Food For Thought

http://www.news.com.au/story/0,23599,24533590-5007133,00.html

As a junior doctor, prescribing antibiotics, writing up fluids and performing basic medical procedures is not the problem. It’s the hordes of paper work, and essentially clerical tasks that we are swamped with on a daily basis, which require no medical training at all that occupy most of our time.

Further, we constantly perform simple tasks eg taking blood & inserting cannulas, both require minimal medical knowledge. These tasks can be easily performed by nursing staff, however they are often unable to do so thanks to restrictions. On the other hand, people have died from antibiotics being wrongly prescribed, a simple litre of saline in a drip can also be fatal to somebody who has heart failure.

It seems the wrong message is being put forward regarding what is occupying junior doctors in hospitals. It’s not prescribing, it’s not performing minor medical procedures. In fact we NEED to do these things to further our competancies and experience. It is all the NON MEDICAL tasks we perform ad nauseum which burden our workload on a daily basis, and contribute to minimal job satisfaction. We did not study for 7 years to fill our simple clerical and administrative forms.

The man/woman has a point. Until we can find a better and more efficient way to process paperwork, this problem will never be solved. Currently, our Health Minister thinks she can solve the issue by handing more clinical duties over to the nurses. The Australian Medical Association (AMA) has voiced some concern about the issue and is subsequently being labelled ‘territorial’ and ‘old-school’.

That being said however, the current move by the Federal Health Minister, Nicola Roxon, to remove restrictions on nurses warrants a closer look. Consider these 2 points:

  1. The main complaint leveled at the public health system today is the long waiting list, whether it be at the A&E  (or ED) door, GP consultation rooms or the surgical theatre. One should fear that Ms. Roxon’s is attempting to put in some spin by shifting the focus to what seems like a ‘turf war’ between doctors and nurses. Clearly this shouldn’t be the case. The onus is on both Federal and State governments to use the returns of the past 10 years worth of prosperity (which is quickly dwindling) in giving what the public rightly deserves. We build a strong nation by building a strong people. Its a lesson lost in the country I was from and I be damned if it would happen here as well.
  2. Is this really a ‘turf war’? Any change should always be met with at least a teaspoon of skepticism. My main question would be regarding the finer details of this change. I have absolutely no issues with giving nurses greater power in clinical decision-making. But which nurses? Won’t they need to be further trained? After how many years of clinical experience in doing so? Can they make the right decisions in light of the patients overall picture? What if its a complicated case (which a lot of inpatient cases are)? etc etc…

    Even for us doctors, we take at least 5-6 years to get to that stage. After that we have 1 years worth of internship, during which we get our title but we still have to be supervised. We can’t prescribe without a senior doctor giving us the all-clear. Mistakes do happen but we are committed to keeping that to an absolute minimum. I am not going to demean my nursing colleagues but I am still going to ask, “Can the nurses do the same and keep up to an adequate standard”?

The band plays on….

Remember you (the non-healthcare related readers) can help this situation by taking good care of yourself. Eat properly, remember to exercise, don’t smoke, don’t do drugs, drink responsibly, have good social networks and get help early. This will go a long way in not only reducing your own grief but also help our ailing public health system.

Cheerio.

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~ by shybeg122 on November 11, 2008.

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