This article - "Physician, heel thyself" - was published in the New York Times on polling day. Written by an oncology nurse, it decried the fact that even today, a significant number of doctors do not respect nurses and the work they perform, dressing them down or treating them with condescension.
Such things also happen in Singapore. During my service in public hospitals, I have seen doctors yell at nurses, jeer at them with sarcastic remarks, and make fun of them behind their backs. Thankfully, only a minority of doctors do this, although more may feel that they are at the top of the pecking order in clinical care. The situation is not helped by the fact that more and more nurses (and doctors) are foreign-born, and adjustment to work in Singaporean hospitals is not the easiest thing in the world.
Nonetheless, good teamwork makes for more effective clinical care. Currently, nurses are doing more and more of the jobs previously performed by physicians - an advanced practice nurse is the virtual equivalent of a medical officer (except for prescribing rights), and may have more knowledge in their area of specialty. Conversely, this frees up more time for doctors to further their skills and knowledge.
14 comments:
My own experience at SGH Ward 44 and CCU some months ago was an eye opener. The nursing staff were exemplary in their standard of knowledge, experience and care. I salute them!
Only if the system trusts and allows these APN nurses to deliver more specialised care. The APN was introduced to the system only these recents years and not many of them are supported in terms of exact role definition. Not many drs want to "let go" seeing some of their patients. End result? APN not knowing how they can help and drs still continuing with their high workload.
APNs are a good idea for easier access and affordabilty issues.....this will probably help alleviate the healthcare costs issue somewhat in the mid/long term.
But if their numbers increase, then some thoughts around malpractice coverage/indemnity and even ethical/professional guidelines will be necessary.
If they are going to start diagnosing patients then there's no running away from all these issues around standards of care and patient safety.
It'll certainly be better to tackle all these issues head on before the first few complaints come in.......
APNs will help to disrupt primary care, forcing Gps to return to hospitals to solve the medical shortage in public healthcare.
For the good of the nation, GPs must return to public hospitals.
"APNs will help to disrupt primary care, forcing Gps to return to hospitals to solve the medical shortage in public healthcare."
Not unless APNs can give botox...
cynic
"APNs are a good idea for easier access and affordabilty issues"
not true. an APN cost way more than a medical officer.
moreover, APNs in a particular hospital's NES where i used to work act as if they were above registrars, bossing them around like they were the senior consultant's f-buddies.
not cool.
"cynic"
And you are refusing to face facts.
When GPs faced a falling income with competition from polyclinics each other, and rising rental, did they slink back to the public sector as you predict they would? No. They found other ways of making themselves marketable.
Why should APNs have a different effect on them?
"an APN cost way more than a medical officer"
Yes. But a medical officer grows more expensive when he grows in experience...
Let me guess - these doctors who treat nurses like dirt, are they the junior HOs and MOs? Senior people usually know better.
Still, nurses themselves aren't entirely blameless. Ever have trouble getting assistance when they're "passing report"? Or transferring patients to the wards because the nurses refuse to update the computer system so the wards look completely full-house? Or having them ask endless, irrelevant questions when the senior specialist has already approved the admission and we're ready to push the patient to ICU / HD / ICA, etc?
While I agree there're many great nurses to be thankful for, something should be done about those who promote self-interest above patient care.
cynic - it was a compliment.
:)
No one is a cynic or idealist, anon - everyone thinks his assessment of the world is correct.
I guess you are talking about yourself angrydoc. Not everyone is as egotistical as you are. There is something called insight.
Nonsense. Everyone thinks his assessment is correct. If someone says he is an optimist, he is not saying that he thinks his assessment is wrong - he thinks his assessment is correct, but he believes he holds an attitude that is more optimistic than his assessment implies.
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