Practice nurse Patrick Arnold has been a nurse at Thirlmere Medical Practice for 18 months and working as a nurse for 13 years. During this time, he has undertaken a number of roles in nursing but by far the most rewarding for Patrick is his role as a practice nurse.
How long have you been a practice nurse and how long have you been working in the Wollondilly LGA?
I worked for two years in private practice within a metropolitan clinic early in my nursing career and upon returning to nursing 18 months ago have been at the Thirlmere Medical Practice; so… coming up on four years.
I nursed for 13 years (11 as an RN) before taking a break and working in manufacturing. Nursing roles have included ward nurse (neuro/spinal/plastics, orthopedics, cardiac care), ICU, theatres and drug and alcohol. Practice nursing feels like the perfect balance of all of these and is by far the most satisfying role to date.
When/why did you decide to pursue a career in nursing and specifically in primary care?
Having volunteered with the SES while completing the HSC I met a number of ambulance officers and an assortment of eccentric healthcare workers. It was always going to be between the ambulance service or nursing. Nursing won out. My rationale has always been you can do just about anything to make money, so why not do something which helps others and feeds the soul.
Tell us about the role of nurses in primary care
One part of the role is maintaining and operating the treatment room. This involves ensuring equipment, medications and vaccines are all available, calibrated, in date and (where appropriate) cleaned/sanitised. With four doctors on staff and up to three on shift at the same time it can become a juggling act to keep procedures, dressings or diagnostics from overlapping, but that is part of the fun of the role.
The bigger part of the role is building rapport with the patient base. I am very lucky to have joined a practice which services quite a close-knit community. By building trust through wound care and education, vaccination, care plans, health assessments etc it puts me in the position to instigate conversations about health issues and preventative options. The advantage of this approach is those who are reluctant to engage with what they deem “unnecessary” medical interventions (like vaccination for example) can have the time to receive and process best practice information and then make an informed decision. If preventative health is viewed and accepted as a positive choice through the wider community, those on the fence are more likely to engage.
The practice nurse complements the general practitioner through the development and management of care plans and the ongoing management of chronic health issues. An experienced nurse should be able to liaise with doctors and provide (where appropriate) triage and the streamlining of service.
What do you love about nursing/what do you find most fulfilling about your role?
Building relationships with our patients. General practice allows the opportunity to foster a sense of community and engage with patients both on an individual and collective level. It is a very satisfying role and one I am glad I came to with the experience I have. Nursing overall has so many moving parts it can often be hard to define what specifically is most satisfying, but it does always seem to boil down to helping people.
What is your biggest challenge as a PN and how do you overcome this?
Vaccinating children. Babies don’t understand what is happening, and it is over so quickly that levels of distress (for both patient and parent) can be managed and pass quickly. With infants, when you build trust with a small child and then “hurt” them, depending on the child and their ability to comprehend what is happening there is a sense of betrayal. Personally, that hits more because it is a child. I think if this part of the job became easy, I would be concerned.
As much as possible I try and distract the child from crying by preparing them for the experience in a gentle, unrushed manner. Failing this, a stuffed toy, lolly or sticker with some kind words goes a long way. Generally, they have settled before they leave the room, but it is definitely an emotionally taxing experience.
Tell me about your ideal work day
The shift starts by checking the vaccine fridge, stock and doctor’s room for re-stocking. Preparation of medications/vaccines as required. Two or three over 75 health assessments and a handful of care plans. We generally have four to five biopsies or excisions through the day and often iron infusions. Add a few chronic wound patients for dressings and you have a full, satisfying day.
What do you like to do in your spare time?
Spend time with my partner and our beautiful dog, Monroe. She is 60+ kg of anxiety and fur, and loves walks and cuddles. Otherwise, when time allows, I enjoy playing music (I play guitar, piano, bass, drums and sing).
Do you have any role models and why?
Obvious choice, but my parents. They have raised me through leading by example. Both are very kind, generous and infinitely patient. I couldn’t find better role models if I tried.
How do you help educate your patients about maintaining good health?
As non-confrontationally as possible. Due to the repeat nature of our patients’ visits, we have the opportunity to have ongoing discussion regarding best practice and health recommendations, generally tailed by follow-up questions and increased engagement over consequent visits.
Many people who are drastically out of shape are very aware of their situation and are embarrassed and/or ashamed (ie bariatric patients). By approaching recommendations or ideas in a manner which ensures the patient does not feel “attacked”, for me, goes a long way towards positive long-term outcomes.
By providing a supportive port of information and assessment I believe we can (over time) help patients reach better health decisions and outcomes.
