Hi all
I would like to kick something about if I may.
This refers to the UK
There is a situation in a hospital A+E where there is a primary care
service based out of the same location. Many of the paediatric
attenders in the A+E department have primary care type problems. The
primary care service are happy that the paediatric nurse (RSCN), who
does the triage, refer patients directly to them rather than to the paed
SHOs. The GPs then either advise or treat or can speak to the
paediatric registrar to discuss or admit the patient.
This system seems eminently sensible to me and is an example of the team
work that so often seems to be missing these days.
There is now a move for this practice to cease - this comes not from the
primary care docs or the original nurse that set up the paediatric part
of the A+E but from a new nurse who is one of the new breed of nurses
that have not been through the generic nurse training but have
specialised from early on.
I find this all a bit odd. It is my impression that the general feeling
these days is that much of what comes into A+E is most appropriately,
effectivly and efficiently dealt with by a primary care physician. To
me this stands to reason with primary care type problems - a GP deals
with these things far more often than a paed SHO (who may be just our of
pre-registration house jobs).
I am tempted to beleive that the nurse that wants to stop referring to
the primary care docs knows little of the majority of medicine that
occurs in the community - but I am resisting this temptation until I
know more.
I would be interested in views from the list - and also to hear of
anyone with experience of triaging patients to on-site primary care docs
or other primary care facility. Does it work? Is it safe? Is everyone
happy?
If anyone can save me the leg work of hunting out any references in this
area then I would be very grateful.
TIA
Cheers all :)
--
Dr Jel Coward
'There's no such thing as bad weather - just bad clothing"
Anon Norwegian
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