I must say that See and Treat is not dead in our minor injuries area,
but doing well at present under the auspices of a fierce and very
competent senior nurse who is dispatching inappropriate attenders (
yes, I mean that ) back to the street or their GP in a timely manner.
It has been a pleasure not to walk through a waiting room of glowering
faces for the past weeks.
BUT, the next initiative from management and upper nursing echelons has
been causing me some more concern: care pathways for the majority of
majors patients coming through, to be funnelled off to gynae,
orthopaedics, cardiology etc, after assessment by a senior nurse in
order to beat the four hour targets.
There are advantages of a senior nurse assessment around the clock, as
they can spot a problem early and involve medical input earlier.
However, it seems that in our eagerness to comply with 4 hour waiting
times we are doing ourselves out of a job. I can see 10 Emergency
Medicine SHOs in the near future twiddling their thumbs while the
majority of patients funnel straight past them OR lie in the corridor
waiting for the specialty doctors to arrive and see them.
This is not the way forward for Emergency Medicine. I believe we would
be expanding our roles towards total care of emergency patients that
come through the door, and many of these will take longer than 4 hours
to sort.
Any other departments undergoing similar initiatives ?
Paul Ransom
Consultant, Brighton
-----Original Message-----
From: Accident and Emergency Academic List
[mailto:[log in to unmask]] On Behalf Of Dunn Matthew Dr. (RJC)
ACCIDENT & EMERGENCY - SwarkHosp-TR
Sent: 30 January 2003 09:13
To: [log in to unmask]
Subject: Re: Trick & Teat is Dead/ Nurse practitioners
Thanks for the postings on these. Looks interesting. To take it a bit
further, what sort of absolute numbers is each NP seeing in the
departments
where they see a lot of patients?
Matt Dunn
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