Kind of on the back of the GP receptionists thread but not really a TAAT?

[yolofish]

DH is having a lot of hospital appts at the mo (rectal cancer with possible spread). Every time we have been in, there is what I assume is a nurse, whose role is to weigh him and then sit in on the consultation.

Could this person be an actual nurse, or is s/he more likely to be an HCP? Because I cannot see why an actual nurse is reqd in clinic appts - understand the need for a chaperone etc, but surely not an actual trained nurse?

I am really not trying to diss these people, who are lovely, but I dont understand - if highly, expensively trained nurses (and dont start me on the lack of funding for student nurses) why are they not actually doing nursing? If less qualified HCP then fine, and those are totally valid, under-valued roles too, but then they are called nurses?

Maybe they're training and learning from the consultations. Also my ds often has the gastro nurse sit in on his appointments so she is up to speed on his case. I have her direct phone line if I have any worries and she knows me and him and can advise on our case straight away. I don't contact the consultant.

Whenever I went for my cancer follow ups, a qualified nurse was always there. This was so a qualified nurse was on hand to support me and to make sure I understood what was going on. I think when you have cancer it's extremely difficult to make sense of anything that's said to you. After the consultant had left the room the nurse would check I was ok. The nurse was also available to telephone or email.

We haven't got to any of that yet... nearly 8 weeks post diagnosis and no treatment plan as more and more tests reqd.

Consultant is amazing, really follows through (eg phoned DH 20 mins ago, is going to operate on him on Sunday).

I totally understand the need for training etc but none of the people involved so far, apart from the consultant, appear to need to be qualified nurses? EG I dont think you need to be a qualified nurse to weigh someone and then sit in on their appt, this could be an HCP?

Again, I am not trying to diss anyone, the people we have met have all been nice, and kind. It just seems to me to be a potential waste of resources if a qualified nurse is sitting in on an appt and doing nothing when someone with fewer quals could do the same job? And that same qual nurse could be on a ward?

If they are only weighing and sitting in, I would guess they are a HCA.

I'm under a regular clinic, not cancer, and there's always a qualified nurse in the specialty doing the weighing and sitting in if needed

For your DH they just do the weighing, but for others, it might be different. Behind the scenes there will be other duties.

Specialist Nurses are becoming the Norm. They are, as well as part of a specialist service, the go between, between the Consultant and Clinic/Patient.

Using Nurses in this way frees up Consultant time and makes Patients feel reassured.

Also Consultants don't always know the best pla es to signpost Patients to etc, a specialist Nurse has a good range of knowledge.

That would drive me round the twist, someone being sat there like a babysitter.

It will be a HCA who has had some training.

Maybe they are there for you to recall the consultation so you could ask questions? I know that sometimes I forget what the consultant said when I've taken my mum, I now take a dictaphone and record the meeting.

Using Nurses in this way frees up Consultant time and makes Patients feel reassured.

That wouldn't make me feel reassured at all, but chaperoned and like I couldn't be trusted to process news on my own body myself . That would really put me off. I mean, you see a GP with no one else there unless you're having an intimate examination.

Macmillan nurses often do that. They are also available for emotional and practical/medical support outside of the treatment/consultations. So I believe. They are there for support for the patient and also do they know what is going on medically so their medical and emotional support is more useful and appropriate.

I found Macmillan nurses nigh on useless. Would hate to have them sat there like a shadow during an appointment discussing my imperiled health. What if you don't want them in there? Can you refuse?

I'm sorry about your DH's diagnosis. Why don't you ask why this person is sitting in on your appointments? Ask the consultant. They should have explained it to you at the start but if you were reeling from the shock of the diagnosis not taking in the details of who is in the room with your for your appointments would be par for the course. I wonder if the person is a Macmillan nurse perhaps?

Registered nurses often sit in with doctors consultations, a lot of patients and relatives have a lot of information given to them and the nurse will always stay and answer any questions and explain what happens next. If you feel uncomfortable with this just speak to the doctor or his secretary in advance and say you don't need a nurse with you. Staff wear nametag or lanyards, their job title will be on that or you could make conversation and ask them what their role is.

Ask next time op, they really should introduce themselves, I'm a nurse and always introduce myself and my role, its good practice and just good manners really, it could be a HCA, taking the measurements down, it's pretty normal for them to be in clinic, it's usually the consultant's decision for them to stay in during the consultation (unless examination is required) could also be a specialist nurse however you would probably have been introduced already if it were. When I was having cancer treatment my specialist nurse was in the room at diagnosis, at subsequent appointments it was just consultant and HCA, i wish you and your DH well with his diagnosis and treatment x

@dontalltalkatonce

and like I couldn't be trusted to process news on my own body myself

I'm a qualified nurse. When I had cancer I couldn't trust myself to process information given to me. My brain was mush, quite honestly and having a nurse there to support me was a god send.

"I'm a qualified nurse. When I had cancer I couldn't trust myself to process information given to me. My brain was mush, quite honestly and having a nurse there to support me was a god send."

A lot of people with cancer experience the above. It is scary and overwhelming. They often have medical appointments coming out of their ears and have to contend with often difficult and lengthy treatment. It affects every area of their life. And if having chemo people often experience "chemo brain" so it can be helpful to have someone there with you and supporting you.

As you say they may just weight your husband but maybe carrying out complex post surgical dressings, suture removal, line removal etc for other patients.

Just ask next time?

I have a heart condition and as such I have a specific heart failure nurse. She's my port of call and will deal with any medication changes, liaise with my consultant for me etc. She also sits in on my appointments.

I'm also pregnant and have a hospital midwife who sits in on my obstetrician appointments. She does what crops up with the obstetrician (will arrange the next scan/appointment etc) and also again is my contact should I need anything sorting, questions answered etc.

This person may well be your husband's specialist nurse or similar and end up being quite involved in his and your care in the future

I’m more concerned about why you don’t know who they are. The “hello, my name is” was a big campaign in the NHS. They should be introducing themselves or the dr should be saying “x is here to x y z”

Next time you go in, say can I just ask what your role and find out who they are and what they do. 😊

nope, none of that information been given at any stage. Consultant is great and really kicking ass, given us phone nos for eg specific cancer nurse, pushing very hard for all the extra info he wants (basically more tests). Nurse person in the room during appts? nothing. I really dont want to disparage her role, but what is she doing??

When we go in to see the consultant, and nurse Irene is sitting in the room having done the weight check, I really dont feel comfortable saying 'hello nurse Irene what is your role?' because basically we are there for the results, to see the consultant blah blah.

And I just wonder about use of resources - if nurse is going to do dressings, or sort stitches etc then clearly they need to be a trained nurse. If, oth, they are just going to sit there and smile, well pretty much anyone could do that?

Maybe they are just sitting there and smiling because that is all you need, if you were to become confused or emotional or give any other signals that you were feeling lost or overwhelmed (all of which can be quite common) she might be getting more involved. She's there if you need her, if you don't she will try to keep quiet and give you space.

You should know what her role is, she’s part of your husband’s care. It might highlight that actually she needs to be introducing herself! It doesn’t need to be a big thing. You could phrase it as “I’ve jsut realised we’ve seen you a few times and we haven’t been properly introduced, what’s your role here?”
Or can you ask the consultant before or after the appt? The receptionist?

It’s very very odd to have clinicians present in an appointment that don’t introduce themselves. I would definitely want to know who they are.