Chitika

Monday 21 April 2014

Doctor and nurse duties must change: report

CHRIS UHLMANN: In Australian public hospitals, it's taken for granted that doctors do jobs such as sedate patients for simple procedures, but an influential think tank says that sort of thinking is costly and has to change.

The Grattan Institute recommends nurses be trained to do it.

The think tank's latest report also questions the practice of nurses bathing and feeding patients who can't do it themselves.It's suggested that nursing assistants take over the role.

The report finds doctors and nurses are squandering valuable skills on work that other people could do.

Brendan Trembath reports.


BRENDAN TREMBATH: Doctors and nurses have clearly defined roles in the nation's public hospitals.But the Grattan Institute health program director Stephen Duckett questions conventions such as doctors providing light sedation, to patients having simple procedures.

STEPHEN DUCKETT: We're suggesting for example the introduction of sedation nurses who can monitor patients and administer anaesthetics to patients who are conscious while they're having a procedure undertaken. And, again, there's evidence from overseas, the United States and England, that this works very well; we're using the skills of nurses it's quite safe and we should be freeing up doctors to do the work that only doctors can do.

BRENDAN TREMBATH: That might be okay for most cases, but how can you ensure the safety of patients if something goes wrong.

STEPHEN DUCKETT: A very good point, what we want to do is to make sure that the doctor is involved in the assessment of the patients to make sure that the patients that do have sedation nurses rather than anaesthetists doing the anaesthetic, the more simple ones and so on. We're also suggesting that this work be done under the supervision of doctors, that is that there be doctors in the operating rooms for example in the next door operating room in case something goes wrong.

BRENDAN TREMBATH: Doctors and nurses have their defined roles at the moment, why change things?

STEPHEN DUCKETT: Well these defined roles developed sometimes 100 years ago and we've got to update the system and basically, what we're saying is that there's increasing demand on the health sector that we're going to be having a whole lot more patients, increased population, aging of the population and so what we want to do is make sure that this growth is sustainable, one way of making it sustainable is to make sure that we provide for this growth in an efficient way.

BRENDAN TREMBATH: Are there any cost savings?

STEPHEN DUCKETT: Yes, there's about $430million in cost savings if we've done that this year.

BRENDAN TREMBATH: The Grattan Institute consulted doctors, nurses and the states.Stephen Duckett says it's a very well founded report.But a national doctors group argues it does not reflect what goes on in modern hospitals.Geoff Dobb is the vice president at the Australian Medical Association.

GEOFF DOBB: You never know the onset of a procedure how it's going to pan out and during any procedure there is the potential for someone to have an adverse reaction to one of the sedative drugs, to have an idiosyncratic reaction, that is to react in a greater way than someone would normally, by way of say dropping their blood pressure or dropping their respiratory rate; it's only after the procedure is completed you know that it's been straight forward and uncomplicated.

CHRIS ULHMANN: Professor Geoff Dobb from the Australian Medical Association ending that report by Brendan Trembath

Source: http://www.abc.net.au/am/content/2014/s3984686.htm

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