How to become a doctor in seven days
click to enlargeAn eminent Consultant in Cambridge, who is clearly as stupid as Dr Crippen, writes in to advise me that two Universities of Formerpoly (Oxford and Bournemouth) are running courses (paraphrasing the appalling grammar) to train our dear friends the "health care professionals" to develop their skills in:
- Patient history taking
- Assessment
- Medicine management*
It can now be done in seven days. I must be very stupid. Mind you, we did not have "upskilling" when I was at University.
Be afraid. Be very afraid.
++++++++++
Anyone interested in learning to be a doctor in seven days should contact:
shsc_cusp@brookes.ac.uk (Berkshire, Buckinghamshire and Oxfordshire)
BEdwards@bournemouth.ac.uk (Hampshire and Isle of Wight)
*I originally wrote the third point above as medical management, rather than medicine management. I am not sure what is meant my "medicine management" - I suspect it is a typo, which would be in keeping with the poor grammar
34 Comments:
And it would be interesting to see how many complicit members of the medical profession are involved in this "up-skilling" process for their own reasons - or even no reason at all.
And it would be interesting to know how many of those being up-skilled have the remotest clue about the political agenda.
Yes. Dr Crippen it's time for you to be back!
For there is much to be said about this.
Is "medical management" what the personnel people do to get me a locum when a doctor's off?
Or is "medical management" what the managers and Directors do?
'Cause there's no way on God's green earth that it will involve patient contact in my corner!
witch doctor - any medical complicity extends way beyond even NuLabs malign influence.
The quacks have been around since the early 1960s (when Tony Bliar would have still been in infant school, and Gordo just starting out at Kirkcaldy High).
www.aanpe.org/AANPEHome/tabid/448/Default.aspx
NPs have been quacking in the States, Canada, Australia, New Zealand and Holland, to name but a few countries who have all embraced the notion of getting the most out of their experienced nurses.
www.bmj.com/cgi/content/full/328/7445/927
In the UK quacks constitute a small fraction of the overall nursing workforce (3.2% in Scotland) - and a fair bit of their time is taken up with education and management, so day to day clinical stuff really does account for a very modest proportion of patient care.
www.rcn.org.uk/__data/assets/pdf_file/0008/27539/nurse_specialists_2006.pdf
The quacks are often portrayed as emblematic of all that is bad in the NHS but surely you can't blame a few ageing nurses for the EWTD or MTAS, and all of the problems that have arisen because of these two recent developments ?
In fact, nowadays, it is almost impossible to find anything positive said about those sitting on top of the greasy medical pole - I wonder why that is ?
Presumably the rabid quack-loathing exhibited by so many doctors is a form of sublimated rage at their own professional impotence when it comes to influencing the journey their (self serving)leaders have taken them on ?
Take a closer look at that flyer: it's not "medical management", it's "medicine management". OK, I don't know what they mean by that, but I read that as "management of medicines" - filling prescriptions, inventory, etc.
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I suspect that they don't know what a "cusp" is.
I have corrected "medical" to "medicine".
I don't really know what "medicine management" means. I suspect it is a typo
John
Dr Crippen,
At college in nursing skills sessions we learn "Medicine Administration" which could be the same thing, which is the first year involves not a lot-- learning to read the drug chart, trying to make sense of the doctors handwriting and checking, double checking and triple checking the dosages. Then how to mix the medications and administer them safely. You may chuckle, but if a doctor has written the wrong dosage down and we give it and the patient dies its the nurses that get the flack. So then we are taught to use the BNF properly for checking dosages if we need to-- it you have never used it before it can be a bit confusing. We also do pharmacology, bit almost certianly not to the same standard at the medics!
Queue pisstaking?
Anyway, we are also taught how to take a history. Sort of. We get one session on it. Assessment is a part part of what we do every day. Skin assessment, oral assessment- we have to be skilled in this.
So presumably, it is a more advanced course in these type of skills for registered nurses who wish to progress to become more senior.
In no way did i interpret that to be "become a doctor in 7 days".
I've searchd high and low through that article and can find no reference to 'becoming a doctor in 7 days' ergo, it doesn't exist and is just Crippen stirring up his anti-nurse buddies again.
