Michael Follan, a ‘a clinical nurse specialist at the Royal Hospital for Sick Children, Glasgow, and honorary lecturer in child and adolescent mental health at the University of Glasgow’ according to his biography, gets on his high horse in ‘CiF’ over some of Dr Crippin’s articles on nurse specialists and ADHD:
The pseudonymous GP Dr Crippen suggests that diagnosis and treatment by nurse specialists – or nurse "specialists", as he calls them – is a "dumbing down" of services offered by the NHS (Should nurses be prescribing drugs for children?, 17 November).Seems like a fair comment, but it stung Michael into a recitation of his own qualifications (pointless, because he admitted he didn’t prescribe himself), and a defence of the government’s policy:
"Competition to get into medical school is intense," he says. "You need nine or 10 GCSEs, mostly A*s, and three A-grade A-levels." By contrast: "The minimum requirement for entry into a three-year nursing course is five GCSEs, and two A-levels if you want to do the nursing degree. Who do you want to diagnose and treat your child? "
The principle that underpins the extension of the prescribing role to nurses is that it gives patients quicker access to medicines, making use of experienced nurses' advanced skills.Nothing to do with cost. Nothing at all.
And if you believe that…
He finishes by asking the same question:
Having given your readers the facts, I would ask them: "Who do you want to diagnose and treat your child?"Sadly for him, he doesn’t get the answer he expected…
Sadly, cost is aa factor in health care as much as in anything else. Clearly a doctor is more knowledgable than a nurse, and also more expensive. In exactly the same way that a licensed conveyancer is adequate to handle a property transaction (once a monopoly of solicitors), but not to conduct a court case, I see no reaason why a qualified and experienced nurse shouldn't be competent to carry out some (definitely not all) of the functions traditionally reserved to doctors. Reducing the cost of health care would make it better not worse.
ReplyDeleteAs ever, the devil is in the detail- deciding just which functions are within the competence of nurses competence of nurses and which are not is not easy- neither is it simple to ensure that nurses pass on all cases for which they lack competence.
Nurses are an important and highly-regarded part of a medical team; this does not give them the training or ability to take on work that is rightly done by qualified practitioners, or DOCTORS, as we used to call them.
ReplyDeleteDivision of labour, because that is what this is essentially about, should not - must not - be used an an excuse for passing medical care into 'semi-skilled' hands.
Nurses, do what you were trained to do; doctors, do what you were trained to do.
The 'one size fits all approach' has been proved wrong so many times; how long must we keep on proving it is wrong.
I remember an episode of 'House' in which he asked a lippy paramedic:
ReplyDelete"You wanna be the doctor? Shoulda worked harder at High School"
In a former life, I trained and qualified as a operating theatre nurse in a military hospital. I assisted anaethetists in setting up drips and administering drugs and post-op care but I would never have even taken it upon myself nor would I have wanted the responsibility of precribing drugs for patients.
ReplyDeleteLeave that sort of thing to them that knows.