Before I started my job as a general practice (GP) nurse, I always wondered what “a day in the life” would look like. At university, you are generally trained for and go on practical in hospitals and as a student nurse, I found I didn’t know what it was like to work in a GP.
Typically, like most other nursing shifts, a day in the life of a GP nurse starts the night before. The day at a GP practice generally starts around 7:30am through to 4:30pm or 9:30am to 6pm, depending on which shift I am allocated. There are no late afternoon shifts or night shifts working in a GP practice, which may benefit some greatly (or be much preferred!).
As the day starts early (and for any extra bit of sleep I can get!) I like to prepare for my day the night before. I’ll make a large dinner and split it, popping some in a container to take to work the following day for lunch, pack a breakfast shake (great to have on way to work or between seeing patients), pack my bag with my nursing essentials (hand cream!) and lay out my clothes for the morning. Having this routine really helps my morning go smoothly and ensures I don’t run late!
At 5:30am, my alarm goes off and I try to sit up in bed before falling back to sleep again. I schedule an extra 15 mins into my morning to allow for time to meditate and journal. Why? This helps me have control over my day, gain clarity and to ground myself. A day started ungrounded will continue into the rest of your day. I pull on the clothes I’ve laid out the night before, wash my face, brush my teeth, pack my bag and get out the door by 6:30am.
Arriving at work
I get into work by 7:30am. Coffee in hand, I start preparing for the day and examining my list of patients for the day (checking for any patients I don’t know and if I have the time, reading their previous notes from the doctors and other nurses). I also check the vaccine fridge and emergency oxygen tanks every morning before patients start arriving, ensuring the vaccines are viable and, if there’s an emergency, there’s oxygen at the ready.
I call in my first patient at 8am and I’m off! Generally, patients are booked in with a nurse for a range of different appointments from wound dressings, INR’s, health assessments, ECGs, vaccines, injections, ear syringes and more! Most appointments are booked for 15 to 30 minutes. However, some appointments can take up to an hour.
My first appointment of the day is for a 6-week old baby. The baby is due for her 6-week routine vaccines; this appointment is also booked with a doctor. The mother and baby are called into the Doctor’s room whilst I go and prepare the vaccines.
I bring them to the Doctor’s room and there we perform the 8 rights of medication (right patient, right vaccine, right dose, right route, right time, right documentation, right reason and right response) before administration. At 6 weeks of age, two vaccines are given and one oral medication. I ask mum to hold her baby whilst I pop the oral medication into the baby’s mouth – trying to ensure the baby swallows most of it!
Next, the vaccines! Usually, if a child has more than one vaccine due, the doctor and I administer the vaccines at the same time to lessen the amount of time the baby is in pain. Both the doctor and I take a vaccine and on three, we simultaneously inject into both of the babies thighs. The little baby instantly lets out a cry but we are quick and within a few seconds, it’s all over and the baby is being soothed in mum’s arms.
My next patient arrives for a review of her diabetes. People who have a chronic illness such as diabetes or asthma are recommended to have a review and check-up at least every six to twelve months. This is to touch base with how they are managing their disease and to update their care plan to align with their health goals. I call the patient into my office and I start by checking their vital signs, height, weight, waist measurement and their blood glucose level. I then check their feet for any signs of neuropathy, ulcers or loss of feeling as diabetics have an increased chance of having feet problems due to diabetes reducing the blood flow to the feet. Reduced blood flow can lead to their feet being more prone to poor circulation, injury or infection. I chat to the patient about when their last HbA1C blood test was (a prolonged measurement of their blood glucose over 3 months) and when they have last seen their optometrist (diabetics also have an increased risk for degenerating or poor vision). We also discuss how their diet and exercise is going and how they feel they are progressing. These health assessments generally take 30 – 45 min with a nurse, then the patient follows up with the doctor for 15 mins.
Over the next few hours until lunchtime, I have a variety of appointments. The appointments consist of patients who have come in for their ongoing injections such as depo injections, wound dressings, ECG’s and a few more vaccinations.
Lunchtime comes around and I’m ready for it as I am pretty hungry! Generally, I am lucky to always get a lunch break for at least half an hour – unlike some hospital shifts! In the lunchroom, some basic snacks such as biscuits, spreads, tea, coffee and sometimes edible gifts from patients are available for anyone to eat – little things like this really do make a difference during the busy days!
The afternoon goes quickly, consisting of more appointments with patients, assisting the doctors with a few more vaccines and some time for sterilising. Some instruments which are consistently used in procedures are reused. These instruments go through a sterilization procedure to ensure they are safe and sterile to be used again for procedures.
Before the day ends, my last appointment is a procedure for a skin biopsy. The patient has seen the doctor with a concern that one of her freckles has changed shape and colour.
I set up the room for the procedure by laying out the instruments to be used, setting up a sterile field and preparing the anaesthetic. The patient and doctor come in, I settle the patient into position and then focus on assisting the doctor throughout the procedure. I also have the task of distracting and calming the patient if necessary by chatting to them; this allows the doctor to only concentrate on the procedure.
Ending the day
With half an hour left of the day, I do a few end-of-day tasks, such as rechecking the vaccine fridge to maintain the cold chain management policy (ensures the vaccines are safe to be administered). I restock my room for the next day and also answer any last messages from reception to follow up. It was a long day, but a successful one. I have met new patients and maintained relationships with old ones, helping all on their health journey. It is nice to be able to make an impact on patients’ lives and follow them along their journey – which is a little different from working in a hospital.