special mention to Dr Ellie
I'm an Irish doc who left due to the crap conditions and working hours in
Ireland. I'm currently working in New Zealand, which treats docs pretty well,
and our hours are extremely humane.
Btw, I certainly don't mean to direct this at you! You sound like a really nice
nurse, and the fact that you even KNOW about our working hours, let alone
care, says so much. Most nurses at home were not aware that we were forced
to be on for 36 hours straight and didn't believe us or care if we mentioned
As any regular reader will know I've mentioned this before, and it gets on my you know whats so much. NZ has a rough population of 4,264,871,very similar to Ireland, so we'll assume that it has a roughly equivalent tax take. Using this as a basis, then how come they can run their system without working their Dr's to death? Maybe, what we should do here is totally dismantle all the health service machinery and rebuild it in the image of NZ or another good example? Oh wait...........thats what the HSE idea was about.....whoops!
Nurses here, if a patient complains of chest pain, do an ECG, give GTN,
do a set of obs, and call you unless the patient is clearly crashing. If
they suspect a patient is in retention, they do a post mict bladder scan.
Many take bloods and site IVs, and only call you when they don't get them in. They take verbal orders for meds. They give first dose IVs-that's a BIG one that's always annoyed me intensely. In Ireland, many times nurses would go so far as to make us give the first dose of say, IV Augmentin, even if the patient had already had it on this admission, and we were just restarting him on it.
Thankfully giving first dose antibiotics has more or less gone in most hospitals, most of the time we happily give them with few problems. I'd really only start thinking about not giving something if I was really unfamiliar with it. Most times though, a quick call the the pharmacy dept is the best line, as to be fair, most Docs don't know much about the routes of all the mad scary type drugs anyways! I agree though, that first dose stuff was nonsense of the highest order in all but a very very few cases.
When I was a student, I worked in A&E on a placement for 6 weeks. Standard practice there for nurses to do ECG's, well in the dept I worked in. By the end of the 6 weeks, I was doing the things in my sleep. Now, as a fully qualified registered nurse....... I'm NOT ALLOWED do them..... for those not in the know, ECG's are pretty simple to carry out, in fact apart from Dr's the people who do them most as ECG Technicians, I'm not sure what qualifications they have, but I'd assume its not a PhD. Point is, its not that difficult.
Taking blood is another one. Nurses in general don't do this. There are exceptions alright, but for the main part they don't and aren't trained to do it. Even if I went on the course.......the hospitals won't let me do it, or put in a cannula. In fact, if I did do it, and it got out, I'd probably be disciplined. (BEHAVE!)
This all seems a bit silly doesn't it? But see it relates back to some of the things that I was saying before....
See, if i start taking bloods and putting in cannulas, then I'll end up doing them all, and I'll never get a Dr to do any of them. This takes time, so how am I going to get the time to fill in all the care plans, reports and ticky box bits and pieces of paper that I'm already snowed under with? I'll still have patient ringing the call bell when they need a hand in the toilet, I'll still have patients to help get washed in the morning, or to make sure that your granny eats her dinner. See where I'm going here?
There's no one really below the nurses that can take on the jobs so that we can take on a few of the extra Dr ones. Yep, there are the healthcare assistants being trained up as we speak, but until they actually create a proper job spec for these people, and sort out the area of delegation and the responsibility of the nurses for the HCA's practice, they are going to sit on the shelf and it'll all be another waste of time.
While I've no desire to become a "mini - doctor" I'd certainly feel that it'd make more sense to have nurses performing quite a few of the roles that the NCHD's are now doing. Unlike the private sector though, the public health system doesn't seem to much a fan of innovation, free thinking or change. Until, that realisation hits home, nothing will change, at least to a degree where things for patients and staff will get better.
Just a final point...........Ellie.......I always try to be nice to the Doc's. We are after all on the same side. Sure, I've let rip at a few of the pompous fools but I've made friends with plenty of your lot. The behaviour shown to you though as a female NCHD was a disgrace though, and on behalf of the muppet nurses that were like that......I'll apologise. It happens though, especially if your at least vaguely pretty, make an effort with your appearance or are a bit outgoing. Its jealousy i think, but who knows........just between you and me though, I'm always nicer to the girls than the lads........dammit.....Mrs Ain't No Angel is looking shhhhhhhhhhhhh don't tell her!