The course appears to offer the first stages toward developing skills in history taking,assessment, medicines management (which is easy to understand really) MEDICINES = drugs, or preparations taken for the treatment of disease, MANAGEMENT = the process of managing. If doctors learnt a bit of medicines management, I would spend less time dealing with the results of polypharmacy, where the prescription of drugs to counteract the unnecessay drugs te patient is already taking is commonplace.
Whe you're talking about the real issues that face the health service, John, you're usually accurate and entertaining. When you start to diss everyone else, you become a bore.
"You may chuckle, but if a doctor has written the wrong dosage down and we give it and the patient dies its the nurses that get the flack."
The doctor who has signed the prescription will be rightly landed with the majority of the blame.
sometimes not even the doctor signing the prescription. I a recent tragic penicillin allergy case, it was the consultant whose name was above the patient's bed who got hauled up before the Generally Malign Council, who had had nothing to do with the prescription at all.
I can't help but sense a bit of hypocrisy in the comments. Nurses annoyed at anti-nurse sentiments bitching about doctors.
Checking doses is important, I'm very thankful pharmacists and nurses are sharp and pick up errors. But that's not to suggest doctors are all morons. I can only think of one dosing error I've made and it was minor. Remember the MDT, that now out-of-date buzzword? We're supposed to be working together, not blamestorming. Sorry, just learnt that word, wanted to use.
However FLMN saying you spend time dealing with polypharmacy does not make you an unusual case. There are as many doctors as annoyed as you at poor prescribing.
Why is UpSkilling written with an upper-case U and S? It vexes me.
Oh, I see why the S is uppercase. To make it say 'CUSP'. I think 'On the CUP' is far catchier.
Hi Rohin-- long time no see!
Anyway, I stand corrected on my comment- apologies. And my comment was not at all supposed to be having a go at the doctors, I have never had a problem with any I have worked with and have found them to be very helpful, friendly and not at all arrogant and expect us to test of the urine of all 30 people on the ward before the end of the day (Rohin!) and generally do their bidding at the drop of a hat.
In all of my training so far (Which admittedly isn't much), we have been told that we will get the total blame if we give a drug at a wrong dosage even if it was written on the drug chart because "we are autonmous healthcare professionals in our own right", or something.
This may also be a lie so that we learn to double and triple check the drugs before we give them-- crafty.
Yes Nurses take pharmacology in nursing school and no it is not anywhere near as in depth as what Doctors study.
I don't think anyone can learn how to do anything in 7 days.
The posters who stated that a Nurse will get the blame if a doctor presrcibes the wrong dosage are 100% correct. It is cheaper and easier for a trust to assign blame and sack a nurse.
A junior doctor at my hospital prescribed two medications that cannot be given together at the same time. He meant to cross off the other med but forgot.
Two nurses gave both of the medications because they were both prescribed by the doctor. This went on for 3 days before it was picked up. The nurses were both fired and told that any reasonably intelligent nurse should have known that those 2 drugs should not be given together. Junior doctor did not even get a slap on his wrist.
Once a Junior doc wrote up toxic drug without specifying that it was to be given once a week. It was given every day and the nurses involved were fired.
Once I saw a doctor order the IV fluids for a patient that was innappropriate. Nurse hung the bag and when the patient died she was fired.
She was also told that she should have known better.
Doctors are much more knowledgeable than nurses when it comes to medications but they are human and can make errors.
It is however much easier, cheaper etc for an employer to sack a nurse and get rid of her and this is what they do.
A letter was actually sent to the nurses on my ward saying that if we make any medication errors because a Doctor A. had sloppy handwriting B. prescribes a wrong dosage/drug C.Forgets to check allergies before he prescribes a drug and we give it....D.Forgets to cross something off and we keep giving it like some robot on auto pilot....
Then we will get in the shit basically.
In the unlikely event that this turns into another ill-informed rant about nurses trying to do the job of doctors for which they are not qualified, here is some EVIDENCE that Nurse practitioners can and are doing a safe and competent job in their extended roles.
http://news.bbc.co.uk/1/hi/health/2069315.stm
http://news.bbc.co.uk/1/hi/health/1910610.stm
http://www.bmj.com/cgi/content/abstract/320/7241/1043?ijkey=2cd3331abee3aa8593cdfc8164498cca25d9b050&keytype2=tf_ipsecsha
http://rheumatology.oxfordjournals.org/cgi/content/abstract/33/3/283
http://www.ncbi.nlm.nih.gov/sites/entrez?db=pubmed&uid=10533859&cmd=showdetailview&indexed=google
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=100791
Dr C’s objection to Nurses doing anything other than what he considers to be core nursing duties appears to rest on the argument that you don’t know what you don’t know, an argument that applies to GP’s as much as nurses. To answer this critism I would quote Anatole France.
