e19 Nursing opportunities & portfolio

[00:00:06] Munir Adam: Hi guys. It's Munir Adam here, and welcome back to another mid-month mini episode on season two. Now, every so often we like to focus on a particular role for a few minutes or so as a way of getting to appreciate each other's roles, which of course is one of the five cardinal aims of this podcast. And today we're gonna be concentrating on the role of the practice nurse.

Appreciating the nurse role and trying to understand what matters to practice nurses and what makes a difference and facilitating those opportunities can go some way towards aiding retention, which of course, as we know is a real challenge. So this episode, as well as being useful to general practice nurses would certainly also be of value to those who are involved with making decisions or influencing, such as GP partners and others working in general practice surgeries, primary care networks, or in out of hours organizations.

But what if you are somebody who's not in that category? Well, a lot of the points that come out, you'll find they're not just applicable to nurses, but may well apply to you as well. So it's worth thinking that and bearing that in mind as you have a listen. And at the end I'll give you my take on that.

So serving the needs of all frontline clinical staff working in primary care and in partnership with Integrated Care Support Services, this is Primary Care UK. 

[00:01:38] Charlotte: Good morning everybody. My name's Charlotte Cooley. I am the GPN Fellowship Lead for North London SPIN Project. And I'll hand over to Debbie to say hello as well. 

[00:01:50] Debbie: Thanks Charlotte. So, hi. So I'm Debbie Brown. I'm the clinical director for Lewisham C P N training hub director of General Practice Nursing for Southeast London Training hub and also program director for GPN SPIN Fellow.

[00:02:03] Dawn: Hi everyone. My name's Dawn Hunt. I am a general practice nurse and I also work for the Integrated Care Support Services, which was formerly the Wandsworth Training Hub. I'm the program director for the Southwest London SPIN Fellowship for New to Practice Nurses, and I also work in collaboration with University of Roehampton overseeing placements within the private, independent and third sector organizations. Um, it's great to be here today.

Where to find opportunities

[00:02:35] Charlotte: So Debbie can you just tell me about some of the opportunities that are available for nurses?

 , if you've just joined primary care, what would you recommend are the key things that you probably need to try and engage with? 

[00:02:46] Debbie: Okay. Well, the first thing I would hope is that they get to know who their training hub is, who their locality training hub, is, and then who their ICB training hub is.

The train hub is where we are able to bring together all aspects of learning and career development and work with the practice, the nurse, the practice, and the pcn. So, I'd also sign- post them to the Q&I transition into general practice nursing. That's a great place to have a look. Yeah. I'd also ask them to look at the capital nurse and what's that around Capital Nurses. There's some great podcasts on the Capital Nurses site. Okay. There's a quite lot of information there. So to get some background and some understanding. And then I would ask them to consider what is it they want to achieve? Where would they, like, what would they want to do? So we've got quite a few programs, as you know, and Dawn and Charlotte. I know that you've got nurses going through them as well. 

 So we've got the, we call it the fundamentals in Southeast London, but it's also called the Foundation Program. . So that's a six month course into general practice nursing, and they have the academic course, which is either be a year, full-time or two year part-time course.

Yeah. And both of these, they're employed while they're studying and the study's all paid for. So they're great. That's, they're that fantastic start of getting onto that career ladder and to think about what your pathway wants to be. 

[00:04:02] Charlotte: Okay. 

[00:04:02] Debbie: Obviously, in general practice, we're we're getting there with preceptorship.

I'm not saying we're as good as all the trust at the moment, but we are really starting to have some fantastic support around the preceptorship program. We've also got all of our nurses, most of our qualified nurses are undertaking the SSSA to be practice assessors and practice supervisors. So again, another great support for them. 

And also your own team within your practice. It's about finding out who have you got, who else is to do within your borough, your locality. Who else can you link in with? And then I can't end this conversation and I know Dawn's gonna talk about it as well, is the GPN Spin Fellowship program. Because again, this is a huge piece of support.

And it's like being part of a family because each of those aspects that I've talked about can seem daunting and very isolating, but actually they all work and bring everyone closer together. 

Peer support

[00:04:51] Charlotte: Dawn, I was gonna ask you about the peer support and the networking for the fellows.

In terms of the scheme, I know you've just taken on a new group in southwest London. What are you including as part of their... 

