Join us as we celebrate International Nurses Day and say a big thank you to all working hard in the face of the virus, while we call on the public to share their messages of thanks on social media using the hashtag #MyNHSNurse. Shine a light in your window from 8.30pm to show your appreciation for nurses. Helen Raine is Head of Nursing and Advanced Clinical Practice at Haxby Group GP Practice in York and Hull. Below, she explains how nursing across the country, particularly within Primary Care, has been revolutionised.

Life as we know it may never be the same again.  I’ve worked for the National Health Service as a nurse for 35 years and the last seven weeks have been some, if not most, challenging times our health care system has faced. It has been a whirlwind of transformation to ensure the nursing services of primary care have adapted to the very changing environment.

Prior to the lockdown announcement on March 23rd, the threat of Covid-19 was not far from everyone’s thoughts.  I was enjoying my annual walking holiday with a group of girlfriends when it really started to become apparent that Primary Care was going to change dramatically and that I needed to return to work. Since then, I have felt that my feet have not touched the ground.

Like the GPs, the Nurse and Health Care teams have had to revolutionise the manner in which they provide care. Whilst routine care was thinned out, and GPs moved largely across to digital consultations, the nurse team was still carrying out essential face-to-face consultations, including childhood immunisations, urgent bloods and Point of Care testing for patients taking Warfarin.

I’ve been so impressed by the resilience of the Nurse and Health Care Assistant (HCA) teams, particularly in the manner with which they have adapted to all the changes the pandemic has required us to make.

These include:

  • doing telephone consultations with parents prior to their child’s appointment for immunisations,
  • carpark clinics for patients moving from Warfarin to an alternative, 
  • contacting women who are due a contraceptive injection and offering alternatives, and
  • a drive through pneumococcal clinic for our most vulnerable patients who have been advised to shield.

The team have all been risk-assessed and those who are unable to do face-to-face contact have quickly adapted to other roles. There are nurses working alongside GPs, Primary Care Practitioners and medical students in the shielding team contacting all our vulnerable patients. One nurse is helping the Medicine Optimisation Team and others are responsible for the management and distribution of the essential Personal Protection Equipment (PPE), ensuring that all the sites have adequate supplies.

Use of technology

The use of technology in the Practice has taken a giant leap and, as a nurse team, we’ve also had to adapt to this; not only clinically, but from a day-to-day communication aspect. Our weekly face-to-face meetings are now held, like many other businesses, via Zoom. These meetings are so important, both to update the team and to support them from a wellbeing point of view. 

The team is not unique and throughout the country primary care has had to adapt, but the challenge might only be the starting point.  As the country starts to contemplate coming out of lockdown, what does this mean to the nursing services in Primary Care?

Part of the Practice operational management strategy is looking at the next phase and this includes the management of long-term conditions, such as diabetes, COPD and Heart Disease.  This is primarily an area in which the Nurses and HCAs are heavily involved with patients providing their annual review.

Technology is going to play a more prominent role here in the future; I suspect many reviews will be via telephone, with patients only attending for absolutely necessary appointments.

Coming out of lockdown

Looking forward several months as a manager in Primary Care I am already considering how we will catch up on all the routine nurse appointments which have been postponed due to Covid-19, alongside planning the annual flu campaign. This is a significant challenge as we will invite over 11,000 adult patients for their flu vaccine and when this happens, social distancing is still likely to be in place.

I have every confidence that, as nurses, we will meet these challenges and continue to provide the best care to our patients whilst also continuing to protect them. As Florence Nightingale said, “Wise and humane management of the patient is the best safeguard against infection”.