Dear Mick
some excellent points and I agree, we must be careful not to blame others
for our shortfalls. Let me however, give you an example of why I made some
of my previous comments.
In some NHS trusts massage has been deemed as an alternative medicine. The
fact that it has claims on being the oldest form of medicine is another
issue. The head of the Trusts alternative medicine is a nurse. In these
instances physios have been unable to practise massage without either a
nurse present or their permission to use this modality on the patient.
I am sure you will agree this goes beyond the semantics of who owns which
modality and is a flagrant attempt on the nursing staff to be the sole
owners of massage therapy, taking it from the traditionally trained
physiotherapists. I in my own experience have been told by a nurse in a pain
clinic that it was not my job to issue patients with a TNS machine. Both
these are examples of core undergraduate physiotherapy skills being assumed
to be the province of nursing.
I am not suggesting professions other than physios should not be allowed to
use these modalities. I do however take offence of those professions telling
me I can not, especially when they have been long established as under and
post graduate physiotherapy techniques.
Regards Kevin
-----Original Message-----
From: Michael Jubb <[log in to unmask]>
To: [log in to unmask] <[log in to unmask]>
Date: 30 May 1999 10:47
Subject: Physiotherapy and Para-physiotherapy
>This is a reply to points made by both Linda and Kevin
>
>Nurses in the UK do not have much in the way of therapeutic interventions
>which are not considered , in the wider sense, as being much more than
>parenting skills (Madwives and Psychiatric nurses excluded). Their move to
>included limited prescription is indicative of their desire to become
>responsible for some aspect of treatment which can be measured and for
which
>true responsibility can be ascribed. That they are moving to assume some
>physiotherapeutic interventions can only be seen as being a "compliment" to
>Physiotherapy/Physical Therapy.
>
>If we use the Military model where physiotherapists are now Commissioned
>Officers (On the basis of their clinical Diagnosis and responsibility) the
>point that Kevin made about assessment comes in to focus as the army would
>not just hand out commissions to anyone, would they? It is also interesting
>that when the Society of Remedial Gymnasts was subsumed into the Chartered
>Society that the services felt the loss of an Exercise Therapist so keenly
>that it designed its own Exercise Therapists course and has been running it
>ever since. My point here is that when a body which is as focussed/limited
>as the RG's, when it joins a larger group with wider scope of practice the
>original opportunity remains but unmet.
>
>Linda makes a good point about massage without assessment but misses an
>opportunity to say that it is not those far removed from practice such as
>the VIPs who should be made aware of the need to promote the use of a
>physiotherapist, it is up to the practitioners on the ground to show
>effectiveness which can be taken by managers to make financial and quality
>of care arguments. Let us not, once again slip into the trap of blaming
>everyone else for our own inability to show effectiveness in a setting
where
>assessment is a key issue.
>
>I apologise to anyone who has read this and become inflamed I apologise, it
>was not my intention to "Flame" but to put forward a few observation to
>encourage dialogue at one of key areas of practice which I believe we are
>not addressing with the "grasp the nettle" approach which is required.
>
>Mick
>
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