1. Maximising the General Practice Nurse Potential
Good morning everyone, I hope you are enjoying the conference so far!
Some of you may already know me… and for those who don’t,…I am Karen Smith and I work as a lead practice nurse and locality nurse lead for Stevenage…
Additionally, I am proud to call myself a nurse tutor!
I've been asked to talk about my development as a practice nurse, as well as maximising the potential we have as nurses in this current environment of change.
This presentation will be a quick overview of how I have become the nurse I am today and my hopes for our profession in the future.
Karen Smith
Nurse Practitioner and Nurse Tutor

2. The challenges faced by the NHS, including an ageing workforce, rise in chronic conditions and complex co-morbidities, recruitment difficulties, financial pressures, all combined with a rise in patient expectations; require new models of healthcare provision and a flexible workforce.
As well as building capacity in our workforce, this includes the development of new and advanced roles and innovative attitudes toward the mix of skills in teams. The current model of primary care is unsustainable, and a new workforce is required to support primary care and community care (NHS England 2016)
Before we start I want read this statement from NHS England…
“The challenges faced by the NHS, including an ageing workforce, rise in chronic conditions and complex co-morbidities, recruitment difficulties, financial pressures, all combined with a rise in patient expectations; require new models of healthcare provision and a flexible workforce.
As well as building capacity in our workforce, this includes the development of new and advanced roles and innovative attitudes toward the mix of skills in teams. The current model of primary care is unsustainable, and a new workforce is required to support primary care and community care”
This statement reinforces the importance of ongoing development of our roles in primary care, as well as becoming a prominent, integral and equitable part of the multidisciplinary work force.
Competencies for the future will include prescribing and advanced nursing skills in order to help deliver care for patients within the practice. Which will be emanated in wider federated organisations of practices and healthcare providers.
This is an exciting time for us and opens up numerous opportunities,… so lets take advantage of them!

3. So where do I begin…?
My journey as a Practice nursing started in 1993…
I was naive,…had little knowledge about my new role I was about to embark upon and was unsure what was expected of me.
I thought my job would be easy… doing a few dressings, blood pressures and ECG’s, which was definitely not the case!

4. To my horror I soon discovered it was much more demanding and diverse.
I realised I was seriously lacking the skills in screening, treating and educating in all sections of the community… from babies to older people.
To demonstrate the complexity of our job,… this practice nurse role tree highlights the multitude of skills and knowledge we need in our everyday lives as practice nurses.
For me it reflects the wealth of knowledge needed in “general practice land” and highlighted to me how very proud of our achievements and ability to juggle all these skills effectivley we should be!
So me being me, frustrated with my lack of knowledge and skills I set about finding out how i could become a good useful practice nurse.
I undertook the “generally accepted” courses such as cervical screening, family planning, child immunisation, asthma and COPD management… the list goes on and on.

5. Education and Career Framework ( HEE 2015)
General Practice Nurse Competencies(RCGP 2012, update 2015)
Under Development CCG Education and Career Framework
QNI/QNIS Standards for Senior General Practice Nurse Education and Practice (2016)
web links: and
However, at the time there was not a structured framework but I was fortunate enough to be supported by other, more experienced nurses.
Today we are fortunate enough to have:
The Education and Career Framework published by Health education England
The Royal College of General Practioners General Practice Nurse Competancis
and the Tutor team are currently developing an Education and Career Framework as well as a web site to help navigate us through our career.
….Additionally, there is now guidelines for Senior General Practice Nurses, which were produced by the Queens institute of nursing, who's website is useful for further information regarding career development!

6. The BSc(Hons) Specialist Community Nursing
Minor illness
The BSc(Hons) Specialist Community Nursing
Nurse Independant/supplementary Prescribing
Mentorship
After several years I was getting frustrated by the constrictions of my role and decided i needed to expand my knowledge and skills to become more autonomous.
As a result, after finishing my minor illness course, I undertook the post graduate “specialist nursing degree”.
For me it was excellent and challenging,… as it not only developed my clinical skills but increased my confidence and knowledge base around the policies that impacted the NHS and primary care.
For those that are interested, the course involves health needs assessment, clinical practice, care and programme management, clinical practice leadership, research and current health policies.
As you can see I have also subsequently become an independent nurse prescriber and mentor
All of which I am very proud to have achieved as I believe it has made me the nurse I am today

7. Primary Care Tutor for Stevenage LTC Nurse Lead for Stevenage
Lead Practice Nurse
Primary Care Tutor for Stevenage
LTC Nurse Lead for Stevenage
Locality Nurse Representative
Mentor
Visiting Clinical Fellow at the University of Hertfordshire
That naive nurse nurse of 1993… is now a Lead Practice Nurse, Primary Care Nurse Tutor, Nurse lead for the Stevenage Locality, Long Terms Contions lead and most importantly to me a mentor to my colleagues, alongside pre and post graduate nursing students, trainee GP’s and medical students
I am now in a privileged position where I work both autonomously and collaboratively within the primary care team
The extension of my role has also provided a unique opportunity to participate in decision making and policy development at both locality and CCG level,… which I hope enables me to I be your voice and advocate
Learning never stops!… I am continuously building on my knowledge, as I am acutely aware of the need for continuous professional development, in order to keep up with this ever changing world that we know as the NHS.

8. To finish… I want to reiterate my passion for practice nursing and want us to be seen as an indispensable credible workforce.
So what about the future…
I want to share my personal thoughts for the future of practice nursing. I hope you agree with them and I am sure you have many of your own thoughts surrounding the future of our career.

9. Opening up pathways so others can follow Role model
We as a work force must be taken seriously and are considered as equitable clinicians in relation to colleagues within general practice
Opening up pathways so others can follow
Role model
Confidence, courage, resilience, risk taking, visionary
I believe…
We as a work force must be taken seriously and are considered as equitable clinicians in relation to colleagues within general practice
We need to be brave and move out of our comfort zones ….
Act as good effective role models…
Have confidence, courage, resilience, learning to be risk takers, as well as visionary.
The opportunities to expand and extend the nursing role, with appropriate training and educa- tion, makes nursing in general practice an exciting career choice, and I believe we need to be role models for all future nurses.

10. How you decide to develop your career is your choice
Nurses need to invest time and commitment to enhance their skills and knowledge
How you decide to develop your career is your choice
We have never been better placed to dictate our career progression and become not “just the nurse”
I want to reiterate that you should grab every opportunity as I did! We will always be learning and as my daughter tells me, “the minute you think you know everything, is the minute you should find a new career”.

11. https://www.youtube.com/watch?v=zZVbTGINcd8 Thank you for listening
just before I finish…here is a quick clip to celebrate nursing
(click on link)
if doesn’t work, right click on link, click copy, go on to internet, right click and click paste, then click enter, and then fullscreen and play