4 NURSING IN PRACTICE SURVEY
‘ Nurses feel at risk seeing patients but most do not want total triage ’
Triaging patients has increased practice nurses ’ workload and most hope ‘ total triage ’ does not continue in the future , a Nursing in Practice survey has revealed .
But the poll of 87 general practice nurses , which sought their views on triage working and face-to-face appointments during the pandemic , reveals they have felt at risk seeing patients in person during the pandemic .
The survey , conducted between 28 May and 4 June , also shows nurses are frustrated that they – and not GPs – have carried out the majority of face-to-face consultations during the Covid-19 crisis , and believe the risks to their safety have not been properly recognised .
The survey comes after an NHS England letter in May instructed practices to offer patients face-to-face appointments if requested . In March last year , NHSE had advised surgeries to implement a ‘ total triage ’ system , so every patient had to contact the surgery before making an appointment .
Most respondents ( 58 %) to the survey said they hoped ‘ total triage ’ or an equivalent would not continue after the pandemic . More than a third of respondents ( 38 %) said triage had increased their workload a lot , with a similar number ( 34 %) saying it had increased a little . Around a fifth ( 22 %) reported no change , while just 6 % found it decreased their workload a lot .
Nurses also shared concerns about contracting Covid-19 when carrying out the lion ’ s share of face-to-face appointments – 77 % agreed GPs should do more in-person work . Many said this burden was contributing to stress .
One GPN , based in the east of England , wrote : ‘ It seems it ’ s okay for nurses to be put at risk while many GPs are behind closed doors ... Why are nurses more expendable than any other members of staff ?’
A nurse practitioner based in Wales agreed : ‘ There have been times I ’ ve felt like cannon fodder , especially at the beginning when GPs were hardly seeing anyone .’
A practice nurse based in south-east England , who estimated 80 % of their time was
spent on face-to-face appointments , expressed concern that the work was putting them and their family ‘ at risk ... for little or no recognition ’, adding : ‘ At times I have felt very anxious , down and overwhelmed .’
Another , based in Yorkshire and the Humber , who reported spending 90 % of their time carrying out face-to-face appointments and 10 % on telephone triage , said : ‘ I feel stressed . [ I ’ ve been doing ] back-to-back face-to-face appointments all the way through the pandemic , with basic PPE , worrying about catching Covid .’ Although many said they felt comfortable carrying out triage , others said it added too much to their workload . A nurse practitioner based in Scotland explained : ‘ You are phoning patients and then bringing them in , so double the time .’
As one practice nurse based in the East of England said : ‘ I do feel training , or refresher training for those who have not undertaken it for a while , should be available . I would feel more comfortable .’ This reinforces the message from clinicians interviewed by Nursing in Practice in June – that ‘ ongoing triage training ’ is needed .
However , most respondents who left comments said concerns had eased since the start of the pandemic , when PPE supplies were lower , and they now felt more comfortable with in-person work . One based in Scotland wrote : ‘ I felt unsafe initially . Now it ’ s just the norm for me .’
Many see the benefit of some form of triage . One nurse practitioner based in the West Midlands wrote : ‘ It works very well as there are a good number of patients that do not need to be seen face to face .’
The survey also reveals that in most practices , a mixture of staff members carry out triage ( 45 %), followed by GPs ( 30 %), nurses ( 15 %) and receptionists ( 8 %). Most use online and telephone ( 51 %) to carry out triage , while 46 % use only telephone and 3 % use only online .
Just over two-thirds ( 68 %) of respondents said their surgery did not have a triage system before the pandemic , echoing findings from a major survey run by Nursing in Practice publisher Cogora last year , which found many practices did not offer triage before the Covid-19 crisis .
By Mimi Launder
Survey findings
Which staff members carry out triage in your practice ?
How does triage impact your workload ?
Do you think GPs should carry out more face-to-face appointments ?
GPs 30 % Nurses 15 %
Receptionists 8 %
A mixture of staff members 45 %
Other 2 %
Increases it a lot 38 %
Increases it a little 34 %
No change 22 %
Decreases it a lot 6 %
Yes 77 % No 23 %
Source : Nursing in Practice survey , May-June 2021 . There were 87 responders to this survey .
ALAMY nursinginpractice . com Summer 2021