In the NHS, 90% of patients have contact with general practice during their care journey, and much of that journey is managed by general practice nurses (GPNs) (Brown, 2017). In recent years, there has been increasing recognition of the need to reinvent and refresh the GPN role. This requires undergraduate nursing education to focus on prevention and managing chronic diseases within primary care, whereas education is often seen as favouring hospital-based nursing (Walsh and Mason, 2018). Giving nursing students experience of primary care would allow insight into the GPN role and present this as a possible career choice (Walsh and Mason, 2018).
A major challenge facing general practice is employing and retaining GPNs (Lewis et al, 2019). An online survey highlighted that one-third of GPNs are expected to retire by 2020, with 40% of GP practices indicating they were lacking appropriately qualified staff to provide patient care (Bradby and McCallum, 2015).
Over the past few years, it is evident that activity within general practice has expanded in terms of the number of patient interactions (Baird et al, 2016). As a result of the challenges facing GPNs, changes have been implemented in Scotland to refresh the GPN role. For example, the Transforming Roles programme altered the focus of GPN roles to encompass public health, care and support planning, and assessment of illness and injury (Scottish Government, 2018). Clearer responsibilities and role definitions have been created, and funding has been provided to ensure effective training and educational support for GPNs (Scottish Government, 2018). The number of consultations carried out by GPNs increased by 5% from 2003 to 2013, highlighting the gradual move of long-term condition management from GPs to GPNs (Scottish Government, 2018). The GPN role now focuses more on successful prevention, self-management, and anticipatory care (Scottish Government, 2018). Also, the 2018 General Medical Services Contract in Scotland noted the need for ‘expert nursing generalists’ who will support patients to live healthily at home and avoid unnecessary hospitalisation. Consequently, £2 million was provided in 2017 to 2018 for further GPN training (Scottish Government, 2017).
This brings me to my personal journey of becoming a GPN as a newly qualified nurse. GPNs assist with aspects of behavioural change and intrinsic motivation, and this is something that has always piqued my interest. The autonomy and responsibility involved in the role is extremely rewarding. Having graduated with an MSc in Adult Nursing, during a pre-registration degree the wide variety of clinical skills and patients to interact with was very appealing. Personal goals within general practice include gaining a non-medical prescribing qualification and progressing to being an advanced nurse practitioner. The programme offered by NHS Education for Scotland will support my progression.
Being male entering this profession initially raised some potential challenges, such as performing cervical smears. However, nursing is all about learning and expanding your clinical practice, and this is what I intend to do. The opportunities for continuing professional development are vast, and will continue to expand as the role develops. The drive for student nurse training in general practice is welcome, as without personal experiences during clinical placements, I would not have been given a full insight into this unique career.
As a newly qualified nurse about to embark on my journey as a GPN, I am pleased to be an advocate for this profession and to begin a career in an area that is becoming increasingly more recognised and appreciated. Although the role of the GPN has undergone vast improvements, it is clear that this is only the beginning. I am glad I will be able to experience these future developments first-hand.