[00:05:02] Dawn: So we do once monthly peer support sessions which are generally virtual, so online on a teams meeting which is great because it means that as many people can come to them as possible.

 We have had one in-person day, which was brilliant. Based at HEE, Stewart House, which was fantastic. And we had a morning with a teacher who was helping us to think about our personal presence and our personal impact. How we can communicate effectively to other people, which was really cool. And very creative and inspiring. 

And then we had the afternoon with Carmel Blackey from Kingston University, learning about how to work within an action learning set as a group and within our peer support people are really beginning to find their voice. And something that's quite helpful is that it's the peer support group is kind of a fixed group.

So that actually you get to know each other and you begin to have that kind of feeling of safety and, okay, I'm figuring out the team dynamic, which is brilliant. So far people have been very positive about it and seem to be really appreciating the networking element of it and just having a space to say, I'm not sure about this, or is anyone else experiencing that?

Yeah. Yeah. So I think it's been really positive. 

[00:06:35] Charlotte: So I think it is, it's quite a steep learning curve. Lots of people mention that when you join general practice, you know, you're going into autonomous working and you can be in a room and you can feel that sometimes you can feel like you haven't got people to lean on and support.

But actually I think part of the networking and the peer support that people get is that you realize there's so many people out there who are really passionate about supporting general practice nurses, and actually once you tap into those networks, you do find that there's so much help and assistance out there.

More ideas

[00:07:01] Charlotte: Yeah. Yeah. I think we are all passionate about our careers within general practice and what the possibilities are in terms of achieving and kind of really taking it as far as you want to go with your with your career and your lives. And I think another key part I think in terms of, there is available CPD funding through the training hubs and also general CPD funding that's available through the fellowship.

 So in terms of people finding courses that they're interested in, across the networks, we can usually find the right people to to help people sign up to those. So that's great. Thank you. . 

[00:07:32] Dawn: And another resource that I just came to mind was that there's a GPN Forum through the RCN as well, which is a brilliant place for I, I guess the bigger the national network of GPN nurses.

And then also just thinking about a practice nurses, local forum of nurses, which can be another great resource for them. Yeah. 

Practice nursing is a great thing

[00:07:53] Debbie: That's what's individualized. That's what's so great about practice nursing and primary care. We have so much autonomy. Yeah. Yeah. And that's where our strength lies in our who we can be.

And it doesn't, and it doesn't mean to say if you want to stay as a practice nurse and not have a portfolio career, that's absolutely fine as well. Some people feel pressurized, don't they? To be this extra and... 

what does Paul always calls us. Oh, the care program super connectors.

Brilliant. That's our power is we're super connectors cuz that's what we do. You know, the patient in a in our, we're in a consulting room. Yeah. We make, contacts three or four different organizations, be it voluntary, be it another referral pathway. We do that for the patient and there's no reason we don't take that skill that we have with the patient, take it into other parts of our roles. Yeah. And networking. Yeah. 

And what's good when you were saying about portfolio role, cause it's such a GP term, oh, I love those... 

Portfolio working

[00:08:53] Debbie: portfolio role, sorry. Portfolio roles: The term is GP led and it's quite new for nurses to use that terminology of portfolio role. Yeah. And is what do we mean? Yeah. Yeah. What do we mean when you say portfolio? I mean, for me it's just the other parts of your role that you are doing. . Yeah. , 

[00:09:16] Charlotte: I think I was doing portfolio roles and portfolio working before I really understood what it was.

And I think now I'm kind of, what does it actually mean to me in terms of the roles that I do and the influence. And I think the reason I started to look at training and development roles or going into different things outside my practice was to try and make the pathways and things better for nurses who are coming in and trying to improve things for nurses who might not as be well connected and try and get a voice I think for general practice nursing, cuz I think that's one of the big parts, is maintaining our voice for nursing and the role of nursing and the importance of it for practice because we are really in danger of. the nursing voice being lost because you know of all the problems that go through the workforce.

 But I think that, the uniqueness of general practice nursing is, the support of the teams and the support of any role in practice. I think, general practice nurses already understand general practice really well, and their ability to kind of train and support anyone else coming into the practice is really vital.

