The trials and tribulations of nurses

A practice nurse's lot is very different from that of her hospital colleague, writes the Jobbing Doctor

I have an impossible task.

I have been ask to chair a whole day conference for local primary care nurses in a hotel in my vicinity. No problem there - I have always enjoyed doing things like this, and the limelight is something I feel comfortable with.

I have seen the programme and it is interested and varied. I will be able to introduce the speakers, deal with questions and smooth things out. There will be an audience of about 100. Ever since I sang my first solo as a choir boy at the age of 7 to a congregation of several hundred, these numbers don't bother me.

I have to give a presentation myself. I enjoy giving lectures and presentations and I have done hundreds down the years.

This is not the problem. The problem is the topic - which is to talk about the trials and tribulations of nurses in the modern NHS. I always thought that the opportunities for advancement and skilling up for nurses were significant. They were being trained to do quasi-medical roles, and their pay scales weren't too bad.

The more I thought about the topic, and researched it, the more it seemed to me that there were two different groups of nurses - those who worked in the hospitals, and those who worked in the community.

Recent reports have suggested that hospital-based nurses now spend more than 50% of their time with administration, and limited amount of time at the bedside with the patients. I believe these figures as my patients tell me stories about their stay in hospital and the hours they are just left to their own devices. I hear stories told to me by my patients who are nurses who tell of ridiculous patient-nurse ratios. Finally, I hear about people who dress in nursing-type uniforms who are not trained or training - they are health care assistants or other such roles, and my patients mistake them for nurses.

The defensive paperwork is enormous, with incident forms, daily plans, protocols and such like. Patients tend to be more ill and frail, and are having more things done, with a quicker turnaround. You have no time to get to know the patients and their families.

These are the trials and tribulations of hospital nurses. But my audience is community-based nurses.

What are their trials and tribulations?

I do think that, in comparison, the practice-based nurses have a better time. They are much more co-ordinated into a team, and have to fill in fewer forms (although old habits do die quite hard as I try to suggest that they do not need for me to fill in a form every time they syringe an ear), and I would suggest that the paperwork is more like 10% of their time.

Practice nurses know their patients. They have regular and reliable hours, and can develop specific roles within the practice. They will get to know all the people they work with really well, and they can park their cars without having problems. No weekends, either.

My biggest problem is that I have to do a presentation in just 15 minutes. The fifteen minute slot is one I really find hard. It is much easier to do a 5-minute or a 45-minute presentation, but 15 minutes? I have to find enough interesting detail to avoid it sounding too concrete and full of lists.

Practice nurses may not be paid so well. There are fewer opportunities for changing to management.

But there is the positive side.

They work with GPs.

What more can you need?

Your White Paper questions answered

There are a multitude of questions left unanswered for practice nurses and healthcare assistants following the publication of the White Paper, the NAPC and Royal College of Nursing are providing a conference specifically designed to answer these issues – Practice Nursing Conference, Hilton Birmingham Metropole – 21 October 2010.
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