Some more comments on the recent Crikey story

Glenn Gardner, Professor of Clinical Nursing at Royal Brisbane and Women’s Hospital Health Service District and Queensland University of Technology:

When we seek help in a hospital emergency department, we do so expecting timely and expert care.

Research tells us that patients do not differentiate medical care from nursing care from allied health care. People just want their health care needs met in a timely and safe manner.

If they can have an X-ray organised, fracture diagnosed and treatment or referral commenced by a nurse practitioner, who incidentally has at least nine years training and experience in emergency care to do this, within 30 minutes, or wait an extra hour to be seem by a doctor, who will provide the same care, what would they choose?

Dr Capolingua only needs to spend some time in a busy emergency department in any one of our major cities to see how well teams of nurses and doctors work to provide safe and effective care for patients without a thought for the politics and artificial professional boundaries that motivate her and the AMA’s views on contemporary health service.

It is time that Dr Capolingua viewed health care from the perspective of those who fund it and use it – patients and their families.


Dr Paul Cunningham, a doctor working in emergency care:

I’m not a member of the AMA. I’m a member of ASMOF. Whenever I hear Dr Capolingua I have the impression of a practical person trying to explain difficult issues. Maybe she’s not very good at it but I understand what she’s trying to say.

I just listened to a Podcast of the 4BC interview. I’ve worked in Emergency for a long time now and I’ve worked with nurses for 36 years. I feel there is not much understanding about these issues in the media. The blog responses to your article I thought was suprisingly pro-doctor however.

The 4BC broadcaster seemed to be arguing that nurses are nearly doctors and they could be somehow fast tracked to take over parts of the role. Unfortunately sorting undifferentiated patints (not just initial triage but actually diagnosing and managing the person) is about as complex as it get’s. Many procedural medical things get more publicity but may be a more easilly learned skill than diagnosing patients with potentialy “anything” wrong with them.

I suppose if most people (and even most nurses) understood what doctors do when someone comes to emergency with a headache, a sore knee or mild confusion then we wouldn’t be having this argument. I guess all I can say in summary is that it’s complicated.

I’d also like to understand your meaning of the word “team” when it comes to these issues. It’s a word one constantly hears in relation to health , and like the term communication, I am perplexed at what some people see in the term.

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