It is a cultural thing - the relationship with the Dr must be good and
the nurses supported in their decision making. Of course they have to be
experienced and well trained. I have found remote area nurses more used
to this as they have a "decision making" mindset, rather than a "pass it
on" attitude. Any nurses who are trying to get at the Dr should have it
pointed out that their jobs might disappear if he goes and they should
look after him.
R
Ian Haywood wrote:
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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