Have had ++ experience with US-trained nurse practitioners, while working on
board cruise ships. They see a lot of minor and major cases, including
cardiac, but also chest infection, ENT problems, UTIs, abdo pain, headaches,
urology issues (e.g. torsion), rashes, asthma (brilliant on this), URTI,
etc, etc (LOTS of etc.s) ...
They also "see" stuff they cannot "see" and do all they can before handing
the case to the physician, by which time the patient has had 99%-100% of the
Hx taken (you might have an extra question here and there), IV in, bloods
done (if necessary - they are very thrifty), analgesia and anti-emetics, etc
given as per PHYSICIAN's prior-stated preferences, etc. etc. etc.
They absorb knowledge at first encounter and implement well. I would compare
them to a senior SHO at conditions they are familiar with, e.g. ENT,
suturing, orthopaedic issues (up to dislocations, reduction of ankle
#-dislocations), etc. And to a house officer on the rest, but with the
confidence in their knowledge and in where the gaps are, which allows
excellent interaction with the physician and virtually NO duplication of
efforts.
The best part is that they always seem to aim to get as far as they can and
then actively "drain" you of anything you can possibly explain about what
the next step should be next time.
I have always wished to have these in the UK...
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