In article <"0222090145-Minor Injury Units"@MHS>, Nick.Jenkins@nevdist-
tr.wales.nhs.uk writes
>I look after 5 and am just being handed my sixth.
Our cottage hospital casualty/medical emergency/MIU dept is staffed by
the nurses and midwives in the hospital who all multi-task. The GP on-
call provides the medical input. Overall I have more input into the
dept because it is my interest.
We do not have formal nurse practitioners - but the staff are probably
functioning at this level
We are desperately short on protocols. The nurses handle loads of stuff
- but will often discuss with us. They are ALS trained and one is ALSO
trained. The dept works on mutual trust, a lot of communication and a
friendly working relationship. No kids leave without being discussed
with a doc. We also tend to do most of our GP OOH via the casualty
dept.
The department does mainly general practice - minor illness, most
medical emergencies, most surgical emergencies, minor trauma - so why
should a consultant have to take it on? - especially since the nearest
is best part of an hour away, knows less of general practice than the
GPs, and probably doesnt want it anyway. (I am not sure if you lurk
Phil - if so let me know what you think).
OK so we do see v sick people - but as part of the pre-hosp phase of
their care - ie primary care.
I guess I wouldnt mind shifting the responsibility to someone else - but
I am unlikely to be too pleased at a hosp doc devised protocol that gets
me out of bed if I dont think it is necessary. I think it can be v v
difficult to write protocols that fit all circumstances - and our local
arrangements provide an effective alternative.
Cheers :)
--
Dr Jel Coward
'There's no such thing as bad weather - just bad clothing"
Anon Norwegian
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