Can anyone tell me why this is so?

Every smeartaker should be able to complete the second phase of a smear- the bi-manual exam. It is not rocket science. It is a technique like many others nurses do- invasive- yes but you are already down there anyway! But not dangerous.

Makes me wonder who designed the original smeartakers courses in the first place?

Is it because we need to justify and prove the value of nursing because the financial benefits to an organisation from nursing are so difficult to prove?

Is it because we, as women, need to describe what we do as nurses, to describe the complexities of nursing and how it relates to the patient/human experience of health and illness?

According to this article, the patient experience is so intrinsically involved in the quality of a service, that the nursing gets dissected within the evaluation of that service. So what happens when the evaluation doesn’t show a great outcome for the service? Where does that leave the nurses? Is it so intrinsically incorporated with the service outcomes that the nursing role gets thrown out with the bathwater?

Is this one reason why nursing is struggling for financial and professional respect/recognition in specialist roles, or why it is often the first service to face budget cuts? With all the research on the value of effective nursing and the positive effect it has on overall quality in an organisation (see Magnet hospital research for example), what other conclusion can we come to about poor funding decisions made for, and on behalf of, nursing?

And yes, once again, this article’s summary states that the study described “clearly demonstrated the complexity and multiplicity of components of the CNS role and its impact on patients”.

Humpph -dont see “health” anywhere in that statement!

Apparently they want a model that estimates the financial impact of task substitution between nurses and GPs. Now there is the first problem I have. This is suggesting that nursing and medicine is able to be “measured” by “tasks”. Have they not learnt anything from the massive amount of research done in the States around quality of health care services, health outcomes  and magnet hospitals. Every time a bean counter tries to measure health we end up in a morass of money saving cuts,and no proven benefits to patients or services.

Then if you read the limitations of the study it essentially makes the study rather pointless to my mind. Because it hasn’t been able to capture the complexity of the practice nurse and the team role in general practice. It doesn’t take into consideration the patient at all- older and high needs populations will change the picture markedly in terms of consultation times and team involvement costs etc. A scary implication is that if you make nurses more expensive and shorten their consultation times (see 6.5) they will make you more money- boom,there goes accessibility and quality out the door, right there!

What it does do is provide a good overview of literature around nursing-PN’ s and NPs in general practice and the issues therein. So I guess it is watch and wait time to see what sort of model gets spewed out. As we all should know- cheap does not necessarily= better! Penny wise, pound foolish….

“The published literature also shows that collaborative, team-based approaches to care—including teams led by nurse practitioners—should be actively promoted to reduce overall spending on health care.”

Because at the end of the day that is a big part of my role,and one that can make the most difference. I just fill the gaps where GPs can’t,not interested, dont have time to, reach. And there are plenty of gaps if you look differently at the wider picture, and at a different angle. It’s  more often that the funding that should follow the need isn’t there at the same gap at the right time, so that’s where innovation and funding flexibilty must happen.

At the end of the day, there is plenty of work to go around, so why can’t we all just pack away our prejudices and patch protection blinkers and just get along.

“We’re not just warm and fuzzy: we’re scientists, we’re social workers, we’re personal counsellors  If we can give the people we talk to about nursing a complete picture of what it is we do–rather than focusing on things like nurses eating their young, or crappy doctors, or how fulfilling it is to wash a back at three a.m.–we’re likely to find many more smart, motivated people who are suddenly interested in becoming nurses..”

Health Leaders Media journalist Rebecca Hendren asks why nurses should get a day when so few others, including doctors, get the same special recognition. One of the doctors I know suggested facetiously that docs get the other 364 days to be special!  Wouldn’t it be nice, they say, if we didnt need nurses week to celebrate how nurses actually contribute to the health of nations.

The nursing advocacy website suggets a T-shirt slogan : “My physician colleagues got 99% of the funding for research and residencies, and all I got was this Nurses Week T-shirt!”

But seeing as how we still have it for now- lets use it for the greater good and blow our own trumpet positively, respectfully and intelligently!

3.3.1 DEMONSTRATION SITES ESTABLISHED AND EVALUATED ACTIVITY
Demonstration sites established for:
• physician assistant
• nurse endoscopy
• surgical assistant (RN).
Public/private partnership demonstration site(s) agreed.
Demonstration site proposals approved for:
• Diabetes nurse specialist prescribing extended practice
• Extended pharmacist practice.

So does this mean NPs are so accepted and entrenched by the health sector that they do not rate a mention?(Make a good Tui ad, that one!) . The report seems a bit doc heavy in terms of focus. Having a look at the Board members I see 5 docs and 2 nurses, so maybe the nursing voice was just not loud enough (again). Wonder what national response from nursing we will see?

Not sure I like the quote that NP’s are “just like doctors without the pay”. I kinda like the idea that I work differently and add value rather than the competitive model that this quote represents…..but it would be great to reduce what Peter Pronovost calls the toxic heirachy. Suzanne Gordon, on her blog, has a great expose on this concept

Still on the PHC subject- practice nurses overthere have got the marketingthing going on..check out this website for information on Practice Nursing

P.S….Note to self- don’t leave it so long between blogs- you will get out of practice and lose what edge you have….

a sqatting scavenger

I have found a new name for those nurses who have decided they will go no further in their chosen profession than where they have been for the past 10(15)(20) years…they are squatters of the worst kind. According to The Muse, they clog up the system, do not let other nurses on their way up the ladder past and generally create a nuisance of inertia.

“Nurses with a passion to be more and do more deserve to run into open arms, not walls.  They deserve a boost, not a glare.  Only when we have relieved the ranks of Squatters, will the profession of Nursing rebound… with loyalty, retention, energy and pride.”

Hear, Hear!