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December 15 - Meet Margaret Umeed!

MU at admissions June 15 cropped.jpg

Hi, my name is Margaret Umeed and I have been a Specialist Nurse Practitioner in Govan Health Centre for the past 18 yrs.

Welcome to my day!

8.30am – 11am

I officially start at 9am but I’m usually in about 08:30 to check the vaccine fridges, download the data loggers and check vaccine stock once a week. Because it’s flu season, I put flu vaccine into all the consulting rooms so that the GPs can immunize opportunistically. Before the surgeries begin I check none of the GPs will need any equipment for implant insertions or removals. I start at 9am and consult every 15-30 minutes till 1pm. Patients are allocated either 15, 30 or 45 minutes depending on the reason they are consulting. For example women booking in for cervical cytology get 15 minutes, those with one long term condition (like asthma) get 30 minutes and those (many) patients with multiple co-morbidities get 45 minutes. We have a mixture of patients in the surgeries which stops you from getting bored, the only “clinic” we run is the baby immunisation clinic, two Wednesday mornings per month with the Health Visiting Team. Because I work in a practice based in a Health Centre I don’t do any treatments: dressings, ear syringing, leg ulcers, suture removal etc. The work is split into female health: cervical cytology, contraception, STI screening, preconception, post natal. Immunisation: baby vaccines, influenza, pneumococcal, shingles, pertussis during pregnancy, meningitis for teenagers and pre and post travel health consultations. Long term condition management: asthma, COPD, CHD, CHF, AF, stroke & TIA, epilepsy, dementia and mental health and Near Patient Testing (NPT) for those who take Disease Modifying Drugs (DMARD) like methotrexate, azathioprine and leflunomide. As a prescribing Specialist Nurse Practitioner I work pretty autonomously: consulting, taking a history, deciding about investigations, prescribing, reviewing and referring if necessary. Although we work autonomously, it is important to have a good support network around us and I currently mentor a new-to-practice nursing colleague and a health care support worker. I have been very fortunate to have GP colleagues who wear “other” hats and who have been very supportive of my out of practice activities and who view the teaching etc as bringing extra benefits to the practice.

11am – 1pm

I usually manage to grab a coffee around 11am. Check emails and try to look at some results: I have 56 items in my DOCMAN (intray) this morning, all of which need actioned in some way. I am responsible for the recall of patients who require tests in the future, e.g. someone has a borderline thyroid function test which needs repeated in 6 months as well as the current DMARD audit which GG&C have introduced this year to raise awareness of possible areas for improvement. Because I have been in the practice for so many years, I have seen many patients literally grow up: it is quite outstanding how some of those babies have turned out as teenagers! Many of the patients within the practice will arrange an appointment with me rather than “bother” a GP, however I was embarrassed recently to have to ask a patient to return to our ST3 for review because I had no available appointments. One of my GP colleagues says I’m a victim of my own success.

1pm – 2.30pm

Lunch is between 1-2pm. Often we will have meetings during the lunch break: Palliative Care, Multi-Disciplinary, Clinical, Team, Significant Event Analysis, high risk of admission patients, Scottish Safety Programme. If there’s not a meeting it’s an opportunity to catch a GP for a query about a patient or with results. I am available between 2-2.30 if there are any results queries from patients and I take the opportunity to deal with some more results and emails.

2.30pm – 4.30pm

Start consulting again from 2.30-4.30. I am very fortunate to work with such a good team of GPs. We are a training practice and have 2 registrars currently. Tutorials with them, the retainer and the GPs are part of the job description. Much of a Practice Nurse’s job involves delivering a Public Health message: in a Deep End Practice this can be quite challenging. We sit at number 30 in the 100 most deprived practices in Scotland and have high levels of social deprivation, unemployment, smoking, drug and alcohol misuse and higher than national averages of long term conditions such as CHD, diabetes, obesity and respiratory disease. In Govan we are fortunate to have been included in various initiatives including early access to Social Work and having the benefit of a Links Worker attached to the practice.

4.30pm – 5.30pm

Stop consulting at 5pm and try and look at the blood results from earlier this morning. The NPT patients will be often phoning first thing tomorrow morning to check results before taking medication, so I need to ensure there is a message in the notes about the results and whether the person can continue with their meds or not. Working in primary care is a truly multi-disciplinary role which can be very frustrating but very rewarding, building relationships with patients, relatives, carers and colleagues over a period of weeks and months (and sometimes years). It offers a level of continuity of care which is not found in any other area of nursing.

Career Pathway:

 RGN 1984-87 (trained at the Western College of Nursing, Glasgow) Staff Nurse, Infectious Disease Unit, Ruchill Hospital

1987-88 Volunteer RGN in Pakistan (2 hospitals)

1988-89 Practice Nurse, Battlefield & Pollokshields

1990-97 Current Post in Govan HC 1997-now Graduated with an MSc in Travel Medicine from Glasgow University

2001 Became an Independent & Supplementary Non-Medical Prescriber 2003 Did PgC Lecturer/Practice Educator (LPE)

2007 Completed a Fellowship by Portfolio for the Queens Nursing Institute of Scotland 2009 Was admitted as a Member to the Faculty of Travel Medicine

2009 Upgraded to a Fellow and appointed as Honorary Secretary to the Executive Board of the FTM in 2012 Re-elected Secretary 2015 I am a Yellow Fever trainer for Health Protection Scotland and was recently involved in developing the online training module. I was a course author, assessor, personal supervisor and examiner for the Foundation and Diploma in Travel Medicine courses initially with HPS and currently with the Royal College of Physicians and Surgeons in Glasgow, in addition I am an examiner for the Membership of the FTM Exam Part 2 (OSCES).

I am a free-lance lecturer, author and peer-reviewer of nursing articles for UK journals and participate as a reviewer for the McMaster Online Rating of Evidence. I currently sit on the Editorial Board of the Practice Nurse journal and as the primary care representative on the Scottish Malaria Advisory Group.

During my time in primary care I have undertaken multiple CPD courses: Family Planning certificate (1992) Marie Curie Cancer Screening for nurses certificate (1994) Adult Asthma Diploma (1994) and Paediatric Asthma Management certificate (1998) Diploma in Travel Medicine (1997) RCN portfolio Specialist Nurse Practitioner (General Practice Nursing) (1999) Diabetes Diploma (2003) Epilepsy certificate (2004) Triage Diploma (2004) Diploma in Tropical Medicine (coursework) 2011 Currently undertaking Mentorship training with the RCPS, Glasgow

Best wishes,

Margaret