Second Bulletin

The second bulletin has just been released. If you missed it, then you can view the bulletin HERE, as a pdf. if you have any trouble, contact the project team.

Observing Nurse Activity - Tell us what you think

In Phase One the AGPNS team used a Rapid Appraisal Tool (RAT) to gather information during practice visits. One element of the RAT was structured observation of an hour of nurse activity, at two different points in the day. We now have records of fifty hours of nursing time in general practice. Our data show that:
 Practice nurses cycle through many tasks in an hour, often returning to the same task several times.
Is this the most effective way for Practice Nurses to work?
 Nurses are extremely responsive to the request of others in the practice. Having a space dedicated to practice nurse clinical activities may reduce the number of interruptions a nurse experiences in an hour.
What are the pros and cons of having a dedicated clinical nurse space?
 Practice nurses range over the entire general practice throughout their day.
What does this say about the nature of a nurse’s role in a general practice?

Practice Nurses and their role in Quality & Safety

The excerpt below is a paraphrase from an interview with a practice nurse.

“We had this girl come in. She just appeared in the surgery in tears and I took her into the treatment room. Anyway she was suicidal and at that stage we didn’t have our other practice nurse as well, but you just have to prioritise. She needed me until I could get a doctor to her. So I just put everything into looking after her and that’s where the team works so well, because the girls out the front just said “We’ve got a medical emergency. The nurse will ring you back.” They just kept taking phone numbers and saying, “She’ll ring you back,” because I couldn’t be disturbed. This girl had come in and she was in a crisis. So anyway in the end I got the doctor to take over and that was it. As it turned out then I had to, sort of, do a lot of following up and ringing for them while they were with her.”

We are interested in what other practice nurses think about this situation. In particular:
 How did the nurse's actions contribute to quality and safety?
 What is the nurse's role in the team?
 What role does the doctor play? Is it appropriate?
 What does this say about access to services?