I've tried to stay out of this debate but finally want to add my two
pennyworth.
In the old days nurses nursed. They didn't prescribe (they told us to do the
writing and take the responsibility for their decisions), they made patients
comfortable by fulfilling their care needs in every respect. It never was a
menial job, and all the doctors on the ward knew that the patients were more
grateful to the nurses who made them comfortable than to the doctors who put
them in pain because it was the nurses who always got the chocolates or
jellied fruits. As a hospital doctor I only once got a thank you present, a
bottle of whisky for saving a child's life.
Now I have no issue with nurses taking clinical decisions that doctors used
to, though I feel that this is one of the ways that the Government is trying
to weaken the power that doctors have. When they finally decide they will
kick us down the salary scale, a strike will find the nurses happily doing
our jobs. Of course the Nurse & Paramedic practitioners will soon cotton on
to this, and after some bloody pay disputes things will end up just as they
are now, except that the experience base of the practitioners will have been
dumbed down and worse of all, no-one will know how to actually care for
(i.e. nurse)a patient.
I already see Consultants who have never learnt how to really examine a
patient properly, they rely on investigations, and on several occasions I
have seen a student nurse refuse to help clean a grossly incontinent
patient. Some Ward managers seem not to see the filth on the walls of their
wards or the fact that patients can go unfed, un-toiletted and even
unobserved.
I could go on ad nauseam about the deterioration in care that has occurred
in hospitals, but all the managers do is to reply that they need more paper
trails and managers.
We do not need more managers, we do not need more paperwork, we do not need
modern matrons. We don't need nurse practitioners. We do desperately need
nurses who know how to make a patient feel better, and doctors who
understand that medicine is both a science and an art (both long in the
learning).
Vic Calland
-----Original Message-----
From: Accident and Emergency Academic List
[mailto:[log in to unmask]] On Behalf Of Rowley Cottingham
Sent: 12 August 2006 17:11
To: [log in to unmask]
Subject: Re: I think we have this all wrong
> Not impying that I think you should not, but I think your tone
> indicates that YOU think you shouldn't be doing some of them. And I
> agree. But I think that at various times, departments and areas of
> departments some of these things should be done by you and at other
> times/places not. And other departments will have different
> efficiencies... The point we need to get to is when the RIGHT PERSON
> DECIDES who should be doing what and when!
>
My tone implies that I think my Trust is getting terrible value for
money. I grant you there are some, but there are very few times when it
is appropriate for someone on £40 an hour + to be doing a job that
frankly could be done by a completely non-clinical person on the minimum
wage like escorting someone from one place to another.
There is no dialogue about this important issue. I wonder why?
/Rowley./
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