Pinning my colours to the mast, I have to say that I share your concerns
Bob, but this is a debate about the whole of nursing training and competence
and 'the profession' rather than just OH.
We probably all view our own period of training as the glory days. I
trained in the early 80s when much of what we did, was done because it had
always been done that way. However we were also taught to question, as the
'research based practice' message was starting to be heard and we were
starting to vocalise it.
However, I can't help feeling that somewhere between then and now, we have
moved too near to the research and too far away from putting that research
into practice and what that really means in terms of hands on care. I also
can't help wondering how many fantastic and able potential nurses have never
entered the profession as they did not quite have the academic wherewithall.
Probably as many as the academic nursing graduates who soon find something
else to do in the world.
Great debate, but do we need to feed it into another group?
Lindsey Hall
National OH Manager
Environment Agency
----- Original Message -----
From: "Robert Dunn"
<[log in to unmask]>
To: <[log in to unmask]>
Sent: Monday, December 08, 2003 8:37 AM
Subject: Re: BCG Vaccinations: dissent?
> Neil, THAT is just the point I was trying to tease out of the debate. We
> are in a position where nurses of my 'vintage' see this procedure as a
> normal and basic nursing skill, that although taught many years ago, gives
> much better evidence based knowledge when I/you/we need to update to use
it
> in present practice, Other of our colleagues are throwing their hands up
in
> horror at the thought of giving such an injection because it is not a
skill
> they have been taught, and they perceive it to be an 'extension' of their
> basic skill base. Does not this whole scenario cast serious doubts on the
> validity of modern nurse training, whereby the profession is gradually
being
> deskilled and losing basic nursing knowledge at the expense of a more
> esoteric, managerial, administrative and academic approach. If I was ill
> and in hospital I would wish the nurse to have the skills to make me feel
> comfortable and cared for. I wouldn't give two hoots if they could write
a
> dissertation. Nursing is about aquiring the practical skills necessary to
> care for people....we must never lose sight of that, because if we do we
> cease to be nurses !!
>
> Regards, Bob
>
> ----- Original Message -----
> From: "Neil & Paul" <[log in to unmask]>
> To: <[log in to unmask]>
> Sent: Friday, December 05, 2003 6:41 PM
> Subject: Re: BCG Vaccinations: dissent?
>
>
> > Robert,
> > The argument is that intradermals are not taught on the basic syllabus
at
> > many of the universities I know. That's the issue. It is an extended
role
> > for want of a better phrase. It is something that many nurses have had
NO
> > training or competency in.
> >
> > Neil
> > ----- Original Message -----
> > From: "Robert Dunn"
> > <[log in to unmask]>
> > To: <[log in to unmask]>
> > Sent: Friday, December 05, 2003 8:46 AM
> > Subject: Re: BCG Vaccinations: dissent?
> >
> >
> > > Neil, thank you for not volunteering!, and thank you to everyone else
> > that
> > > took the bait of 'proper'. For your info I am fully upto date and
give
> > > BCG's regularly, as do ALL my nursing staff. I do wholeheartedly
agree
> > with
> > > Greta in as much that I would not employ an nurse that would refuse to
> > give
> > > vaccinations, and BCG's in particular. It would make the
administration
> > of
> > > the the OH service very difficult, if not impossible, if we had to
> > organise
> > > clinics around individual nurse likes and dislikes, especially with a
> > small
> > > team. The point I was trying to make is that intradermal injections
> > > essentially are a basic nursing skill which should not require
> discussion.
> > > Sadly, along with many nursing skills that made the nurse a unique
> > > professional, they have been eroded to the detriment of modern
nursing,
> (
> > > incidentally, this same portfolio of basic skills is now carried out
now
> > by
> > > non-professionally accountable HCA's). Modern nurse training tends
to
> > > focus on psuedo-medical, technical, administrative, academic and
social
> > > issues, and no longer deems it necessary that registered nurses need
to
> be
> > > equiped with what were a few years ago accepted to be the basic
> practical
> > > skills of nursing. The administration of Intradermal injections are
> not
> > > some non-existant, outmoded 'extension of role', so where is the
> argument?
> > >
> > > Bob
> > >
> > > ----- Original Message -----
> > > From: "Neil & Paul" <[log in to unmask]>
> > > To: <[log in to unmask]>
> > > Sent: Thursday, December 04, 2003 6:37 PM
> > > Subject: Re: BCG Vaccinations: dissent?
> > >
> > >
> > > > If you haven't given an intradermal for 30 years Robert I will not
let
> > you
> > > > practice on me - sorry
> > > >
> > > > Neil
> > > > ----- Original Message -----
> > > > From: "Anne Beckerton" <[log in to unmask]>
> > > > To: <[log in to unmask]>
> > > > Sent: Thursday, December 04, 2003 2:23 PM
> > > > Subject: Re: BCG Vaccinations: dissent?
> > > >
> > > >
> > > > > Well said Robert!
