NCHDs performing inappropriate work is causing a "pseudocrisis"

Jane5

http://www.imt.ie/news/latest-news/2011/05/inappropriate-work-is-creating-a-pseudo-crisis-%E2%80%94-nchd-chair.html

I like this guy Dr. Murphy, and also our new health Minister! Go them! Finally someone higher up comes out with it.

Bottom line, the country can't bloody afford for everyone to pfaff around anymore. We need doctors to do their jobs-and not nursing and portering, we need nurses to do their nursing jobs instead of care assistant work, secretarial work and portering, and etc etc. Instead of searching for more doctors in foreign countries while closing emergency depts due to lack of medics, USE the ones we have as actual doctors instead of "First Dose Technicians" and on-call phlebotomy, and "Senior/Junior/Only Qualified person in Whole Hospital to Wheel out an ECG Machine".

Heck I worked on an absolute joke of a Med for the Elderly ward once where the nurses refused to do BLADDER SCANS ffs, stating that it was the doctors job.

Unless you actually picked up the bladder scanner and beat the patient with it, there is actually no way you could hurt someone with it, and it printed out the amount in mls that was in the bladder, so unless you can't read, there is no possibility of inaccuracy. Still-every time they decided a patient needed a quick bladder scan-they called doctors to wheel the machine OUT OF THE NURSES STATION, place it on the patient, print out the paper, and bring it back to them.

Really, really glad that these insane practices are being brought out into the open now-it's just a pity it has taken a massive recession to make it necessary to do so.

take everything

Jane5 wrote: »

http://www.imt.ie/news/latest-news/2011/05/inappropriate-work-is-creating-a-pseudo-crisis-%E2%80%94-nchd-chair.html

I like this guy Dr. Murphy, and also our new health Minister! Go them! Finally someone higher up comes out with it.

Bottom line, the country can't bloody afford for everyone to pfaff around anymore. We need doctors to do their jobs-and not nursing and portering, we need nurses to do their nursing jobs instead of care assistant work, secretarial work and portering, and etc etc. Instead of searching for more doctors in foreign countries while closing emergency depts due to lack of medics, USE the ones we have as actual doctors instead of "First Dose Technicians" and on-call phlebotomy, and "Senior/Junior/Only Qualified person in Whole Hospital to Wheel out an ECG Machine".

Heck I worked on an absolute joke of a Med for the Elderly ward once where the nurses refused to do BLADDER SCANS ffs, stating that it was the doctors job.

Unless you actually picked up the bladder scanner and beat the patient with it, there is actually no way you could hurt someone with it, and it printed out the amount in mls that was in the bladder, so unless you can't read, there is no possibility of inaccuracy. Still-every time they decided a patient needed a quick bladder scan-they called doctors to wheel the machine OUT OF THE NURSES STATION, place it on the patient, print out the paper, and bring it back to them.

Really, really glad that these insane practices are being brought out into the open now-it's just a pity it has taken a massive recession to make it necessary to do so.

First ****ing doses.
Also stuff like ferrying ABGs halfway across the hospital at night, using the machine, and then back again- very time consuming.

Traumadoc

I remember as an intern , the nurses in ICU would call us to print out stickers for blood requests , the decision to order the blood test was entirely the nurses they just refused to use the computer.

This is one of the few times we were bullied by nursing staff, the other was in a certain paediatric hospital.

opinion guy

Jane5 wrote: »

http://www.imt.ie/news/latest-news/2011/05/inappropriate-work-is-creating-a-pseudo-crisis-%E2%80%94-nchd-chair.html

I like this guy Dr. Murphy, and also our new health Minister! Go them! Finally someone higher up comes out with it.

Bottom line, the country can't bloody afford for everyone to pfaff around anymore. We need doctors to do their jobs-and not nursing and portering, we need nurses to do their nursing jobs instead of care assistant work, secretarial work and portering, and etc etc. Instead of searching for more doctors in foreign countries while closing emergency depts due to lack of medics, USE the ones we have as actual doctors instead of "First Dose Technicians" and on-call phlebotomy, and "Senior/Junior/Only Qualified person in Whole Hospital to Wheel out an ECG Machine".

Heck I worked on an absolute joke of a Med for the Elderly ward once where the nurses refused to do BLADDER SCANS ffs, stating that it was the doctors job.

Unless you actually picked up the bladder scanner and beat the patient with it, there is actually no way you could hurt someone with it, and it printed out the amount in mls that was in the bladder, so unless you can't read, there is no possibility of inaccuracy. Still-every time they decided a patient needed a quick bladder scan-they called doctors to wheel the machine OUT OF THE NURSES STATION, place it on the patient, print out the paper, and bring it back to them.

Really, really glad that these insane practices are being brought out into the open now-it's just a pity it has taken a massive recession to make it necessary to do so.

