> -----Original Message-----
> From: Accident and Emergency Academic List
> [mailto:[log in to unmask]]On Behalf Of Andrew Conway Morris
> Sent: 20 May 2004 11:57
> To: Martyn Hodson
> Subject: skills (was acute medicine)
>
>
> This thread appears to be degenerating into an us Vs them style
> debate whilst whinging about arrogant Drs, stupid nurses and
> other caricatures may be enjoyable mess/coffee room chat it is
> hardly the way to conduct decent debate on this list.
You are right here Andrew, but occaisionally peoole need a real short sharp
relaity check
> There is a belief that jobs can be divided down into their
> constituent parts and if a person is trained in each of these
> parts they should be able to do that job from published
> evidence it is apparent that extended role nurses can and do
> operate at a level of safety and ability equivalent to an SHO
> (all be it generaly more expensively).
the price comparisions have probably changed in recent years, with EWTD, New
deal etc.
suddenly start becoming a lot less expensive if the Junior Docs aren't b
expected to work nearly twice the hours of the Nurse in the simialr role
>The difference is that (as
> Rowley has said) these SHOs are going to go on and become the
> people who extended role nurses turn to for advice/help as they
> become more senior without that experience at an SHO level it
> is going to become harder for them to operate at a middle grade
> and senior level.
this has to be considered, but this shouldn't mean a degradation of service
or preventing service development
there's a point where the 'learning curve' flattens out, the trick here is
to get people onto a flat bit so they don't slip back if the skill is only
used infrequently for a period
> Just because tasks can be performed by others
> dosen t mean its not important for SHOs to get experience in
> these areas.
absolutely - but equally we shouldn't tolerate delays and poor service by
inexperienced and poorly supervised practitioners just to support one group
of people's percieved learning need !
> With regards to unhealthy deference to comparatively
> inexperienced doctors I m sure we can all think of examples
> where we have been narrowly guided from disaster by the voice of
> an experienced nurse and likewise I can think of several
> occasions where the voice of experience has been plain wrong.
> Healthy respect of colleagues knowledge, skills and abilities is
> required rather than application of clichid sterotypes to every
> new professional you meet.
Absolutely -
however dressing downs from senior nurses over nurses percieved 'insolence'
and complaints aobut Medical Staff not being followed up by senior medical
staff because they have come from staff more junior than the person being
complainted aobut.
Also an assumption held by some doctors that they out rank all over members
of the team solely becasue they are a doctor.
this of course is compounded by the back stabbing culture in nursing which
can be prevalent in some places at some times
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