Does anyone on the list have any idea what Martyn was saying in that email?
I certainly don't.
Translations gratefully accepted...
AF
----- Original Message -----
From: "Martyn Hodson" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Saturday, August 12, 2006 7:03 PM
Subject: Re: I think we have this all wrong
>> -----Original Message-----
>> From: Accident and Emergency Academic List
>> [mailto:[log in to unmask]] On Behalf Of Vic
>> Sent: 12 August 2006 17:48
>> To: [log in to unmask]
>> Subject: Re: I think we have this all wrong
>>
>>
>> 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.
>
> Or more to the point the perception rightly or wrongly is that doctors
> are rich and nurses poor...
>
> It is very easy to sat 'the nurses' but it forgets that until
> relatively recently , it wasn't qualified , Regsitered Nurses providing
> care on wards, assisted by support workers it was un(der) supervised
> students and/or used and abused as required because of their status 2nd
> level nurses...
>
>
>> 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.
>
> Or if Crippen (he of the blog) is to be believed, this has already
> happened...
>
> The question is will none medicla staff ever replace Consultants and
> other senior doctros - probably not but we will see an increasing move
> away from service provision by the trainign grade medical staff ...
> The comparision between the a few months I nthe speciality SHO and the
> several years if not decade + of experience of the senior Nursing
> staff... Vic alludes to this but sees the regualrisation of thepractice
> he describes as a threat rather than explicit acknowledgement of the
> practice...
>
>
>> 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.
>
> While we continue with the systems we have there should be little fear
> of thesituaion getting worse - it could get better however if all the
> Nurse academics were made to maintain a clinical caseload, much I nthe
> way the vast majority of medicla academics do ....
>
> The greatest risk in the above scenario is direct entry ( whether
> graduate or undergraduate) 'physician assistant' roles - we have no
> imperitive to employ the combat medics returning from Viet nam so do
> we need to create what is turely a 'mini doctor' rahter than adding
> roles to established Professional groups ?
>
>
>>
>> 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.
>
> All health professionals need to take back ownership of the clinicla
> education of students - just because people aren't employed by the
> hosapitals anymore doesn't mean hospital staff don't have the
> responsibility - however the absence of governmental will to provide and
> protect time for mentorship...
>
>>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.
>
> Which is indicative of a culture where those roles are not seen as
> desirable by the clinically focused senior nurse( who is now in a
> clinical specialist, Nurse practitioner or ECP post) leaving those who
> see a a ward managers job as a way to management roles - and
> consequently advocate for management by brown nosing rather than for
> their staff and patients ...
>
> Equally it is a reflection of a situation where understaffing to a
> dangerous degree is an accepted part of Nursing and therapist
> practice...
>
>>
>> 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.
>
> Which is obvious as admitting otherwise would mean damaging their job
> security ...
>
>>
>> We do not need more managers, we do not need more paperwork,
>> we do not need modern matrons.
>
> We do as it has taken back some pride in nursing rather than nursing
> disappearing into ( and becoming assimilated of)management above the
> senior sister role ...
>
>> 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).
>
> And how exactly do you propose to provide that AND keep people in
> Nursing who do care aobut clinically focused things - when tesco will
> pay more for the nurse looking for their first management post ...
>
> --
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