Bladder scan ? Easy answer to that - I'm not trained

Malmedicine

1st dose antibiotics (GRRRRrrrrrrrrr)
Any IV furosemide (Even bigger GGGGGGGGGrrrrrrrrrrrrrrrrr)
ECG's (meh I'll just be asked to read it anyway)
Phlebotomy 3 to 4 days of week during the day (I want to tear my hair out at this been ongoing in the hospital for the past three months!!)
Bladder scans (supposedly nurses not trained or covered to use - don't remember any training I got with one apart from the instruction guide at the fron)
Portering of bloods and patients occasionally ( because I can't wait 2 hours for the porter to ferry bloods to the lab?)

And its the same excuse everytime "We are not covered to do that?"

RobFowl

Malmedicine wrote: »

1st dose antibiotics (GRRRRrrrrrrrrr)
Any IV furosemide (Even bigger GGGGGGGGGrrrrrrrrrrrrrrrrr)
ECG's (meh I'll just be asked to read it anyway)
Phlebotomy 3 to 4 days of week during the day (I want to tear my hair out at this been ongoing in the hospital for the past three months!!)
Bladder scans (supposedly nurses not trained or covered to use - don't remember any training I got with one apart from the instruction guide at the fron)
Portering of bloods and patients occasionally ( because I can't wait 2 hours for the porter to ferry bloods to the lab?)

And its the same excuse everytime "We are not covered to do that?"

Agree with all these gripe except the USS one. Really none of us should be doing these without training.
Unfortunately the old see one, do one, teach one mantra still exists in medicine. On an extreme measure it results in the antenatal care/ misdiagnosed miscarriage scandal. So on that level can see wht the refuse. That said we as a group should also refuse to do things we are not trained for but we don't or can't due to peer and career pressure.

Mrs Fowl is a nurse and they tend to do thins better than us in some ways in that they are protocol driven and have to be signed off on competence on a procedure before being allowed do it on their own.

I certainly had minimal USS training before being expected to do foetal assessments etc.

Malmedicine

RobFowl wrote: »

Agree with all these gripe except the USS one.

Bladder Scanner
Its a scan to see residual urine volume in the bladder not an antenatal assessment tool.

Malmedicine

RobFowl wrote: »

Mrs Fowl is a nurse and they tend to do thins better than us in some ways in that they are protocol driven and have to be signed off on competence on a procedure before being allowed do it on their own.

QUOTE]

Protocol's have there place though and at times are brilliant but they can create there own problems because they replace commonsense at times.
Take the protocol for NG tubes in my hospital it says that before an ng is used any times that there must be aspirate of between ph 2-5.

Now two issues have arisen with this
(a) NG feed was refused because patient had an aspirate of ph 1.5 it appeared. I questioned this to the degree of I've seen the xray where do you think the ng might be with an aspirate of 1-1.5. Lungs was the response I got!!!!!!!!!!!!!!!!!!!!!!!

(b) NG feed again refused because even after xray reviewed (well under the diaphragm) no aspirate could be optained. Even after repeat review and pushing 5cc of air through ng to hear bubbling, hg fee was refused as I may be hearing bubbling in lungs and that it wasn't in the protocol

RobFowl

Malmedicine wrote: »

Bladder Scanner
Its a scan to see residual urine volume in the bladder not an antenatal assessment tool.

If you're not trained to do it you still shouldn't be.........

Large Ovarian cysts or even pregnancy sacs could theoretically be mistaken for a bladder ny someone with no training.
Bear in mind nurses undergrad training has no practical USS training, nor indeed did I as an undergrad med student.

Don't want to sideline the topic as Ist dose antibiotics and ECG's etc are a complete waste of resources and time to get an on call doctor to preform.

Dozen Wicked Words

Where I work:
Nurses give First Dose Antibiotics.
Nurses give IV frusemide.
Porters, if informed bloods are urgent, usually have them gone of the ward in 10mins at the latest.

No issue with taking ECGs but being 100% honest, don't feel competent to read them. So in the end I am still going to call a Dr to review it.

No nurse will do a Bladder Scan where I work, nor will a Doctor. We don't have a bladder scanner.

Although the Care of the Elderly staff you describe don't sound helpful or particularly professional, in general, An Bord Altranais say a Nurse should not to do anything they do not feel competent to do, its their registration that they are protecting. You can think others "should" be competent, unless there is paperwork ad nauseum to prove it, ABA don't care.

Just read the quoted article, not sure what to make of this part:

"He added that other inappropriate work, such as updating records, was also time-consuming and costs the health service up to e40 an hour in overtime."

What records does he mean?

opinion guy

dooferoaks wrote: »

What records does he mean?

Was wondering about that myself. If people weren't chronically overworked and run into the ground I would have thought there should be more record keeping (using the hypothetical computerised medical chart system:D)

drzhivago

dooferoaks wrote: »

What records does he mean?

Believe it might relate to rewriting prescription sheets at night because wasnt done during day and noting a blood test in chart because someone hasnt formally written in chart that blood test was high or low even if patient on correct treatment for the condition.

On call services were meant to be for emergencies but have degenerated into night skivvy for any service that wants a doctor or sometimes in my own far distant intern days for any part of hospital that needed a man ( ie fix leaky tap, change lightbulbs, find stuff in dark store-rooms)

Ah those were the days eh fowler