Rowley Cottingham wrote:
> I have been thinking. Never a good thing, I know. But I am becoming
> increasingly convinced (and this thread on ENPs has reminded me) that we
> are going down the wrong path.
I think I agree...
....but
I work 'fee for service' - the govt pay me but I bill them for every
patient I see.
I have made our office (surgery) more efficient by using electronic
scheduling that we all have on our desktops...and...fetching patients from
the waiting room myself. Indeed my colleagues frowned, but they all do it
now. It is quicker, less error prone than having the staff do it, and
allows me to manage workload better.
In our emerg - we have one super slow nurse (and we only have one nurse on
at a time) - I often just do stuff because it is quicker (fetching patients
- taking xr form to xr etc) - but I do try, deliberately to leave 'nursing'
type tasks in a pile for the nurse to catch up with. I think this is part
of setting a speed/efficiency example whilst not removing her responsibilities.
Sometimes it is painful, I pulled an open, non-fractured, disloc ankle with
a white, cold, pulseless foot with entonox because the fentanyl was taking
just to long to arrive (and it went well with little discomfort and a very
happy patient :)
Now then - our emerg nurses are not NPs they don't have any particular
extended training - most are excellent. They take first call for us
(primary care and emerg) and see everyone first (unless they hear of
something bad coming in and then they notify us). They suture most things,
treat urtis, assess (sometimes with no physician attending) folks with
chest pain, deliver babies (usually with a physician, but not always) etc
They are marvellous - and a 1 in 3 in this rural area would be untenable
without them.
Just some thoughts.
Jel Coward
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