Dr Brendan O’Shea , 2025-07-31 10:13:00
Dr Brendan O’Shea discusses challenges and opportunities with former IGPNEA chair Rita Pender
Rita Pender has recently stepped down as IGPNEA Chair to become interim Director of Nursing Education within the Association and will continue as Lead for GP Nursing on the Nursing and Midwifery Board of Ireland, within NMBI’s (Pilot) Professional Competency Scheme.
In discussion with Dr Brendan O’Shea, she describes the landscape of Community Nursing, particularly GP Nursing, including the challenges and opportunities, which are important for the growth of GP Teams, throughout the Irish health system.
Rita notes that, due to an ageing population and Sláintecare policy, her current role is especially timely.
Rita Pender. Pic: Dr Brendan O’Shea
She highlights a shortage of at least 600 Public Health Nursing positions, which impacts GPNs in affected communities. As one of 37 Nursing Sub Discipline Leads in the NMBI Pilot CPD scheme, she leads 16 GPNs trialing the NMBI competence tool for recording of a variety high-quality postgraduate learning.
By 2030, NMBI aims to make this CPD mandatory for all registered nurses and midwives, which will significantly affect practice for both GPN’s and general practices.
Rita has more than 30 years of experience as a Registered General Nurse, Registered Midwife, Public Health Nurse, and General Practice Nurse. Her career includes positions as a GP Nurse with Dr Des Cody and Dr Andrew Cody in Tallaght, Dr Jim McCarthy, and Dr Anthony McCusker in Clondalkin.
She later retrained as a Public Health Nurse, and worked in this role for over seven years before returning to general practice nursing. Rita subsequently worked in her home county of Kildare, then at the UCD Coombe Family Practice and Rialto Medical Centre Hospital, (both located in Dublin 8).
She says that GP Nursing offers a wide variety of patient interactions and a distinctive level of mutual trust and continuity within GP teams, which she considers unique within the health service.
‘I am enthusiastic when encouraging younger nurses to consider general practice, a growing nursing specialty that offers diverse patient interactions and opportunities for community impact, although not as yet a recognised subdivision with the NMBI.’ The ESRI report (June 25) projects that GPN positions in Ireland will need to increase by 33 per cent to 38 per cent to meet future demand through 2040.
‘Women’s Health offers especially rewarding care, as patients trust GPNs and often share their concerns easily and openly. This allows for holistic care and valuable opportunities to identify prominent issues during screening, antenatal and post-natal visits. With appropriate educational support, General Practice Nurses (GPNs) can offer significant value to general practice, including those aiming to reach their full potential as Advanced Nurse Practitioners.’
‘A problem for my younger colleagues however is the continuing and largely total absence for opportunities for career progression within GP Nursing. While a small and growing number of my own colleagues are establishing as Advanced Nurse Practitioners in a range of areas of care, for the most part there is no career pathway or progression for most GPNs. An important job of work requires to be undertaken by the IGPNEA, the ICGP, the relevant Unions (IMNO/IMO) and the HSE to address this.
The persistent challenges surrounding the recruitment and retention of Public Health Nurses are an increasing concern within Primary Care
With good commitment, the solutions here are obvious. Acknowledging GPN’s terms and conditions in alignment with their HSE colleagues, with an emolument directed to the practice through PCRS, could serve as a starting point. Similarly, recognising the attainment of an MSc or PhD qualification in the same way may also be considered appropriate. Finally, recognising and practically supporting GPNs CPD, in accordance with the NMBI is also an obvious and increasingly important step to take, if we wish to attract numbers of younger colleagues into what is otherwise a challenging, vibrant and very rewarding area of nursing.’
Gaps in Public Health Nursing
The persistent challenges surrounding the recruitment and retention of Public Health Nurses are an increasing concern within Primary Care. When a PHN vacancy remains unfilled in a community, this immediately affects GPs, and particularly GPNs in neighbouring practices.
Two significant areas impacted by vacancies include complex wound management, and parental concerns regarding lack of childhood developmental assessments. In affected regions, these issues lead to a substantial number of clinical queries, which typically become the responsibility of GPNs.
While GPNs frequently take initiative by seeking guidance and training from the IGPNEA, this arrangement is less than ideal.
In future…
In addition to guiding and delivering on a quality and evidence based system of CPD for GPNs as required by the NMBI, adequately supported by the HSE, Rita sees few limits to what GP Nurses can deliver, with the support of GPs, the practice team and the broader health system.
‘This is particularly important if the health system overall continues to change, so that more care is delivered at the community level and in general practice, continuing the very clear trend established during the last five years. ‘Could you see GP nurses, particularly those with midwifery qualifications and experience delivering Medical Termination of Pregnancy?’ I ask – ‘Absolutely,’ she replies. The current legislation does not include nurses; however, future amendments may enable their participation in the programme, and GPNs would be able to deliver it.
‘What about GPN delivery of PeP and PreP (Post Exposure Prophylaxis and Pre Exposure Prophylaxis) for gay men and for sex workers ?’ I ask. ‘That is also absolutely possible. With the right training, professional support from within the practice and community pharmacies, and adequate practice funding through the PCRS.’
‘Regarding the working relationship which the IGPNEA has with the ICGP, Rita observes that ‘this has really delivered a lot during the last five to 10 years, but there is an enormous potential to deliver even more.’
In particular she highlights increasing the volume of multidisciplinary education at all levels, with shared learning involving GPNs and GPs, (and similarly between GPNs, Medical and Nursing Undergraduates, and GP Trainees).
‘More broadly, as General Practice continues to grow in importance, in the context of the larger health system, and given the extent to which so much of what we do in general practice is documented and measurable electronically, the scope for ongoing research, expanding our job descriptions, and ongoing education is very exciting.’
There are no limits… 
