Dr Crippen,
I am an F1 doctor in England. You are a (late) middle-aged GP somewhere in the UK. Right?
When was the last time you spent any time with a large group of nurses? Sure, your practice may have a typical dumpy middle-aged Practice Nurse, whom you and your GP Partners foist all the boring asthma clinics onto, letting her measure PEFRs for a day, but she is hardly representative of all nurses.
I have been working as a doc for a year now (and I know my career is brief compared to yours), and I ahve experience of modern nurses which is more accurate, current and varied than yours - working with a multitude of them, of all levels of experience and seniority, every day and night, on the wards. And I agree with Vicky Pollard, that nursing is a back-breaking, dirty, thankless, shit job. It is disgustingly low paid also, and I don't blame anyone for not wanting to go into it.
My feelings on the new nurse specialists are split. In favour of them, they make my life easier as a junior because they are much easier to access than a SpR/Consultant if I need advice about a specific area, and are often friendly and approachable. For example, the Diabetes Specialist Nurse, able to spare the time to educate the patient about insulin pen choice, dosing regimes, how t use the BM self-test machine etc. I could do all she does, but I would never, ever leave work if I took on all the jobs of the specialist nurses (TPN nurse, Diabetes nurse, Pain nurse, Stoma nurse, ad infinitum), and, as great as my job is, I really, really enjoy having a life too. So, let them do their Specialist Nurse roles, they help the doctors and the patients. When things become complicated or dangerous, it's up to the doctors to sort it out, which is fine. Most of the specialist nurses I have met recognise when a problem exceeds their expertise for whatever reason, and usually advocate calling the appropriate SpR. They are super-helpful in managing SPECIFIC conditions, that aren't too complex and don't feature multiple co-morbidities. They help patients and doctors. They are important, now that doctors are permitted to have a life outside work. Thank you, EWTD! I do have a problem with a rare breed of specialist nurse who doesn't know that not having a full medical education and apprenticeship can sometimes blinker her expertise and make it irrelevant in the greater picture, or who is overly bossy (a common trait).
Essentially, I appreciate the nurses for doing a really gross, crappy job fairly well, and the patients do too. On my current ward, they are without fail, phenomenal, and their efforts are appreciate by all the medical team. I don't blame school-age people who dont want to do it, especially with the appalling pay. And I don't blame nurses who want to specialise and progress, as long as they are well-trained and aware of their limitations (as should we all be). I don't like it when they boss me about, but oh well, I boss them about too.
Pharmcists, now that's another matter. Pushy, bossy, overpaid, underworked, pill-counting, BNF monkeys, with no clinical experience at all. They are the ultimate protocol/algorithm-driven automatons. We have independent prescribing pharmacists in my hospital, who know drugs very well, but I seriously doubt could tell you a normal BP, could interpret a TFT, could read a chest x-ray, or examine an abdomen. Yet these people are effectively allowed to prescribe anything. A lot work on the medical admissions unit, where they'll be encountering allsorts of presentations. I doubt they have a chance to sticky to their area of prescribing competency, given that literally any disease in the world could walk in.
****
Incidentally, the nursing students from the 'real' university locally are far brighter and interesting than the gormless chavettes from the local ex-polytechnics. I value the degree nurses from the real degree-awarding institution, rather than the diploma/faux-degree blank-starers from the old polytechnics. That's by-the-by, just a vote in favour of the degree nurses who I don't have to explain everything to twice. The degree nurses have a greater understanding of physiology, pharmacology etc, and tend to be generally brighter and more focussed on their jobs. I like them.
Source
I am an F1 doctor in England. You are a (late) middle-aged GP somewhere in the UK. Right?
When was the last time you spent any time with a large group of nurses? Sure, your practice may have a typical dumpy middle-aged Practice Nurse, whom you and your GP Partners foist all the boring asthma clinics onto, letting her measure PEFRs for a day, but she is hardly representative of all nurses.
I have been working as a doc for a year now (and I know my career is brief compared to yours), and I ahve experience of modern nurses which is more accurate, current and varied than yours - working with a multitude of them, of all levels of experience and seniority, every day and night, on the wards. And I agree with Vicky Pollard, that nursing is a back-breaking, dirty, thankless, shit job. It is disgustingly low paid also, and I don't blame anyone for not wanting to go into it.
My feelings on the new nurse specialists are split. In favour of them, they make my life easier as a junior because they are much easier to access than a SpR/Consultant if I need advice about a specific area, and are often friendly and approachable. For example, the Diabetes Specialist Nurse, able to spare the time to educate the patient about insulin pen choice, dosing regimes, how t use the BM self-test machine etc. I could do all she does, but I would never, ever leave work if I took on all the jobs of the specialist nurses (TPN nurse, Diabetes nurse, Pain nurse, Stoma nurse, ad infinitum), and, as great as my job is, I really, really enjoy having a life too. So, let them do their Specialist Nurse roles, they help the doctors and the patients. When things become complicated or dangerous, it's up to the doctors to sort it out, which is fine. Most of the specialist nurses I have met recognise when a problem exceeds their expertise for whatever reason, and usually advocate calling the appropriate SpR. They are super-helpful in managing SPECIFIC conditions, that aren't too complex and don't feature multiple co-morbidities. They help patients and doctors. They are important, now that doctors are permitted to have a life outside work. Thank you, EWTD! I do have a problem with a rare breed of specialist nurse who doesn't know that not having a full medical education and apprenticeship can sometimes blinker her expertise and make it irrelevant in the greater picture, or who is overly bossy (a common trait).
Essentially, I appreciate the nurses for doing a really gross, crappy job fairly well, and the patients do too. On my current ward, they are without fail, phenomenal, and their efforts are appreciate by all the medical team. I don't blame school-age people who dont want to do it, especially with the appalling pay. And I don't blame nurses who want to specialise and progress, as long as they are well-trained and aware of their limitations (as should we all be). I don't like it when they boss me about, but oh well, I boss them about too.
Pharmcists, now that's another matter. Pushy, bossy, overpaid, underworked, pill-counting, BNF monkeys, with no clinical experience at all. They are the ultimate protocol/algorithm-driven automatons. We have independent prescribing pharmacists in my hospital, who know drugs very well, but I seriously doubt could tell you a normal BP, could interpret a TFT, could read a chest x-ray, or examine an abdomen. Yet these people are effectively allowed to prescribe anything. A lot work on the medical admissions unit, where they'll be encountering allsorts of presentations. I doubt they have a chance to sticky to their area of prescribing competency, given that literally any disease in the world could walk in.
****
Incidentally, the nursing students from the 'real' university locally are far brighter and interesting than the gormless chavettes from the local ex-polytechnics. I value the degree nurses from the real degree-awarding institution, rather than the diploma/faux-degree blank-starers from the old polytechnics. That's by-the-by, just a vote in favour of the degree nurses who I don't have to explain everything to twice. The degree nurses have a greater understanding of physiology, pharmacology etc, and tend to be generally brighter and more focussed on their jobs. I like them.
1 comment:
gormless chavettes - That's a new one for me. Sounds like a new model being introduced by General Motors.
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