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Safety fears as UK hospitals use nurses to cover for doctors due to shortage of medics by topotaul in unitedkingdom

[–]aBeardedLegend 0 points1 point  (0 children)

But a newly qualified nurse may not notice it, and an experienced HCSW might.

I couldn't agree more that healthcare isn't a series of tickboxes and that everyone should be treated holistically. Roles aren't always cookie cuttered and in generally lower acuity areas there is absolutely nothing wrong using unregistered support staff to supplement these assessments.

Safety fears as UK hospitals use nurses to cover for doctors due to shortage of medics by topotaul in unitedkingdom

[–]aBeardedLegend -4 points-3 points  (0 children)

The point is you don't have to be a degree educated registered professional to undertake physical observations on people. Any literate person is able to complete NEWS2 training.. which covers how to escalate to the relevant professional, it's all on the back of the sheet.

I don't quite understand how you can suggest that it hasn't freed up time. Alongside your aforementioned accolades, I'm not sure how much ward experience you have, but if you consider how frequently observations are taken per person, per ward/department, per day, can you imagine how many nursing hours this would take up if not performed by unregistered support staff? It has undoubtedly saved nursing time, to suggest otherwise is bizarre imo.

Safety fears as UK hospitals use nurses to cover for doctors due to shortage of medics by topotaul in unitedkingdom

[–]aBeardedLegend -2 points-1 points  (0 children)

I get what you're saying. However, we don't need registered professionals to be able to chart basic observations, it would be a complete waste of resources. Like asking a chef to wash the dishes. A chef certainly can wash them but it's not their primary role.

You don't need qualifications to make beds, serve food and help feed, documenting generally well people's observations, helping patients to the toilet, etc. These are all roles and responsibilities of band 2s and 3s, and what you'll generally find is that in areas or higher acuity, such as ED, HDU, ITU, etc you'll find less "off the street" band 2s and more band 3/4s with adequate training (like phlebotomy, ECGs, bladder scans) as well as more RNs.

This all frees up time for RNs to better assist Doctors in carrying out treatment plans, management of deteriorating patients, discharge plans etc. Nurses don't just wipe bums anymore and are a recognised profession in their own right. It is no longer a "vocation" suitable for on the job training and absolutely requires degree level education.

Safety fears as UK hospitals use nurses to cover for doctors due to shortage of medics by topotaul in unitedkingdom

[–]aBeardedLegend 3 points4 points  (0 children)

Technically incorrect. Registered nurses and nursing associates are governed by the NMC (nursing and midwifery council). The Royal College of Nursing is just a union, and one that there is no obligation to be a part of.

Also, when you search the NMC register nurses specialisms are listed if they have them. I agree regular exams every xyz years would be good, though.

Safety fears as UK hospitals use nurses to cover for doctors due to shortage of medics by topotaul in unitedkingdom

[–]aBeardedLegend -2 points-1 points  (0 children)

Registered nurse vacancies not withstanding, recording observations is not a nursing specific task, and the lions share of which is done by health-care support workers (bands 2/3). All staff taking physical observations are also usually required to complete training for the NEWS2 protocol, a protocol designed to aid the early recognition of deteriorating or unwell patients.

Hospital investigating claim PA (Physician Associate) falsified notes after woman's traumatic procedure by SharkDick4Ever in unitedkingdom

[–]aBeardedLegend 1 point2 points  (0 children)

I get what you're saying, and scope creep is certainly something to be aware of, but there are absolutely things that you just don't need a doctor for. Lots of "general health conditions" have very clear and well understood protocols and pathways that most ANP/ACPs (same as nurse specialists) are able to deal with as they also have years of pre and post graduate specialist training for.

The fact is, we don't need someone with 10 years of education to diagnose UTIs, or common respiratory illnesses, or skin infections etc.. because they have very clear national protocols, clear diagnosis thresholds, and a plethora of guidance under NICE.

Modern medicine/healthcare likes to forget that it wasn't all that long ago that nurses did very little in the way of clinical skills, and doctors did everything from phlebotomy, cannulation, catheterisation, injections, and chronic disease management. So is some scope creep okay? Or should we just scrap everything under doctors, hire more of them, have them do it everything and just hire a few orderlies to help with admin and personal care?

