changing attitudes

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last week a close friend of mine asked me if a gp could limit the contraceptive services that they provided. his gf had moved house and whist a new patient medical had found out from the practice nurse that the practice only prescribe the oral contraceptive pill no other forms of contraception, as she wanted a contraceptive implant removed, she was directed to family planing . This made her upset and he wanted to know if the gp was allowed to do this and if the gp wasn't, he was going to make a complaint. After all his money pays the gp salary surely we should get what we need from the health care system, (this shocked me as i could not see what disservice had been done wrong)

From going on a hunch i explained that this was probably a professional discretion judgment due to the training of the gp/ practice nurse which i explained, i was able to find out that contraceptive services are additional to the gp contract and that they can provide all or nothing.

Patient complaints and attitude are not new however this reaction that we are what servants that they have paid for, not professional who may not do what the patient wants, as we are trying to give them the best care is frightening.

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Specializes in Medical and general practice now LTC.

My last job was as a practice nurse and it is an added service that is supplied by the GP and they can claim extra for providing the service. My previous employer was one of a handful of gp's that provided a service which included implants insertion and removal. The training is hard to do initially and very time consuming and even we had times where it wasn't suitable and convenient for the patient that we also refered to family planning. I would say a lot would depend on the size of the surgery and gp's working there.

It does amaze me the amount that make the claim I pay for your services. Most of us pay towards the health service so means I pay my own wage, guess tax man can find a way of taxing everyone as self employed

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Specializes in Nursing Home ,Dementia Care,Neurology..

Seems to be a public attitude,I've heard kids in the street,dropping litter,saying "well there's someone paid to pick it up,I'm only keeping them in a job".People are far to keen to complain without discussion first.

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sliverdragon as a practice nurse did you ever have pre-registration students, i currently in placement with one and its a culture shock, as the practice nurse has far more responsibility and automny my than most wards nurses i've worked with.

if you did what kinda nursing care were they involved with and what were the limitations to what they could do.

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Specializes in Medical and general practice now LTC.
sliverdragon as a practice nurse did you ever have pre-registration students, i currently in placement with one and its a culture shock, as the practice nurse has far more responsibility and automny my than most wards nurses i've worked with.

if you did what kinda nursing care were they involved with and what were the limitations to what they could do.

Sometimes we did if they was working with DN but we didn't have them actually allocated to us as gp's felt they had enough to do with medical students and FY2 students. It depended what experience they had to what we allowed them to do but they did give injections, helped with dressings etc.

It is a different world working as a practice nurse but most things have a group directive from the PCT which covered a lot of stuff we did, plus plenty of courses to go on

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Yeah most our out with the DN although i've spoked, i've become aware of QOF and chronic disease management, injections bp pulse and height weight urinanalysis(SP). it has been quite intense in the learning by being present when patients ask questions or respond, and not be

have to ask whats a fy2.

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Specializes in Medical and general practice now LTC.
Yeah most our out with the DN although i've spoked, i've become aware of QOF and chronic disease management, injections bp pulse and height weight urinanalysis(SP). it has been quite intense in the learning by being present when patients ask questions or respond, and not be

have to ask whats a fy2.

instead of HO just doing 1 year post reg they now have to do 2 years and in the second year they go out to gp surgeries. What I love about practice nurses is you really get to know your patients especially the chronic conditions you manage and the variety you get like childhood immunisations, dressings, suture removals, chronic care management to name a few. Can be very busy

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Specializes in midwifery, ophthalmics, general practice.
. After all his money pays the gp salary surely we should get what we need from the health care system, (this shocked me as i could not see what disservice had been done wrong)

From going on a hunch i explained that this was probably a professional discretion judgment due to the training of the gp/ practice nurse which i explained, i was able to find out that contraceptive services are additional to the gp contract and that they can provide all or nothing.

Patient complaints and attitude are not new however this reaction that we are what servants that they have paid for, not professional who may not do what the patient wants, as we are trying to give them the best care is frightening.

I've worked in general practice for nearly 20yres now (how scary is that!). GP's dont actually have to supply contracetive services.. as Anna says, thats an extended service. for a GP to actually fit implants requires training and also the feeling among some gps is, it requuires a bit of skill. I certainly know surgeries where the docs dont feel competent to fit implants- mainly because they might only fit one a year and thats not enough (would you feel comptent changing a hickman line if you only did one a year?). My current practice is the local family planning clinic, our doc goes on 6mthly updates and could fit an implant with her eyes shut. I'd rather see her!

on the complaint culture- yes its getting worse. I had a patient make an official complaint about me last week because I kept her waiting 20 mins for an appointment. I had good clinical reasons for that (the patient before her was actually ill!) but its seems that doesnt matter. we have abuse thrown at us for not supplying drugs the patients feel they are entitled to (remind me again how much paractemol costs) and I have on occasions felt threatened. we are now looking at fitting panic buttons- something we would not have considered when I moved to general practice. People want everything done yesterday.

Karen

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Specializes in midwifery, ophthalmics, general practice.
sliverdragon as a practice nurse did you ever have pre-registration students, i currently in placement with one and its a culture shock, as the practice nurse has far more responsibility and automny my than most wards nurses i've worked with.

if you did what kinda nursing care were they involved with and what were the limitations to what they could do.

as a clinical practice teacher, I often have pre reg students with me. they are always shocked at how much we do in General practice. as a nurse practitioner, I work automously (still cant spell though) and carry a great deal of responsibility. the PN's i work with are highly skilled, extremely knowledgable nurses, who can do just about everything. I know of PN's who are doing minor surgery, lots do cryotherapy. As secondary care seeks to shift work out to us in Primary care, the role of the nurse is expanding and growing.

and to think when i first moved to general practice, I used to take my knitting because i saw so few patients!! saw 42 today.......

Karen

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