> -----Original Message-----
> From: Accident and Emergency Academic List
> [mailto:[log in to unmask]]On Behalf Of Rowley Cottingham
> Sent: 19 May 2004 11:03
> To: Martyn Hodson
> Subject: Re: Acute Medicine
>
>
> I am starting to regard nursing as the entry point to healthcare.
> You will remember the suggestion I
> made about 3 years ago about a universal training programme (UTP)
> that produced a generic
> healthcare worker that could take on further training in modules.
i think to some extent Nursing had done this for a long time but by stealth,
with a very much generic baisc preparation for practice, and then you become
whatever kind of nurse you want to be, given the width of Nursing practice
it's sometimes hard ot think that nurses come out of the box in one of 4
flavours Adult (general)/ Mental Health / Paeds / learning disabilities
>
> It almost seems that nurse training is becoming that by default.
> I scarcely regard ENPs as nurses in
> the traditional sense any more - yes they can revert to nursing
> when they need to, but they are
> becoming a skilled resource with thoughts, plans and ideas that I
> for one am happy to take very
> seriously. The transition was started by midwives, and other
> groups of nurses are essentially
> following a similar path.
if you also include the experience of the Distirct Nurses - as another of
the developers of nurses as autonomous practitioners, plus Helath visitors
and the creep of autonomous roles in other areas of nursing practice
>
> I know the tired old argument about SHOs, but they are really
> inexperienced generic doctors. We
> are replacing them in essence with a group who do little else
> after directed training following clear
> protocols and get good at it. We see the same mistakes every six
> months because the SHOs are all
> going through the same experiential process. Once past that, they
> don't make the same mistake
> again, but them buzz off to urology or something.
for far too long the establishment , and many professional groups have
placed a lot of value on the opinions of Junior Doctors
>
> I don't expect skill uptake to die out - I am seeing more and
> more people gradually becoming more
> proficient in specific skills. Five years ago, who would expect a
> Level II HCA to be undertaking
> phlebotomy and placing venflons? They do now, and very competently.
>
this has been a recognition that psycho-motor skils do not make a
profession - something some areas of healthcare stil lstruggle with
> What we have to think about is how we ensure that enough doctors
> with skill to train and
> supervise these skill-specific workers are around - middle grade
> land is the desert. We need to
> avoid the trap that the obstetricians have fallen into - if you
> don't have a normal birth you get a
> Caesar. Whatever happened to lift outs, Keilland's mid cavity and
> so on? A few poorly trained and
> inexperienced doctors took huge hits when something went wrong so
> the profession moved away
> from intervention apart from LSCS.
this is the key aspect - who do people look towards when there is a
problem - middle grade and senior doctors and a few senior nurses / midwives
Martyn Hodson
A+E nurse
somewhere in the North !
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