On Saturday 24 February 2007 19:24, Ian Haywood 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.
nurses are the worst worrywarts about being sued, and the risk is bugger all
for them.
change of attitude to reasonableness is going to take time
>
> > 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.
ECG can be faxed, they could have a webcam to show the GPAssist doc what the
situation is
>
> 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.
this is the hardest part - to let the nurse believe that they are capable of
making a decision, putting in an IV, giving some drug
because I can recall perfectly well when nurses put urinary catheters in
female patients and doctors put them in male patients
and for the non-medical listees, its a lot easier to find 'the way in' in the
male than in the female of the species.
--
Tiger got to hunt,
Bird got to fly;
Man got to sit and wonder, "Why, why, why?"
Tiger got to sleep,
Bird got to land;
Man got to tell himself he understand.
-- The Books of Bokonon
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