"An education isn’t how much you have committed to memory, or even how much you know. It’s being able to differentiate between what you do know and what you don’t."
In this respect nurses are at least as highly educated as their medical colleagues.
dr C
i love u more than you realise
BUT
its really not in your best interest to continue to slag off whole massive sections of the population
i) genuine patients
ii) nurses
iii) people who went to poly or former poly
since you didnt go to a former poly, and probably have not been round any, and have not met some of their better grads, then really you are as unqualified to comment as a nurse practioner is to advise on which insulin a diabetic should be taking
youre just making yourself look like a dick
really suggest you have a rethink, you need people who went to former polys on your side, many of them are the highest earners in the land far eclipsing the oxbridge crowd despite the inbuilt networking advantages oxbridge gives you, and significantly paying the tax that keeps the fucking nhs going
for what its worth i did a postgrad at a former poly, and we swapped with members of other unis from time to time, and the top %s of the former poly were far better than the public school tossers infecting the other unis, as the professors would openly admit, there is a wider range at the bottom too but not cos of the reasons u would have
you seem to have a downer on every fucker in the country who didnt follow ur exact course in life, well think hard cos thats such a deluded position to be in
On the "Proper Uni" vs "FormerPoly" debate:
I did my nursing degree at one of the best universities in the country. I'm now doing some post-registration training at FormerPoly. The quality of learning I'm getting from FormerPoly is no less rigorous and just as evidence-based as what I got from Proper Uni (and Proper Uni gave me a bloody good set of training).
Just because it's done at FormerPoly doesn't necessarily mean it's bad.
Anonymous, you say one shouldn't insult people from former polys (although that's not what Dr C did), but then you insult my ilk by saying "public school tossers infecting other unis". Tut tut.
Hello faith, indeed a long time. In my defence I only asked you to test 28 urines, not 30. I mean sheesh talk about exaggeration.
Nurse anne, I don't doubt what you say, but it's a real eye-opener to me. I would expect to face repercussions if I prescribed the wrong thing.
Fair point Rohin, I don't think we should insult people for being ex-public school any more than we should insult people for doing training at FormerPoly.
It is unfortunate that far too often debates on here tend to degenerate into a "them vs. us" stance - usually doctors vs nurses. It's a shame because all over the NHS there's countless examples of doctors and nurses working together extremely well.
Sorry Dr.Rohin,
My mistake.
Should I be discliplined for my calculation error?
I missed you when you left, you're better looking than "Dr.Cock" and urine testing just wasn't the same without you.
+++++++++
I went to a FormerPoly for my first degree and I'm now doing my nurse training at one of the oldest and top schools of nursing in the country. At least, its one you would have heard of!
I don't care where I study, be it a FormerPoly or one of those "ProperUni" that are spoken about. At the end of the day, admittedly, a degree from Roehampton is not going to seem as prestigious as a degree from Durham but I don't think that should mean the qualification should be worth any more/less.
I don't mind the public school tossers either, as long as they don't get in my way (joke).
'Medicine management' is what proper doctors call prescribing. It is a common feature of newly self-important noctors to use two words where one would do. Hence 'consultant nurse', 'nurse practitioner', 'specialist nurse', 'consultant practitioner' etc. instead of just 'nurse'.
Faith Walker
At the end of the day, admittedly, a degree from Roehampton is not going to seem as prestigious as a degree from Durham but I don't think that should mean the qualification should be worth any more/less.
Indeed. Whether or not I trust the judgement of a clinical colleague depends on his/her day-to-day conduct, not which ProperUni/FormerPoly he/she went to.
re "Anonymous, you say one shouldn't insult people from former polys (although that's not what Dr C did), but then you insult my ilk by saying "public school tossers infecting other unis". Tut tut." yea ur right im sorry its been a bad day, im not perfect either
if u want someone to have a pop at i would have thought PCT managers and execs would have been 1st in the queue
Sign me up, I could do with one of them!
