‘Anger as medical and nursing boundaries blur is no surprise’
Imagine that the NHS has been transformed into a garage workshop, and assume that my car thinks I lead a double life as Top Gear’s The Stig, or has filled itself with the wrong fuel, albeit free at the point of delivery. I seek help.
Like doctors, highly trained mechanics know what’s going on under more bonnets than Jane Austen could have ever dreamed of. Turning back the clock would probably reveal an obedient nurse busily tidying a set of spanners or folding tow ropes. But this scenario has changed. I now have the choice of asking that my car is jacked up and repaired by the NHS garage nurse, who actually may not be the best person to deal with my car. If the task at hand is too difficult, further advice needs to be sought. And if all else fails, at least I would probably be supported in making healthy lifestyle choices such as “mobilising” to the bus stop.
The workings of the human body are far more intricate than those of the internal combustion engine. Many doctors, having undergone years of rigorous study followed by further professional development understandably feel threatened and angry that the line between medicine and nursing has blurred. How dare nurses encroach on their territory?
Yet despite this, the NHS Careers website describes medicine (and not nursing) as being about “helping people – treating illness, providing advice and reassurance, and seeing the effects of both ill health and good health from the patient’s point of view.”
In the cost-effectiveness versus quality debate, it is little wonder that some doctors may feel upset and fear for their patients’ wellbeing - just consider all the shroud-waving which accompanied the introduction of non-medical prescribing.
But then I wonder how I would feel if GP consortia were to decide on the basis of competitive commissioning that HCAs could emulate nurses? Throw in a couple of study days, and expect unregulated Band 3 HCAs to undertake travel consultations or diabetes reviews? I think I’d be shroud-waving, too.
Both nurses and doctors can have academic backgrounds. Post-qualifying, nurses often undertake further studies in their spare time, and these tend to be partly or wholly self-funded. Yet if asked, not one of these nurses would say that they are doing this because they want the kudos of becoming mini-doctors and looking cool in stethoscopes and scrubs. Instead, they talk in terms of patient outcomes and service improvement. In other words, they are nurses who are proud to continue being nurses.
Nurses and doctors hold the same core values, and there is more that unites us than divides us. Of course, there will always be gaps in knowledge and experience for all clinicians, as the preparation needed for our respective roles differs.
But if we are truly complementary, it seems puzzling that it is easier to have asked whether nurses should ever emulate doctors than whether doctors should ever emulate nurses.
I’ll have to think long and hard about it – my bus isn’t due for a while…
Jane Warner is locum practice nurse in Somerset; and associate lecturer, General Practice Nursing Foundation Programme, University of Plymouth
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