"Am on call this weekend as a ENT reg and received a call from a "Senior Nurse Practitioner"(her words) in a local walk in centre. She had seen a chap in his seventies with hearing loss for the last week.She had examined both his ears and had found nothing abnormal.
Upto this point, no problems with the conversation. She then proceeded to tell me that she wanted me to admit him and arrange an urgent scan.
She did not have any idea of what type of hearing loss he had. She had never heard of Rinne's or Weber's and got very annoyed when I proceeded to question her further. According to her, she had been taught that sudden hearing loss required a scan as this could be an acoustic neuroma.
Before the usual Noctor supporters on DNUK jump up and say that I should have just accepted to see the patient, I did tell her that she could send the chap to the hospital and he would be assessed by my SHO and me.
But she insisted that he needed to be admitted and scanned. Oh and proceeded to ask for my GMC number.
I am normally a patient person when it comes to dealing with stupid fools but this really annoyed me. However I managed to stop myself from swearing at her down the phone and spoke to one of the doctors in the same centre. He was a locum chap who saw the patient and examined him properly and called me back.
The patient had actually had a cold and developed a conductive hearing loss over the last week.And he is going to come to the ENT clinic next week for an audio and review.What I can't understand is how these poorly trained idiots are allowed to work without supervision? What are the assessment criteria for them to be certified to work in a independent/semi-independent environment?And if they cause such trouble for small specialities like ENT, how much of a hassle do they cause other, busier specialities. "
The above tale is one of many that happen on a regular basis in the NHS. Before the same old trot is rambled out in defence of empowering the ignorant, I am not insulting anyone without a medical degree. I am talking of any worker who is empowered way beyond their means. This includes GPs who try to do the job of consultants after hardly any extra training, they then call themselves GPSIs and try to work as specialists. This includes several varieties of nurse specialist who are employed in roles in which they have to work as general physicians, they simply do not have the knowledge or training for these roles. Walk in Centres sum up the inefficiency of the new privatised NHS, there is no continuity for patients, there is precious little training for staff and these centres cost a hell of a lot of money for the appalling quality work they do.
At the same time as the ignorant are empowered and overpaid, we have people with a lot of training who are wasting their time carrying out menial tasks when they could be doing other more productive things. It certainly appears that a lot of proper nurses are rather appalled by what is going on, it seems that these days proper nursing is being completely neglected and basic standards are not being maintained on the wards:
"All of the above may be true for a minority of senior nurses but unfortunately the vast majority of band 5/6 nurses seem to have lost the plot. They can no longer prioritise work effectively, they cannot safely administer medications, they cannot measure and record patient observations correctly or add up simple MEWS scores correctly and they cannot recognise the signs of a deteriorating patient. Lets get the basics right before we disappear up our own backsides."
Quite right.
