NPs in the UK?

Silverdragon102, BSN · Jun 9, 2008

From my experience in a City in West Yorkshire I can say no, NP's have not all but replaced GP's. My previous surgery where I worked had 4 GP (general practitioners) and 1 NP and the surgery where I was a patient had 3 NP and approx 15 GP's

karenG · Jun 11, 2008

oh I wish!!

there are currenlty about 4000 nurse practitioners over here. we have major problems here with registration. its possible to use the title NP without having undertaken a recognised training programme. Which can be frustrating for those of us who have! It is hoped to open a register soon, which will regulate things and the title will become advanced nurse practitioner.

I currently work in general practice, and in the area i work there are maybe 10 nurse practitioners (covering south east London- quite a big area). My current practice has 1300 patients so its very busy. General practitioners are still in the majority over here and I think always will be.

nice dream though!

K

allnurses Guide · Jun 11, 2008

It also depends on where in country you are, the GP practices around where I live have practice nurses but not many nurse practitioners, the NP role is mainly hospital based and the scope of practice for those in hospital is very varied with massive differences in what the NP's do.

For example, the team of NP's I work with are all prescribers, they take medical histories, make differentials and initiate treatments for the patients they see but within the same hospital we have nurse practitioners who are responsible for managing the bed capacity of the hospital and have responsibility for issuing equipment and drugs out of pharmacy and the equipment library out of hours. There is a nurse pracititioner who spends her days doing the cannulations and venepuncture for the doctors in her speciality, and there are some who don't have anything beyond a basic nursing qualification.

I get very concerned as we really need regualtion of the title of ANP, because if as a profession we have such confusion about what a nurse practitioner should be doing what does the poor patient think.

Also with the differences in the NP roles within the current finacial climate it is easy for the trusts to decide that we are not an essential worker, a neighbouring trust has restructured thier NP teams and insisted that they spend 50% of thier time working as a ward nurse and I worry that because there is still very little uniformity in the NP's in the UK that unless we can say this is what we do and provide for the patient we don't have any way to defend ourselves when decisions like this are made.

I am lucky, we work with the consultants and we have very strong medical support, if it was decided that we be put back to ward work our surgeons would pitch a fit.

karenG · Jun 11, 2008

hmm in my experiance, working here in the south east of England, I would say that most NP's are primary care based. certainly when I am involved in lectures etc, the majority of NP students are primary care based. In kent there are very few (can think of maybe 4) NP's working in secondary care (hospitals). the majority of nurses working in secondary care using the title NP have not undergone a recognised training course (how does a 6 wk course equate when compared to a 3 yr masters?) and they are not allowed to prescribe.

registration for us cannot come too soon..

Trauma Columnist · Jun 11, 2008

Just curious: I work in a large nephrology practice and handle two chronic dialysis units with a total of 200 patients. I examine, assess, plan and prescribe meds to manage their medical needs. Another part of my job is in the hospital, doing rounds on all our hospitalized patients. I might alsor place central lines - internal jugular and/or femoral lines. Much of what we do in the US is based on how it is reimbursed by Medicare which is the gov't insurance that covers the elderly and disabled.

Does anyone know how dialysis patients are taken care of in the UK? Just curious. Thanks for any info.

allnurses Guide · Jun 11, 2008

We have specialist dialysis units based within our hospitals so they are cared for by the hospital teams.

THe patient would have a renal medic in charge of his care whilst in hospital and attend usually as an outpateint to the unit at the nearest hospital. If there are in-patients who require dialysis they will be taken to the unit within that hospital or for something like PD the dialysis nurse will visit the ward area to assist the patient there.

You rarely get a cross over of primary and secondary care in the UK, the GP's and primary care practitioners communicate via letter and telephone with the hospital and vice versa, it does mean that there are communication break downs and often some tensions between the 2 services.

For example, I am a surgical nurse practitioner, as part of my work I assess patient for fitness for surgery in a pre-op assessment clinic where they are assessed and clerked, if I find them to be hypertensive although I can start medication as a prescriber, I will often defer to the GP as they can get quite tetchy if you start medication on thier patients. I have started running a pre-op hypertension clinic and am trying to work with the GP's to find thier preferences whilst staying in the NICE guidelines.

I then see these patients on admission and make sure that nothinghas changed, then am responsible for their management post op. With my patients as they are endocrine patients mainly this will involve some fluid management and electrolyte monitoring.

I do ward rounds with the docs and on my own, but decision making is collaboratively, I have worked with my medical lead for many years so I know what he wants for his patients, the only decision I am not able to make is one of discharge as it is hospital policy that this must be a senior level medic.

Once they are discharged the GP gets a letter informing them of what has happened and we see them in out patients clinic.

Trauma Columnist · Jun 11, 2008

Wow - that sounds so organized!!!

I'm impressed.

Its chaos here!