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Original poster

Out of hours care provided by nurses rather than doctors... good idea?

52 replies

Eleusis · 12/04/2007 08:56

I think this is a reduction in the quality of care. And, I wonder if the the hole left here is big enough to open up the private market. Do you think we'll start seeing private GPs offering out of hours care by doctors rather than nurses? Hence widening the gap of haves and have nots.

BBC article

OP posts:
SueW · 12/04/2007 09:16

The GPs wanted out didn't they - they voluntarily turned down an additional 6k a year they were offered to provide out of hours care - so what choice does the NHS have but to put nurses in?

I'm sure GPs will now jump at the chance to charge £120 for a 15 minute consultation to recommend two paracetamol and plenty of rest!!

Original poster
Eleusis · 12/04/2007 09:39

I also think that A and E will start seeing people who aren't actually emergencies but want to see a real doctor.

OP posts:
pansypants · 12/04/2007 09:42

no nurse led care is protocol led and imo care in a/e is best served by good medical staff and experienced anciliary staff , and i dont mean just nurses.(not just nurses in dismissive way by the way)
There is a whole plethora of staff that are required to work in hospitals and support a/e not just drs and nurses.

nailpolish · 12/04/2007 09:46

experienced nurses can be as good as/better than a doctor

pansypants · 12/04/2007 09:48

sorry final pennorth worth, if people didnt abuse the a/e service and quite frankly turn up with bot all wrong with them a/e would be left to the people who really required its service.
i know people will say that the gp service is poor and that why they go to a/e, but as patients we need to be applying pressure in the appropriate way, even if it means sitting in the gps surgery and insisting that we are seen, and complaining thru the apprpropriate channels if we feel that the service is inadeqate. We also have a responsibility not to go to our gp when there is pap all wrong with us!As someone said a couple of paracetamol and plenty of fluids -- its just commonsense to me

pansypants · 12/04/2007 09:49

npolish honestly no disrespect, but not in a/e, where you can get a vareity of pateints with a lot wrong with them. It need to be a collaborative service. We need both

Original poster
Eleusis · 12/04/2007 10:08

Personally, if I'm sick enough to go to the doctor, then I want to see a doctor. I'm quite happy for a nurse to take my blood and assist my care under the direction of the doctor. But, for what I pay in NI, I expect to see a doctor.

Perhaps they should have docked a bit more than £6000 for the priviledge of not working out-of-hours?

OP posts:
Tigana · 12/04/2007 10:13

hmmmm
round here it is often the nurses who are spotting and acting upon the very ill patients waiting to see an out of hours dr anyway tbh.
Seeing a nurse is FINE as long as there is also a Dr around if needed, and they turn up quickly and are competent.
I don't feel I have to see a dr, I just want to see whoever is capable of diagnosing and treating the problem.

FlossALump · 12/04/2007 10:13

Some specialist nurses are fabulous. One I work with knows more about the whole experience the patient and their family goes through with the diagnoses' they are given than any consultant. Yet she encountours a lot of snobbery that she is 'just a nurse'. Some of these nurses have spent as long studying at university as any doctor, and have much more day to day experience with patients. However, I do think it is probably a cost saving excercise on the governments part.

Surfermum · 12/04/2007 10:19

On the unit I work on, which is stand alone and not based within a hospital, if a patient requires some medication out of hours the nurses have to contact the on-call medic to get a prescription approved. The nurses are far more experienced and knowledgeable about our area of expertise than any of the on-call doctors, they end up just telling them what it is they need and the doctor just rubber stamps it.

nailpolish · 12/04/2007 10:21

ok, im just talking from working in a&e, personally, where the drs will ask the nurses for advice, thats all

FlossALump · 12/04/2007 10:21

Does happen a lot. You end up telling the drs what is needed, and the dose and they sign for it. Not supposed to be the case mind. Cerain things you frequently do though, you just know.

nailpolish · 12/04/2007 10:22

yes thats right floss

specialist nurses are ace. i dont know why people make a big deal of nurse prescribing

FlossALump · 12/04/2007 10:23

A recent personal experience - I saw a consultant - my hand was just badly bruised.

Few days later, I could feel it wasn't right. Went back, saw a specialist nurse, got the xray I should have had in the first place and I had a nasty fracture of my hand.

FlossALump · 12/04/2007 10:23

How are you btw NP?

nailpolish · 12/04/2007 10:25

im great floss, jsut sold the house. moving back to Edinburgh, looking for a new job back in nursing (scared! havent picked up a tpr chart for 2 years!)

how are you? how many babies do you ahve now? im pants at keeping up...

are you back in Bristol?

glitterfairy · 12/04/2007 10:30

I am a nurse so am biased but would rather be cared for by an experienced nurse than a recently qualified doctor.

I am totally in favour of more nurse led services and nurse prescribing and think it is both safer and should, in theory at least be more patient focussed.

Original poster
Eleusis · 12/04/2007 10:44

But, if doctors were out there doing the work then they would have the practical experience that nurses have. I think some of the posts here have cause and effect mixed up.

OP posts:
pansypants · 12/04/2007 10:45

gf you are most correct.... nre drs know v. little and are lucky to have the back up of experience. To the earlier poster, nurses do not have do the same training as drs , as uni,,, it is compltely different, hence the nurses and drs need to work together.
nailpolish,,,i dont know you but have seen lots of posts,,any place will you lucky to have you your posts are always v caring and educational- and its good to do something scary once in a while < backs out of the door in case nose is pushes in where it isnt wanted>

nailpolish · 12/04/2007 10:47

oh thank you pansy

i agree doctors and nurses need to work more together. i think htat is happending already, to be optimistic

bundle · 12/04/2007 10:49

Our family has had v good care both from out of hours doctors and eg triage nurses in A&E depts. I've also seen some of the work of senior nurse practitioners in NHS drop-in centres and they are v good at spotting what is/isn't within their skill range and referring on when necessary.

Surfermum · 12/04/2007 10:55

Where I am the on-call doctors won't ever get to the same level of expertise in our field because they are only around for 6-12 months. It's not that they aren't working, it's that the patients they see on a daily basis have completely different diagnoses. Our own doctors who have the experience in our field don't do the on-call.

FlossALump · 13/04/2007 08:42

NP - yes we are back in Bristol and no 2 is due in sept.

Brilliant for you to go back to nursing - I really hope you enjoy it, what sort of area? Congratulations on the move - I hope you are happy there.

Pansy, no not the same training as doctors, but several years spent post registration at university making them experts in their fields.

nailpolish · 13/04/2007 14:58

ooh floss good luck with the new baby

expatinscotland · 13/04/2007 15:13

I don't mind.

In the US, most of the time I saw a nurse practitioner or physician's assistant because otherwise you'd wait ages for an appointment.

And this was when I had really good insurance.

Then, if you needed the doc, the NP or PA would get them and they'd be on straightaway.

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