-----Original Message-----
From: Accident and Emergency Academic List
[mailto:[log in to unmask]]On Behalf Of Paul Middleton
Sent: 19 May 2004 12:41
To: Martyn Hodson
Subject: Re: Acute Medicine


<snip>

ENP's manage many areas of emergency medicine very well, but they perform a
specific role for which specific extra training and protocols are needed,
precisely because nurse training does not lend itself to the diagnostic
process. If there is to be a "generic healthcare worker" it should be just
that, and not a nurse with extra modules!

Incidentally, for those who seem to have a jaundiced and bitter take on the
dominance of the medical profession, what do you want that is different?
What exactly does "..for far too long the establishment , and many
professional groups have placed a lot of value on the opinions of Junior
Doctors.." mean exactly? I think in this context there are far too many
complaints and not enough constructive solutions. If you think you can do
better, tell us how....or alternatively retrain as a doctor!!  :))

Paul

why does nurse training not lend itself to the diagnostic process?, Nurses
use diagnostic skills each and every day, just the profession has at times
chosen to specifically eschew the use of the term 'diagnosis' for whatever
reason, or ridicule it in the way that NANDA does by trying to avoid any
medical terminology in 'nursing diagnoses'.

how much is terminology and semantics ?

how much is different 'cultural expectations' of examination and history
taking ?

how much is the fact that Medicine has approximately twice the period of
time to impart it's pre registration learning ?

In terms of anatomy and physiology teaching, i don't know where you have
experience of nurse education it's a significant and in depth part of all
pre registration programme,s however aspects of this learning is not
necessarily  presented in A+P teaching but as part of the content in other
topics - isn't 'integration' of pure theory , applied theory and practice
sone of the holy grails of most health Professional education

my comments with respect to Junior doctors, is the situation where an
individual with days to weeks  of experience in a speciality is permitted
and encouraged  to disregard  the opinions and viewpoints of those with many
years of experience in a speciality. Sadly some of the older members of the
nursing profession still encourage this unquestionaing reverance of Medicla
staff regardless of grade.

then there is of course the 'hoop jumping' required by other professionals
to undertake a 'doctor's job' which is often a psychomotor skill (
cannulation, ABGs etc) - or something that the practitioner does everyday
but not that particualr route or location ( IV drug administration) - i'd
suggest the bolam test for some interventions  is probably  now based around
the requirements for Paramedics or Nurses to undertake an intervention
rather than for the Doctor to undertake it.

're- training as a doctor' is not a way to improve things only remove
yourslef from the problem, I have so say some of the most grossly
patronising doctors i've met have been people who trained as Other Health
Professionals before becoming doctors ( except it has to be said Max fax s
who were dentists first - who seem to be well balanced and happy people as a
rule), but equally i've met some docotors who have bene able to use their
previous experiences to enhance their medical practice in many and varied
ways.

Martyn
a Nurse somewhere in the North
---
Outgoing mail is certified Virus Free.
Checked by AVG anti-virus system (http://www.grisoft.com).
Version: 6.0.682 / Virus Database: 444 - Release Date: 11/05/2004