> > > > > Anne
> > > > > ----- Original Message -----
> > > > > From: "Robert Dunn"
> > > > > <[log in to unmask]>
> > > > > To: <[log in to unmask]>
> > > > > Sent: Thursday, December 04, 2003 2:18 PM
> > > > > Subject: Re: BCG Vaccinations: dissent?
> > > > >
> > > > >
> > > > > > Dear All
> > > > > >
> > > > > > To add fuel to this particular fire, I cannot see for the life
of
> me
> > > why
> > > > > any
> > > > > > nurse should refuse to give an intradermal injection provided
they
> > > have
> > > > > been
> > > > > > given appropriate training and have been deemed competent in the
> > > > > technique.
> > > > > > When I trained as a 'proper' nurse (State Registered Nurse) 30
> years
> > > > ago,
> > > > > > Intradermal, Subcuaneous and Intramuscular injection technique
was
> > not
> > > > > > optional, it was a requirement of completion of the training,
and
> > was
> > > in
> > > > > > fact taught within the first 6 weeks of our nursing career in
> > > > preliminary
> > > > > > training school. Refusal to carry out any of them would have
led
> to
> > > > > > incomplete competancy and failure of the course. Has modern
nurse
> > > > > training
> > > > > > gone so far into the realms of social sciences and academia that
a
> > > basic
> > > > > > skill such as intradermal injection technique is no longer
> required?
> > > > Any
> > > > > > person (not just a nurse or physician) is able legally to give
any
> > > > > > injection, provided the person receiving it is aware of the
status
> > of
> > > > that
> > > > > > individual, and that the individual has received appropriate
> > > > training.....
> > > > > > it is not rocket science afterall..!!
> > > > > >
> > > > > >
> > > > > > ----- Original Message -----
> > > > > > From: "Fields Shirley" <[log in to unmask]>
> > > > > > To: <[log in to unmask]>
> > > > > > Sent: Tuesday, December 02, 2003 3:05 PM
> > > > > > Subject: Re: BCG Vaccinations: dissent?
> > > > > >
> > > > > >
> > > > > > I certainly wouldn't mind if any of the nurses declined to give,
> > > > > personally
> > > > > > I don't like intra dermal injections and have therefore always
> > > refused.
> > > > > >
> > > > > > Shirley Fields
> > > > > > OH Manager Burton NHS
> > > > > >
> > > > > > -----Original Message-----
> > > > > > From: diane romano woodward [mailto:[log in to unmask]]
> > > > > > Sent: 02 December 2003 15:02
> > > > > > To: [log in to unmask]
> > > > > > Subject: Re: BCG Vaccinations: dissent?
> > > > > >
> > > > > >
> > > > > > All seem to be very positive about nurses doing this.
> > > > > > Is this considered to be an extended role that one can chose not
> to
> > > do?
> > > > I
> > > > > > remember opting out when working in the NHS some years ago as (I
> > > think)
> > > > it
> > > > > > is possible to cause some disruption to the arm if they are
> actually
> > > > > immune.
> > > > > > On that basis I felt it was better to let OHP take
responsibility,
> > > (they
> > > > > get
> > > > > > paid more..)
> > > > > >
> > > > > > For those of you in the NHS would you frown upon employing a
nurse
> > who
> > > > > > declined to do them, as long as they could do heaf tests, Hep Bs
> > etc?
> > > > > >
> > > > > > Best wishes,
> > > > > > Diane
> > > > > > (independent practitioner)
> > > > > > ----- Original Message -----
> > > > > > From: "Fields Shirley" <[log in to unmask]>
> > > > > > To: <[log in to unmask]>
> > > > > > Sent: Tuesday, December 02, 2003 10:49 AM
> > > > > > Subject: Re: BCG Vaccinations
> > > > > >
> > > > > >
> > > > > > Hi Chris (remember me)
> > > > > >
> > > > > > At Burton one of our nurses is currently undergoing training
from
> > the
> > > > > chest
> > > > > > clinic nurse to do BCG's. There is no reason why nurses cannot
do
> > this
> > > > > > procedure with adequate training.
> > > > > >
> > > > > > Say hi to Sally
> > > > > >
> > > > > > Shirley Fields
> > > > > > OH Manager
> > > > > > Burton NHS Trust
> > > > > >
> > > > > > -----Original Message-----
> > > > > > From: Baldwin Chris (RFF) Occupational Health Nurse Advisor
> > > > > > [mailto:[log in to unmask]]
> > > > > > Sent: 02 December 2003 10:01
> > > > > > To: [log in to unmask]
> > > > > > Subject: BCG Vaccinations
> > > > > >
> > > > > >
> > > > > > Good morning everyone,
> > > > > > a question particularly for NHS colleagues. Do NHS Occupational
> > Health
> > > > > > colleagues allow the vaccination to be nurse or doctor
> administered?
> > > > your
> > > > > > comments and thoughts on this are appreciated.
> > > > > >
> > > > > > chris Baldwin
> > > > > >
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