Advanced Nurse Practitioner, Karen Bache, qualified at The Royal London Hospital in 1978.

The first day – Karen as a student nurse at ‘The London’

She gravitated to Greenwood Surgery 15 years ago having first gained further qualifications and worked in two other practices in the town. There she became a key member of an amazing nursing team that constituted the backbone of the practice through good times and bad.

Her encyclopaedic knowledge, nimble brain, and wide clinical experience made her ideally equipped to deal with anything and everything that cropped up in the practice. She was what we call ‘a safe pair of hands’.

We read stories of ‘physician’s associates’ whose lack of clinical experience cause them to miss obvious life threatening conditions. The practice nurses’ extensive experience (both in primary and secondary care) gave them ‘clinical antennae’ – enabling them to quickly spot conditions that, if left, would have an unhappy outcome.

The nurses were exceptionally adept both at encouraging screening and looking after those with long term conditions such as diabetes, cardiovascular conditions and asthma/COPD – the latter being one of Karen’s special interests. It was their hard work that resulted in the CQC’s comment that: “Female and male life expectancy is above the local and national averages.”

Sue and Karen

When admitting patients to hospital it was customary for a doctor to first phone the ‘on call hospital doc’ and pass on the details of the case. As the nurses took over more of the roles traditionally falling within the domain of the doctor, Karen turned out to be very good at giving a concise and accurate history – and, when quizzed, had all the necessary facts and figures at her fingertips. Occasionally a dyed-in-the-wool hospital doctor would demand to talk to “the GP” … and I’m 99.9% sure they always regretted it!

She was fortunate to work as part of an exceptional team. Being mutually supportive brought out the best in them and created a fun workplace.

The Team

Let’s give Karen the last word. Here are three recordings of her talking about life as a practice nurse with an extended role. Firstly, here she is explaining the scope of her work in the practice. Press Ctrl while you Click here to view.

Next she discusses the changes she has seen in the nursing profession over the decades – and egged on by some old geezer rooted in the past, harks back to the values of yesteryear. That said, I suspect we weren’t quite as wonderful as we thought we were … and I’m equally sure that those just starting their careers will have conversations identical to ours in the years to come (just as those who preceded us did all those years ago when we were just starting out.) Press Ctrl while you Click here to view.

Finally here’s Karen discussing practice funding by the NHS (or, rather, lack thereof) – which is not of great interest to the wider public except inasmuch as it has very important implications for patient care. Press Ctrl while you Click here to view.

Karen always regarded herself as a nurse first and foremost as she felt it better enabled holistic care – but, in her dual role, she merited a gold star from both Hippocrates and Florence Nightingale!

Dr John Cormack

If any of her patients want to send Karen a farewell message please email them to the editor (wendy@ourtownmagazine.co.uk) and they will be passed on.