I recently spent a fabulous afternoon observing a Queen's Nurse seeing patients in a busy London surgery. She is a highly skilled nurse practitioner (NP) and demonstrated all that is good about the work of nurses in GP surgeries. She knew her patients well. They trusted her. The conversations flowed easily and the patients shared their stories, fears, and the reasons for attendance.
The patients ranged from a mother who had brought her child for an asthma check after an unplanned hospital admission, a patient needing a routine cervical smear, numerous adult diabetics attending to discuss management, and a gentleman with a long-term mental health problem that had recently exacerbated.
It was a joy to observe the NP discussing self-management at every opportunity. She was completely focused on the patient throughout the consultations and when she turned to the computer screen, she told the patient what she was looking at from previous records and what she was writing as a result of the consultation. Her communication skills were masterful.
What struck me was the knowledge the patients had of their own conditions, something the NP encourages in all her patients. This meant that the consultations were well informed and decisions about medication management were detailed and individually focused. The patients were all truly equal partners in their care, and spoke confidently about their conditions and the ways in which they managed their medications and lifestyles.
I observed a highly motivated, well trained and educated NP who was keeping patients well and supporting them to improve their health. The patients would thereby avoid inappropriate A&E attendances and potential hospital admissions. It was true patient empowerment in action and an illustration of the huge potential impact of nurses in primary care.
We must do all we can to encourage practice nursing as an attractive career option and support the development of these nursing skills, to maximise confident self-care in patients.