Venue: GP Surgery 1

Today, I was given the opportunity to spend my time with the Nurse Practitioner and I was quite surprised as to how similar their role is to GPs. I was able to see some patient consultations and learn some important skills and qualities required in order to work with a healthcare related career. 

The first patient I saw was mother with a 2 week old newborn child regarding the suspicion of a chest infection for herself. The nurse used the stethoscope to listen to her chest and was able to rule out a chest infection immediately due to the fact that her chest sounded very clear and there was no ‘rattling’. She then asked the patient a couple more questions before concluding that she was just suffering from a really bad cough from which she would recover from given time. Despite, the patient not requiring any medicine, the nurse assured her that she had done the right thing by coming in. I am able to reflect that this made the patient feel more comfortable and will also make sure that the patient isn’t veered off coming to the Surgery regarding any other suspicions. Additionally, the nurse prescribed the baby with some nose drops, to help try end prevent the baby from catching the cold from her mother. I learnt that to be a good practioner you will always be actively looking to improve health of anyone irregardless of whether they have specifically voiced a problem or not.

The next patient I saw was a gentleman who had two children: a four year old and a newborn child. He had come to the surgery regarding a concern about Muscular Dystrophy as both his father and brother had suffered from it. He wanted to organise some genetic testing as he was worried about himself and his children. The nurse admitted that she didn’t know much about Muscular Dystrophy so couldn’t advise the patient on the subject now. She said she would speak to the GP and then organise another appointment. I learnt to value integrity as a vital quality for a clinician to posses as you must be very honest and apparent with your patients in order for them to trust you. It’s better to admit that you don’t know rather than providing inaccurate information which could potentially harm a patient. The nurse also had to check which type of Muscular Dystrophy the patient’s brother and father were suffering from. When she did this, she explained to the patient that the reason why he wouldn’t be able to look at the records (confidentiality) so he doesn’t feel like he has been excluded from the consultation. I am able to reflect that being honest with a patient will often have a better result than not as the patient will appreciate the fact that you want to make sure you’re providing them with the correct information.

One of the other patients I saw was a lady wo had come back for a follow up appointment to hear about her blood test results. The blood test actually revealed that the patient has now got Type 2 diabetes which the nurse had to break to her in a sensitive way. She spoke with care and compassion and then reassured the patient that help would be available for her so she doesn’t become too alarmed by her new diagnosis. I learnt the significance of being able to reassure a patient whilst ensuring that you’re not unnecessarily raising their hopes or making any false claims. In this scenario, the nurse assured her that she would receive support rather than a miraculous cure. During the consultation the nurse noticed that she appeared to be extremely tired so she asked her about it. The patient said that she has sleep apnea so doesn’t often receive a good night’s sleep. I learnt the significance of being very observant in a clinical setting as sometimes, the patient may not mention all their symptoms but these can be noticed by just watching them. This particular patient was also experiencing social issues including family issues such as the trauma of having to go through her daughter attempting to stab. The nurse told me that this problem had been going on for a while and she was trying to keep on top of it. This made me appreciate a practioners role of being a patient’s advocate and acting in their best interests. T nurse suggested that the patient gave her permission to sign her up for educational sessions on diabetes to help her deal with her new diagnosis. However, she was adamant that she didn’t want to attend. This was quite surprising for me, as I know that the NHS does provide a section of its funding towards educating people and I did not think people would reject sessions like these. The nurse did try to encourage her to go to the sessions but she did not pressure her in order to show respect for patient autonomy.

For most patients their GP surgery is their first port of call for any issues. Sometimes a clinical practioner will just be expected to assure them in order to stop them worrying. One example of this that I saw today was a lady who was receiving chemotherapy and was experiencing a few side effects from the treatment. She was concerned about pain she could feel in her stomach and was worried about the possibility of the cancer having spread to her intensities. The nurse examined her and then told her she had nothing to worry about. The significant aspect of the way she communicated this was that she explained why she shouldn’t worry rather than just expecting her to take her word for it. This transparency between clinicians and patients is extremely important as patients do have the right to know about their disease or illness properly and truthfully.

Posted by:Life of a Medic

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