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I don't think anyone would argue that G grade nurses are a valuable asset in A&E, I still remain guided by them when needed, and always will be. Many have skills which I am unlikely to be able to better However despite having far more experience of acute medicine and surgery, including 'tendon repairs' than Mark Dawes, I tend to involve nursing staff in cardiac arrests and many other conditions because I always felt that A&E was a team effort, which involved members of the team all contributing their individual skills. It is surely foolhardy not to involve senior medical staff in the management of critically ill patients. Many Sprs entering A&E have a lot of experience in areas allied to A&E such as anaesthesia, general medicine, orthopaedics and ICU and have far more skill than Mark Dawes gives credit for.It would appear that this experience can now be picked up instantly by attending a theoretical module at your local seat of learning, thereby offering the scope for instant solo practice! yours not so humbly Francis Andrews FFAEM (+ others) lecturer in Intensive Care Medicine/hon Spr in A&E and ICU liverpool On Mon, 15 May 2000, Mark Dawes wrote: >With reference to G grade nurses in A&E- > >1) To achieve G grade status requires at least 4-5 years plus in A&E - which >means a hell of a lot of exposure & experience to not only 'minor' patients >but also critically injured patients > >2) Almost certainly means that the nurse advises & guides the SHO who has >just finished his/her house jobs & has very little insight how to manage >both 'minor' and compromised patients attending A&E > >3) The G grade probably has a far greater experience than most of the SpR's >who are just commencing their A&E placements! > >4) G grade nurses don't only treat the 'minor of the minor' - I've observed >ENP's at certain trusts - manage cardiac arrests, manage & refer both acute >surgical and medical patients, reduce dislocated joints, reduce common >fractures and perform tendon repairs without the input of SHO's or middle >grade staff. > >The NHS doesn't recognise and reward the hard work and dedication that any >of its health service professionals provide - whether its a D,E,F or G grade >nurse or casualty SHO. >I can honestly say - I couldn't give a monkeys who is treating me as long as >I can be assured that I am being managed by someone who is confident & >competent & proficient at what they are doing!? > >Mark Dawes >A&E > > %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%