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I have been thinking about scope creep and how NPs seem to be encroaching on registrar duties
In the vein of looking for a positive are there any "doctor" jobs that would actually more appropriately be given to other staff members.
I would suggest discharge planning could be a main one - when a patient is medically clear nurses could determine if patient best for rehab/home/respite, get family/patient views and present solution to medical team for approval.
Routine family updates as well. If there is a change in condition appropriate for senior team member but if its just a "mum is going well home in a few days" that doesn't need to be escalated I would think
your thoughts?
- Venepuncture.
- Peripheral IV cannulation (including US guided)
- Urinary catheterisation (both male and female)
- Protocolised initiation of pain relief
- Protocolised initiation of XRs
- ABGs and Arterial Line Insertion
- Simple wound closure
- Joint aspiration
- POP application
- Tertiary surveys
There's more but that's the first of the list to come to mind. It does require an engaged consultant supervising team who will give first right of refusal to junior staff who want to learn or practice a technique.
I don't believe discharge summaries should be allocated to nursing staff or junior medical staff but should be the responsibility of the senior doc in charge of the patients care.
Oh these are all things already in existence where I work. Effectively I'm quite happy with the system as it stands although I'd be willing to give over more procedural skills to nurse practitioners, etc, beyond just that list. Those are just the main things that pop into my mind
It's already in place in my department 😀
I'm a Consultant working between Trauma Service and EM. I'm very much not under the impression that consultants do nothing
Extremely busy 😀
That's why I want it
When things are busy I look for ways to make things more efficient and safe. Delegation may form part of that but not always.
I'm looking for ways to make things more efficient and safer for patients on a system wide level. Transfer of care (in hospital or on discharge to a GP) is a major risk point in a patients care and deserves consultant level transition. It's also more efficient to have an appropriately concise and targeted handover from a consultant than a screed of randomly collated facts by the intern or nurse.
A scribe can of course form part of that consultant level discharge completion
No not Senior Registrars. Consultants 😀
Equally any transfer of care within the hospital should require a consultant to consultant discussion.
I think the Consultant should do the discharge as the most senior and experienced member of the treating team. It's not a sleight on you
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Yeah stat decs should be the absolute norm