----- Original Message -----
From: "Dunn Matthew"
> I'd also say that it is linked in terms of philosophy: if you create the
> philosophy that the consultant deals with the 'minors' while the SHOs see
> the 'trolleys', then consultants are less likely to be called for advice
on
> sicker patients.
Couldn't agree more, Matt, it's all about creating the right "culture". When
I was an SR, my consultants were rarely troubled for clinical advice, and
that's still very common in many departments. In my own unit the SHOs freely
and liberally "use and abuse" us for advise, both for minors and for trolley
patients, we routinely attend all resus "blue calls", and we do all
sedations and procedures. In my view, that's the only way to get your
department moving, to keep it safe, and to train your juniors.
> I would say, however, that this case may have just been a bit of bad luck
> that could have happened in any department.
Could be, we may all be prejudging, but there's a salient lesson. In the
pressure to achieve targets, we (i.e. the clinicians) remain the only
patient advocates. If we don't protect clinical priorities, no-one else
will.
> I have been a bit sceptical over the past year of so about trick and treat
to put it mildly. My suspicions were correctly founded. It doesn't require
a degree in rocket science. [Danny McGeehan]
And if you read this month's EMJ, you'll find that some of our speciality's
finest (academics) are also very sceptical about see and treat. You're not
such a lone voice after all, Danny, far from it!
Adrian Fogarty
|