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Friday 28 October 2016
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The road less travelled

Practice manager Brenda Nasr’s route into primary care was adventurous. From Liverpool to Saudi Arabia and stocks and shares to a secret wedding, she tells her story

Arabian adventures, hairspray and stocks and shares were all unlikely steps along the road to practice management for Brenda Nasr.
It would have been impossible for the 16-year-old school leaver, who set out as a hairdresser in 1996 to know she would end up running Earle Road Medical Centre in inner city Liverpool.
“I came here and turned this practice around, it is what I was employed to do. I have delivered,” she says, a claim supported by her win at the 2013 General Practice Awards as practice manager of the year.
Nasr has taken outreach seriously. She set up patient participation meetings and invited welfare officers from housing trusts in to speak to patients.
She also had Liverpool City Council training bus along to teach patients how to use computers for two weeks and has run multiple patient workshops on childhood immunisation, healthy heart, women’s health and cervical screening.
Hairdressing suited Nasr for a time as she’s a “people person” but it was cut short due to health reasons. “I had a lot of knee problems and the [doctors] said that standing was no good,” says Nasr.
From there Nasr’s next job was as far removed from highlights and perms as you can get. She went to work for the biggest stockbrokers in Liverpool, Tilney’s. With them for five years as a transfer clerk, she would handle millions of pounds every few weeks in stocks and shares. A world a way from hairdressing, she says: “It was very much a male-dominated environment, and my colleagues used to have me making tea for them.” Although the former hairdresser enjoyed her role, she was unfortunately made redundant when the stock market “went through a bit of a crisis”.
It was perhaps a blessing in disguise as it meant Nasr started her job in Walton Hospital (now Aintree University Hospital), Liverpool. This brought her back to working with people. She got to work across several departments as a medical receptionist in: A&E, outpatient clinics, the day ward and medical records.
Nasr says: “I loved the outpatient clinics, because I liked the patient contact; I got on well with the nurses I worked with, the doctors I worked for. I was focused on patient care. I wanted my clinics to be the best. That is something I have carried throughout my life.”
Having worked at the hospital for just over 15 years it’s no surprise that Nasr still has friends from her days there. “I worked in the medical records department for the longest.
I can honestly say that the girls I worked with are still my friends.”
Not only did Nasr’s friendship circle grow but her clinical knowledge expanded while working in the medical record department. She went on to do clinical coding, a speciality that GPs are required to do.
Relationship woes struck and Nasr and her boyfriend at the time split, she “needed to go away” and this is where her overseas journey began.
After seeing a job advertised for a medical records specialist in King Khalid Hospital, Najran, Saudi Arabia she jumped at the chance. Similar to her job at Walton Hospital, she was a perfect candidate.
Understandably doubts crept in before leaving. She reminisces: “I remember flying down to London, and the chap at the hotel said, ‘What is a nice woman like you doing shutting themselves away?’ and it was at that moment my stomach lurched, and I thought, ‘Oh my goodness, what am I doing?’ I thought, I have given my
job up.”
Nonetheless she still went and flew to Saudi in January 1989. Her role was to establish a sense of order to an office that needed medical records organising. It was “bedlam, because everybody just did their own thing”.
Nasr had to set up rotas and manage staff in an office that had no system. Index cards were set up and patients were given dispensary numbers as “a lot of them had the same name”.
It’s no surprise that the change in country was a huge cultural shock to a woman who had only ever holidayed in Europe. And these cultural differences were something that
Nasr was well aware of as a British woman. But she earned respect by working hard.
“My boss used to call me, ‘tiny English,’ because there was an American woman, who did the other half of my job and she was always off sick. Whereas ‘tiny English always comes in to work.’ I am only five foot two, you see and she was big.”
‘Tiny English’ made such an impression on her Saudi colleagues that they did not want her to leave when the job was done. Proud of what she achieved, she says: “I took on the challenge. It was very difficult, because, you do not know, first of all, if you are going to like it. You have got to overcome many barriers.”
However, there were wider issues at play as Saddam Hussein invaded Kuwait, which, borders with Saudi Arabia and the Gulf War began.
The “nerve wracking” experience meant she had to live with her bags packed all the time in case of an evacuation. Thankfully, it never came to that for Nasr.
Although she had left her job in Saudi, she had planned on staying after having met Mohammad Nasr whom she went on to marry. Mohammad is Egyptian and an interpreter and they met on Nasr’s first day in at the hospital. Nasr had often joked that she would get married abroad and not tell anyone after a broken engagement in England and this is what she did when she married Mohammad in secret in Cairo. Intent on staying in Saudi with her new husband, she flew back to England to tell her family. However, when back in Liverpool her mother suffered a heart attack and this meant Nasr decided to stay in England. Rather unconventionally her husband stayed in Saudi and the couple would meet twice a year “and that is how it has been ever since”.  
Having decided on staying in England she found two part-time jobs both in hospitals working on receptions. Then in 1994 she made her way into the world of general practice after completing management certificates that she funded herself.    
“It is very different to working in a hospital. I had gone as a receptionist, just to see if I liked it. And from there on, I then had a couple of supervisory jobs, until I got a practice manager job,” she explains. The inner city practice in Liverpool had a diverse patient list. Nasr’s previous experience meant the task ahead unfased her. She went on to work in various practices until she started at Earle Road Medical Centre six years ago.
It’s no surprise that Nasr’s bubbly personality has helped her to connect with her patients. But sadly our heroine was able to connect on a deeper level following a diagnosis of uterine cancer two years ago.
“I was shocked; I was not ill or anything, and I had two little spots of blood, no bigger than a 10 pence. And that is what urged me on for the women’s health talks, because we have done a few, and I tell my story – not to be vulgar, but to draw awareness.”
Nasr’s life experience is an invaluable asset in her role as a practice manager. “I remember my boss from the hospital days, and she knew her job, I admire that very much. She did not just talk the talk, she could do the walk.
“I take on board the experience I had in Saudi of dealing with other nationalities. As they say to me here, ‘You are a diplomat, you put things in a different way’. I am approachable, and a patient said to me, yesterday, ‘Do not retire, Brenda,’ which I have no intention of doing, certainly not in the near future. Not at all.”