What patients and practitioners want and need
Lorna Dhami – QN
General Practice Nurses have been coping with the stresses and demands generated by the COVID pandemic and the backlog it has created. It doesn’t seem the right time to consider adding anything to our remit. And yet, embracing a new opportunity is what I am doing.
My plate already felt full as a Queen’s Nurse working in a Deep End practice – as well as the NES GPN Advisor for NHS GG&C and a representative in the NE Glasgow Practice Nurses Forum. But an invitation from the Queen’s Nursing Institute Scotland prompted me to make room on that plate.
Just over a year ago I became part of the Healthier Pregnancies, Better Lives Steering Group and actively engaged in its Listening Sessions and surveys. The focus is on preconception and interconception health, education and care.
I went into it with curiosity and interest but not a firm idea about what the ‘it’ was. I knew the focus is on helping people of reproductive age make informed choices about their reproductive lives. Our society thinks and acts as if avoiding pregnancy or being pregnant are the only options. What gets overlooked are the benefits of preparing well for pregnancy,
Through this work, I started to notice how frequently promoting good health before a first or next pregnancy falls through the cracks between General Practice and Sexual & Reproductive Health services (which focus on pregnancy prevention or termination).
I must admit I knew better, especially having spent the first decade of my career as a midwife. I knew the importance of reproductive health to overall health. It is not a secret that a woman’s health and wellbeing at the time of conception is the single best predictor of pregnancy and birth outcomes.
But this is not routinely part of a GP Nurse’s role. I simply assumed another health professional was meeting those needs. Mostly, it turns out no one is doing this vital work. This was pointed out very well by HPBL Consultant, Michele Stranger Hunter in this recent blog: (read here).
You can find a wealth of other information about preconception/interconception health, education and care on the QNIS/HPBL website (here) . There are a variety of fascinating blogs about key topics – and especially about what has been learned through surveys and Listening Sessions with both patients and practitioners. Hearing their voices and views have convinced me this is a golden opportunity to make a positive difference.
Their essential messages are:
- Practitioners realise there is a gaping hole in services to reproductive age women (and men)
- They are genuinely keen to consider taking on preconception and interconception screening, counselling and care.
- Primary care is the not only the most logical place for this to happen, but also where patients and clients want it to happen.
- Patients want personalized risk information from a General Practice Nurse or a GP that is factual and compassionate, not judgmental or biased.
- Practitioners were very open to this potential change in practice, if they have sufficient training and time.
Objectively and subjectively, making pre-pregnancy health part of primary care is a very good idea and one well worth pursuing together. As health services are being reconsidered and refreshed post-pandemic, this may be exactly the right time to integrate ‘preparing well for pregnancy’ into our practice as GP Nurses.
[Note: An earlier version of this blog appeared during summer 2022 in NES’ GPN Connect journal]