked in general practice for some time will have developed particular interests, and are likely to have undertaken either in-house training or formal education relating to these. These areas of interest are often shaped by the needs of the practice, or relate to the skills of others within the practice team. Many GPNs develop skills relating to long-term conditions (eg diabetes, asthma or hypothyroidism) and this links to quality improvements in care highlighted in the new General Medical Services contract.2 These nurses may run their own clinics, independently of a GP, where they will encourage patients to manage their own care more effectively. This approach of helping patients to become experts in their own care should be adopted by GPNs across all levels.3

Specialist practitioners (general practice nursing)

The qualification of 'specialist practitioner' is recorded on the nurse's list held by the NMC. Anyone using this title should have undertaken an NMC-approved degree, involving the following:

  • study in general practice nursing
  • the wider aspects of community nursing
  • leadership.

These nurses will have had their competence assessed in both theoretical and practice settings to confirm that they are capable of functioning at a specialist level.

Nurse practitioners

Nurses who use the term 'nurse practitioner' (rather than advanced nurse practitioner) have not necessarily taken extra qualifications. It may be worth asking what additional study they have done so that you can be sure of the level at which they are practising. However, it may also be worth checking the practice information leaflet, as this often provides details of clinical staff, including their experience and qualifications.

Nurse partners

Nurses partners have a share in the general practice business, and will therefore be involved in deciding how the practice works and what services they offer. For more information see
http://health.groups.yahoo.com/group/NursePartners.

References

  1. Nursing and Midwifery Council. The PREP Handbook. London: NMC; 2004.
  2. Department of Health. Investing in General Practice: The New General Medical Services Contract. London: Department of Health; 2003. Available at: http://www.doh.gov.uk/gmscontract/thecontract.htm.
  3. Department of Health. The Expert Patient. London: Department of Health; 2002. Available at: www.dh.gov.uk/assetRoot/04/01/85/78/04018578.pdf

 

This document is intended as a guide only.
© Crown Copyright September 2006.
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