[00:10:17] Dawn: it's interesting also, thinking about portfolio roles with how wide you spread yourself. At one stage I got over enthusiastic and I had a flatmate who was doing some incredible research with people who had come outta prison and had really positive experiences through working with a trust.

And so I ended up interviewing some ex prisoners and found it so interesting. But it didn't link into any other work I was doing. And in the end it was a bit of a red herring and it was, I had just stretched myself too far and I, sadly I had to give it up. The work's still going on, but I'm just not a part of it.

 But I think if you, if your roles have some kind of overlap, then it works brilliantly, but for me, I think that was just something that was, it was outside of the NHS, it was outside of the training hubs, and it was just one, one string too many in my bow. 

[00:11:16] Debbie: I'm just saying that's a pair of recognizing for yourself, what is it that you want to achieve? And in what role does this fit? So you've, you've articulated that so well, Dawn, because like you say, personally, it was something you wanted to get into and understand and what could you do differently to help and support people.

But when you're looking at your other roles, where does it fit now? But maybe you're born and picked up again later. Who knows? That's the great thing about, isn't it? To be seriously, honestly, Charlotte, you I'm sure gonna agree. That's the great thing about practice nursing though? Because I was told once many years ago that we are like dishwashers.

No one knows they want us until they've got us. Once they've got us, they can't do without us . But it's up to us using our voices. Yeah. Using our expertise and honing our skills, developing into who we want to be. 

[00:12:05] Charlotte: Yeah. And I think it isn't it? The loss of a practice nurse for a practice is felt really acutely.

And I think that's it. You summed it up perfectly, Debbie, is that once they, once we've gone, once you know that resource has gone or lost or moved, I think that's the thing that practices then recognized. The value and the importance of having teams. 

And I think having portfolio roles, you people have a perception that actually it's gonna take you away. But I think what it's done for me is it's really knitted me into general practice even more across lots of different areas. And I think, I've got, so many kind of anchor points across the system because of all the different roles that I have done and continue to do with portfolio working. I feel really lucky as well that actually the opportunities that I didn't think existed...

There are so many opportunities, whether it is around clinical work, development of your clinical skills, support of other people; around education, leadership. I think the portfolio working now that's available can make your career so rich and diverse I think as a practice nurse. 

I've always loved being a generalist because, you never ever get bored, ever. And there's always something, and yes, there is a challenge, but there's challenges everywhere across the system. And I think, you know, the best bits about primary care really are where nurses come together and we really appreciate what we do and how we support each other.

Yeah. So 

[00:13:23] Debbie: it's great. No, a hundred percent Charlotte, that that sums up nicely actually. , what a high note to end on.

Final comments

[00:13:35] Munir Adam: Opportunities and arrangements vary so much from area to area, and over time that the aim of this mini episode or even a full-length one wouldn't really be to serve as a prospectus for all of the available opportunities because it would become outdated very quickly. Rather, what we've just heard are insights from three experienced nurse leaders shared in a natural, lighthearted, and unstructured way. I dunno about you, but I enjoyed that and I found it authentic.

I also found that in barely 12 minutes, it covered some important points that could be relevant to many of us. So here's my take on it. The first point is that regardless of your role, if you are interested in opportunities, then you should have a look at what's available in the system. And so for example, in the case of England, this would mean the training hubs, and each area has a local training hub, and we'll include relevant links to resources in the show notes. 

Another point was the benefit of peer groups. So it's worth asking yourself whether you are part of a peer group or not, and whether that might be something that may help, for example, dealing with professional isolation, opportunities, calibrating with each other. Oh, there may be other benefits to you as well. 

Another important point that came out was that practice nurses found it incredibly helpful if they felt supported by the other professions, and I think it's fair to say that that probably applies to all of us. Well, that makes me feel even better about having this podcast, primary Care Uk, because that is one of the functions: to appreciate each and understand each other's roles and to support each other.

And then they talked about the benefits that portfolios can bring in terms of adding variety. So are you a portfolio PA or gp or clinical pharmacist, for example. Would you want to be? 

And finally, know thyself. It's important to be self-aware and to pursue the opportunities that appeal to you because not every opportunity has equal value to everyone, as was pointed out earlier.

So which of these points might you need to work on? I leave that for you to ponder over and decide. But that's it for today. Do rate and review us on Apple podcasts. Do share with others, and until next time, keep well and keep safe.

Disclaimer

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