On Saturday 24 February 2007 14:55, John Mackenzie wrote:
> > Another alternative would be to "upskill" the relevant nursing staff
> > so that they dont call for trivial issues. Perhaps developing some
> > good protocols for them to manage the common trivial issues and
> > beefing up indemnity so they are protected if they take decisions
> > according to these protocols. It is legal worries (often unfounded)
> > that drive a lot of this stuff
In my experience (despite my tender years I'm a professor in hospital 
protocols) they often simply don't work. All must have a "if concerned, call" 
clause, and those who want to use it will.

> 2) Acute AMI > GPassist confirms history
> and acute ECG changes, 
This would require a lot of explanation for the nurses, depending on 
confidence/skill level, but the principle is sound.

I could easily see a scenario where the local GP gets called regardless, you 
would need to be fairly clear that the GPassist service needs to be called 
first.

There is a strong culture within the healthcare industry that the doctor's 
lifestyle/sleep/sanity is not important, many nurses I've met hotly defend 
their 'right' to have me out of bed whenever they choose. In some places, 
this could be very hard to change.

Ian
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