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….

“In fact, I’d have to say that the available supply of up and coming GPs seems to this  wry  observer to be improving. Friendly, not up themselves, thorough, competent, they could almost be nurses.” Bristol Michael