The last 4 and half years of med school were obviously a waste of time, I often thought so.
This post has been removed by the author.
'upskilling' for us patients too, here:
http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2008/01/02/nhs102.xml , 'NHS patients told to treat themselves', Daily Telegraph, 04/01/08.
There is, of course, some mileage in the Self Care concept but this kind of report worries me:
"...The Prime Minister claimed the self-care agenda was about increasing patient choice and "personalised" services.
But an internal Government document seen by The Daily Telegraph makes clear that the policy is a money-saving measure, a key plank of DoH plans to cut costs..."
"I don't think anyone can learn how to do anything in 7 days" ... Nurse Anne this is a little disspointing. there are loads of things you can learn to do: make pesto, play a few chords on the guitar, the 4 times table. Surely these can be achieved with 7 days of really hard work.
I am sure the course is the usual bollocks that HCP's (and i am one) go to. To be honest the course seems to be teaching skills, which people involved in health care, in any form, should already have.
Is there anywhere a suggestion that this course is intended to skill other lesser mortals to the standard of St Crippen of the Prescription Pad?
Were history taking, assessment and the management of medication ever solely medical tasks?
Granted the trendy poster is a bit silly. I hate these sort of insulting abbreviations- lets blame the media department who probably designed it for them :-)
Most of the comments so far reflect exactly what I first thought on reading the poster and posts. There is no suggestion that anyone is trying to turn into a doctor in 7 days. Medicines management is just that...check the NMC guidlelines/local hospital policies- same terminology is used. History taking and assessment are nursing skills as well- though we are not talking about medical assessment here but more basic stuff that will affect nursing care- the good old ADLs, falls assessment, pressure areas etc etc. The scope of nursing skills in terms of IV drugs for example has changed drastically in the last decade...I'm pretty sure most medics would rather nurses who are competent are titrating dopamine/noradrenaline safely rather than having to keep doing it themselves? Or giving IV antibiotics? As for the comments about where the buck stops...if you give the wrong drug as a nurse, you will be dealt with within the boundaries of your professional responsibility/competency. The same would , I assume, go for doctors. Unfortunately, getting rid or nurses is indeed easier/cheaper. I try to encourage students/newly qualified staff (nurses, doctors) to think about what the consequences of every drug might be and not to be afraid to question. Easier said than done sometimes. Everyone has there own personal horror story- my one involves mis-administration of two chemo drugs by two doctors. Outcome was the junior took/was made to take responsibility and left the profession. The sister in charge of the chemo suite on the day was also disiplined. Apparently even though the doctors had ordered the drugs, collected it and administered it without any nursing input, the sister should have "double checked" that they were doing their jobs properly. Hmmm.
Speaking of medicines management, maybe we can help you doc...
http://www.healthcarerepublic.com/bulletin/IndependentNurse/article/777891/Call-give-GPs-nurse-training/0CF040D78F65F3CC924D8EECF1F0D128/?DCMP=EMC-IndependentNurse
希望大家都會非常非常幸福~
「朵朵小語‧優美的眷戀在這個世界上，最重要的一件事，就是好好愛自己。好好愛自己，你的眼睛才能看見天空的美麗，耳朵才能聽見山水的清音。好好愛自己，你才能體會所有美好的東西，所有的文字與音符才能像清泉一樣注入你的心靈。好好愛自己，你才有愛人的能力，也才有讓別人愛上你的魅力。而愛自己的第一步，就是切斷讓自己覺得黏膩的過去，以無沾無滯的輕快心情，大步走向前去。愛自己的第二步，則是隨時保持孩子般的好奇，願意接受未知的指引；也隨時可以拋卻不再需要的行囊，一路雲淡風輕。親愛的，你是天地之間獨一無二的旅人，在陽光與月光的交替之中瀟灑獨行.......................................................................................................................................................................................................................................................................................................
ALL IM GOING TO SAY TO THIS DOCTOR IS YOU HAVE NO RIGHT COMMENTING ON ANY NURSING AT ALL OR TRAINNIG TO BECOME A DOCTOR YOUR NOT PART OF SQA OR PART OF ANY HEALTH MANAGING IN THE NHS.YOU WILL BE REPORTED.TRUST ME YOUR IN NO WAY AUTHORISED TO SAY ANYTHING!!
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