Practice team blog
All posts from: February 2012
Our Practice section contains two articles about the use of illegal drugs – one about the legal and ethical issues nurses face when their patients use cannabis for therapeutic reasons, and one discussing nurses’ attitudes to substance users, and whether drugs should be decriminalised.
Unsurprisingly, opinions on the general issue of drugs varied, but that didn’t really matter – our opinions aren’t going to affect anyone’s health and safety. Nurses’ opinions, on the other hand, do affect others. Whether you’ve been aware of it or not, it’s almost certain that some of your patients have used illegal drugs. And in some cases that fact may have been relevant to their presenting condition.
If you haven’t been aware of their drug use it may be because those patients have not disclosed the fact because they feared your disapproval. They may even have worried that you would refuse to treat them or might alert the authorities. And you might even be surprised at which patients they were; drug use isn’t the exclusive preserve of the young – 69-year-old Sir Paul McCartney may have decided to give up cannabis but some of his contemporaries are doubtless still indulging in that and other substances.
The impact of UK drug laws on healthcare and health professionals is rarely discussed and difficult to quantify, but they certainly present health professionals with dilemmas and difficulties. They may also cost the NHS far more than we realise. While some patients’ treatment is directly related to their drug use, how many others with unrelated problems suffer complications because the professionals caring for them did not have important information that would affect treatment decisions? And how many harm themselves because they find it difficult to access information that might make their drug-taking less dangerous?
Political debates about whether drug laws should be abolished, relaxed or tightened up tend to look at issues around criminality. Perhaps next time politicians take a leaf out of the nursing book, and look at the issue holistically. Tackling drug use costs the UK eye-watering sums – perhaps we need to find better ways of spending that money.
News that a training course for practice nurse training is to be accredited by the Royal College of General Practitioners (RCGP) is significant.
Practice nurse training across the country is patchy, poorly provided and follows no set standards.
As practice nurses are employed by general practice, GPs need to be involved and taking responsibility for their training. This step to accredit the Foundations of General Practice Nursing course at Plymouth University is a sign that GPs are finally recognising the deficit in practice nurse training.
GPs are more likely to pay to send their staff on courses accredited by the RCGP so hopefully this will help improve access to training for practice nurses. The coming Care Quality Commission standards will also help.
By April next year under CQC standards, GP practices must prove they employ “sufficient numbers of suitably qualified, skilled and experienced persons” who receive “appropriate training [and] professional development” and are “enabled…to obtain further qualifications”.
Some GP practices will find it difficult to adhere to this standard and it will push them to look more closely at their staff training needs.
The lack of access and availability of practice nurse training has been accepted for so long but it is of course unacceptable – let’s hope this is a move forward.
I was watching some student nurses deliver some sensitive and effective care on a ward last week.
Their attitude to the patients was both respectful and compassionate. It made me think about this group and wonder how they must be experiencing the current media onslaught on nursing.
And the negative stories about nursing students which have been out in the last year or so – reporting a lack of compassion and a lack of numeracy skills. It’s hard work training to be a nurse – combining the dual demands of studying and practical placements.
It requires dedication and energy. And it is a challenge to be on the wards dealing with very sick patients, seeing things that your friends who are studying other subjects will very likely never see.
The majority of student nurses take on this challenge as young adults and as we know training as a nurse makes you grow up fast. At least when you get to your third year you begin to feel as if you know what you doing and you can take the variety of challenges in your stride more easily.
I am hoping the Student Nursing Times Awards which we have launched this year will go some way to supporting and celebrating the efforts of student nurses and all those involved in training the nurses of the future.
If you are a student nurse in your third year, a mentor, lecturer or run the best nursing course then please take this opportunity to enter online by March 2nd.
“It’s so bizarre how differently one is treated in a Sisters uniform…” @lopo485
Our news editor Steve Ford sent me this lovely tweet last week.
The comment from @lopo485 got me thinking about the value we place on uniform and how important it is to patients and other staff.
Many years ago, when I was a ward sister, I decided to stop wearing my sister’s uniform and dress in white like the other registered nurses.
During this time I gained a real insight into the power of uniform - and particularly that of the sister. I suddenly had to spend more time explaining who I was. I realised how much harder it was for my team to get things done. Staff, ranging from porters to consultants, frequently apologised - “sorry I didn’t realise you were the sister”.
But my experiment stopped late one Friday afternoon. I was sitting with an elderly patient who used to be a nurse and she asked me why I didn’t wear my sister’s cape. I explained that I felt uniform created artificial barriers and hierarchy between the team and described my experiences.
She sat there for a while and said: “But isn’t that the point? People look for you - and up to you, and your uniform is something to be proud of. You’ve earned it and the respect that goes with it. It gives you the authority to get things done and people need to know who you are.”
She was of course right. Ward sisters are the lynchpins who hold their wards together, and they need to be visible and accessible. Last week Sir John Tooke, head of University College London’s medical school, suggested nurses lack adequate role models, and championed the ward sister “as a very strong representative of the caring profession”.
My experiment taught me that all staff should be respected and their views listened to regardless of the colour of their uniform. However, health professionals have to work as a team - and all teams need a leader. On busy wards, a distinctive uniform enables patients, visitors and staff alike to recognise that leader immediately.
As lopo485 says: “people seem to notice me more, everyone wants to speak to me! Random [people] shout good morning sister! It’s lovely really!”
I couldn’t agree more - it is lovely, but it’s also an important statement: “I’m leading this team and you can come to me for support.”