Sunday, 26 October 2008

Consultant Nurses

Nurse consultants. What a great idea give a nurse a degree in 3 years that used to be a RGN qualification and then call them a consultant because you can use them to follow up patients cheaper than a real medical consultant can.

ND’s most recent encounter with an alleged (nurse) consultant came after reading the idiot consultant commissar’s letter advising us what to do and a subsequent visit request by the patient as the nurse consultant said this should happen as she was a consultant. This resulted in a phone call to the comrade nurse consultant which went something like this:

Consultant nurse commissar: I think this patient needs to be on digoxin for their heart failure.

ND: Why?

CNC: They have an irregular pulse

ND: Which they have had for years and seen several consultant cardiologists who have been happy with the patient’s treatment so why do they need this drug?

CNC: It is in the protocol

ND: Is that the same protocol that all the consultants have used but based on their experience have decided not to use this drug? Any reason why we should start it now? Has the patient changed?

CNC: It is in the protocol

ND: Has the patients conditioned worsened (no it is the same)? Have you done a recent ECG (no it was 2 years ago) a recent echocardiogram (no it was 2 years ago) have you checked their kidney function and potassium (no it was 2 years) and you want to start Digoxin without any of these tests? So why does the patient need Digoxin?

CNC: It is in the protocol

You can see where that conversation went = nowhere. Even our unqualified medical students could have done better.

If Northern Doc had done what this alleged (nurse) consultant had done and not done the basic tests above as a junior Dr in the UK ND would have been killed. Done that in the USA ND would be an invisible corpse in a swamp.

Outcome? No change in the patient’s treatment but loads and loads and loads of unnecessary work for already over stretched (doctor) consultants and GPs. But not nurse consultants who can probably count their patients on a three fingered hand and those they make a difference to on a digit less hand.

Praise be to the Party and the new dumbed down “consultants” who make sod all difference to patients but generate lots of unnecessary work for other professionals.

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