We’ve had quite a few retirements at work recently, and several colleagues have slipped away quietly into the darkness, saying that they “didn’t want any fuss”.
Well, blow that! It’s my turn soon and I want it clearly understood that I shall expect a great deal of fuss when I go.
I want to see strong men in tears, and women wailing, gnashing their teeth and (hopefully) rending their garments in good Biblical fashion. I want the biggest display of public grief since Princess Di bought it (but without the flowers - I don’t want all those flowers). A present would be nice, too. I shall place a list with Harvey Nicks.
It’s surprising how much more bearable work is, once you can see an end in sight, largely because you can ignore any ‘initiative’ (don’t you just hate initiatives?) with a timescale longer than six months, and smile serenely as threats are made to cap pensions, abolish merit awards (sorry, CEAs) or introduce uniforms for consultants.
OK, I made the last one up, but I’ve never had a problem with uniforms, largely due to the 16 years I spent in the RAF Medical Branch, and I’ve always thought it would be a good idea for doctors to wear them. At least patients would know who we were, and we could make sure that all those over-promoted ‘nurse consultants’ with stethoscopes ostentatiously draped around their necks could be clearly differentiated from proper consultants by the colour of their uniforms (they’d have muddy brown, we would have nice red ones, with gold piping and those big gold epaulettes like South American dictators, or commissionaires at the Odeon).
Still, it’s too late for me now. I’ll have to serve out my time tieless and ‘bare below the elbow’ (which, if you think about it, means that you should also be bare below the waist, unless you have unduly long arms; not something I’d like to inflict on patients or colleagues, come to that).
Incidentally, in an earlier blog I talked about Henrik Thomsen, the Danish radiologist who was being sued for libel by GE Healthcare. That case has been settled out of court, and I assume it will have been a condition that Henrik says nothing more about it in public. And that, of course, is the problem with the libel law as it currently stands - victims, or should I say defendants, can’t afford to take their case to the judges if their accuser offers an out of court settlement which is anything less than ruinous. I just hope that GE realised that they had slipped up by pressing the case, and accepted nominal damages.
Simon Singh, on the other hand, did have his day in court recently, and it seems to have gone well. However, it is not unknown for judges to sound sympathetic, and then deliver a contrary verdict, so we have to wait, hopefully not too long, for the outcome.
Tags: Libel
Hi Bob
Could you explain how nurse consultants are over-promoted? I don’t understand. What are proper consultants? In my hospital we have medical consultants and nurse consultants each with very different job descriptions and responsibilities. I’m not familar with ‘proper consultants’.
Yes, you got me there Dr D - i was being flippant and deliberately a bit archetypically arrogant. By ‘proper consultant’ I meant a medically qualified consultant (but then you knew that, didn’t you - you old rascal!). But although I might have been playing to the gallery, there is an important point here. It matters to patients what people are called, and it’s getting harder and harder for them to tell. Nurse (and physiotherapy and radiographer) consultants chose that name with the deliberate intention of implying equivalence with medical consultants They’d no doubt deny it, but it’s true.
Believe it or not, I am a keen proponent of skills mix, and have spent a lot of time helping nurses to extend their role as referrers for imaging investigations, and even more time developing the role of radiographer practitioners. The radiographers almost without exception do a terrific job. They have no problem working to protocols, and know when to ask for medical input (although even there, the College of Radiographers has been making claims in print that radiographers could do 60-80% of the radiology reporting with no further training). On the other hand, nurse practitioners seem to be different. Although some are very good, a significant and increasingly troublesome minority are becoming a pain in the backside. Once they get their ‘ticket’ they see no need to work to the agreed protocols, and feel entitled to refer patients for any imaging investigation they choose, despite understanding very little about the processes involved (as witnessed by a recent referral for ‘CXR - front and back please’). The worst examples of this have been nurse consultants, some of whom really do seem to feel that the title of itself equips them to stray into areas of practice for which they have no training.
I almost begin to believe that those doctors who are rabidly anti any form of skills mix, and who i have persistently argued against over the last few years, might have a point. It does seem that the ‘give an inch and they’ll take a mile’ argument might hold some truth, and the danger is that politicians intent on providing cut-price medicine really will be taken in by some of the wilder claims of, inter alia, the RCN and CoR. We’re already hearing complaints from GPs who find that their referrals for a ‘proper’ consultant opinion are being hi-jacked by specialist nurses. and although many of them do a good job, there are now examples where patients are being harmed by the resultant delays in obtaining a medical opinion.
So no, nurse consultants aren’t all the same. There are good ones who really do understand the fact that, as you say, they have a different job description and responsibility to medical consultants, and I would have offended them by my last blog. And yes, it’s a bit naughty of me to caricature colleagues in this way, but this is journalism, not a textbook, and this is not really an apology. And it did at least stimulate a response!
Bugger!
I’ve just realised that my last response was actually as long as the original blog - if I’d held it back for a few days, I could have saved myself the trouble of writing anything for next week.
Two blogs for the price of one. Well done Bob, keep up the good work!