Primary care nursing is very different to hospital nursing in a secondary or tertiary setting. However, I have found that the transition from secondary to primary care has been positive.
Practice nursing is a diverse and varied role, seeing patients from newborn to end of life, and from a wide range of different backgrounds and ethnicities. Sometimes I meet a patient just once, for a blood test or travel consultation; others I see regularly for wound care or for support to manage chronic conditions. Over the past year I have learnt so many new skills, including ear care, smoking cessation support and cervical screening. This is on top of the many transferable skills I had already developed working in hospitals – venepuncture and wound care to name a few. I also enjoy the flexibility that comes with having my own clinics and I have an improved work-life balance, with options to work at weekends for the Primary Care Network if I want to.
Practice nursing is much more about autonomous practice than hospital nursing and this did take me a couple of months to get used to. However, we still work as a multidisciplinary team, and I have the support of GPs, physiotherapists and pharmacists if I have queries about a patient. I also carry out some appointments jointly with a GP, especially if I have a patient with a wound I am concerned about. I have been supported by all these individuals in my transition to primary care to support the provision of high-quality patient care.
The Queen's Nursing Institute (QNI) (2020) described the role of the practice nurse as an evolving one, which is likely to play a crucial role in the transformation of primary care. The QNI standards go on to explore the support that should be provided to a nurse who is new to primary care. I have had good opportunities to develop my skills through a number of different courses, enabling me to develop competence in adult and childhood immunisations, travel consultations, cervical screening, and diabetes care. As further opportunities arise, I hope to continue to be able to expand my knowledge and clinical skills in relation to other long-term conditions and women's health in particular.
‘Over the past year I have learnt so many new skills, including ear care, smoking cessation support and cervical screening’
Another opportunity I have had as a result of moving into primary care is participating in the Salaried Portfolio Innovation (SPIN) Scheme – New to Practice Fellowships from Health Education England (2023). This is a scheme that is designed to help those new to general practice to develop a portfolio and be supported in the early stages of their career in primary care. It involves monthly peer support sessions, in which we are able to collectively reflect on our practice and learn from each other, while building a network of other new practice nurses. There is also additional funding available for fellows to use for continuing professional development that can be used to attend courses, conferences or buy books to help support our development (NHS England, 2023).
As a SPIN fellow you are entitled to 4 hours' funded time each week, for 2 years, to develop your interests and improve care through a project of your design in your own practice. I have been accepted by a portfolio host, meaning that I am funded to work 1 day a week at a university to support the teaching of nursing students. I have an interest in education, and I really enjoy sharing my knowledge, skills and experiences with the next generation of nurses. This experience will also benefit me in the future if I decide I want to work within nurse education, as it has given me experience and skills in academic teaching.
I am enjoying my new role as a practice nurse, and I am also gaining further skills and confidence through the opportunities from the SPIN fellowship. I have now been in primary care for 12 months and am proud of all the things I have achieved over the past year. Many of these opportunities would not have been available to me had I remained in a secondary care setting, especially with the issues around releasing staff from clinical areas to attend training and the funding of specialist courses.
I had spent a lot of time beforehand considering whether I should make the change, and it has certainly been the right decision for me. I am excited to see what the next year holds as I continue to build on my career in primary care.