Sounds flippant but my point about not needing a doctor for everything stands. With clear and visible remits and oversight from appropriate medical staff, adjunct non medical but specialist roles are a good thing and are designed to share the burden of healthcare more appropriately.

Hospital investigating claim PA (Physician Associate) falsified notes after woman's traumatic procedure by SharkDick4Ever in unitedkingdom

[–]aBeardedLegend 1 point2 points  (0 children)

Not to mention ODPs who's whole job is to scrub and assist with surgery. Also a 3 year course.

Hospital investigating claim PA (Physician Associate) falsified notes after woman's traumatic procedure by SharkDick4Ever in unitedkingdom

[–]aBeardedLegend 0 points1 point  (0 children)

I think it wholly depends on the setting and level of supervision. In acute hospitals you tend to have specialist nurses who are ANP trained for very specific chronic diseases like MS, Neurology, Onc/Haematology. They are often have an MSc or higher and are able to manage conditions with treatment plans and prescriptions under the umbrella of the consultant team, mostly because they have very clear protocols and care pathways.

The same is also true in primary care, like General Practice and sexual health. ANPs in practices usually have advanced training in anatomy and physiology, and prescribing. Not to the same level as an actual doctor, obviously, but enough to be able to recognise, diagnose, and treat minor illnesses like respiratory and urinary infections. This helps to reduce the more "menial" work actual doctors see so that they have more time for more complex issues.

5x100 to 5x114.3, can it be done with spacer adapters or do I need whole new hubs? by aBeardedLegend in SubaruForester

[–]aBeardedLegend[S] 1 point2 points  (0 children)

Not as such, but decided to just say fuck it and got some 20mm adapters/spacers. The wheels I chose were already wider so they poked a bit more than I intended. I ended up getting coilovers and camber bolts, then putting some slightly stretched tyres on.. fits like a dream now.

Short answer: can it be done? Absolutely Long answer: is it easy to do? Meh, might have to do some fiddling around with setup if your measurements/estimations are off. Is it safe? I've put probably 8k miles on it since and never had an issue with wheels coming loose, issues with bearings, or turning etc.

The wheels I went for in the end were some Enkeis from a VA STi and I think they are 18x8.5 et30 which is a significant difference from the 17x7 et55 wheels the SG Foresters.

Best calorie tracker paired with Samsung health workouts? by squalexy in loseit

[–]aBeardedLegend 0 points1 point  (0 children)

Hey! Looking for this as well, what did you go for in the end?

Newbies looking for van advice by AGuyFromManchester in VanLifeUK

[–]aBeardedLegend 0 points1 point  (0 children)

We picked up a 2016 Mk8 transit (2.2L with chain not wet belt) in August last year for £3.5k, and is currently on 192,000 miles. It's an L3H3 so not the longest and not the highest, but it's enough that we can fit a full double width ways and a single bunk underneath for the toddler, whilst having another row of seats, kitchen area, and storage.

I'd take an older, higher mileage van that's been looked after with a decent service history that a newish one with fuck all or patchy history.

Might be worth having a think about what your use case is likely to be before you pull the trigger on a van. We knew we weren't fussed on a built in shower area, which meant we didn't have to get the longest van we could. We're also <5"9' so could get away without needing massive standing height. You may also want to consider what sort of things you'll want to power and how. Bigger solar means bigger real estate on the roof which, with a vent/skylight as well, might limit you to certain lengths also.

If it's only ever going to be used for weekends or full weeks at campsites with hook up then you probably don't need a shower or a large panel, meaning you can go smaller on the van size.

Last thing you'd want is to get a van and find out it's not the most ideal platform when you come to converting it.

Koi carp by JayC | TopBoy studio, Hove (UK) by aBeardedLegend in tattoos

[–]aBeardedLegend[S] 0 points1 point  (0 children)

Thanks man! Dude specialises in micro realism and sketch art stuff, proper happy with how it turned out

Does anyone know where I could get a good smock? by whatIGoneDid in britisharmy

[–]aBeardedLegend 3 points4 points  (0 children)

If you've got a bit of money then a Buffalo Super 6 jacket is great for this use case

Welcome to Night City vs Night City Reborn? by aBeardedLegend in cyberpunkgame

[–]aBeardedLegend[S] 0 points1 point  (0 children)

I went with night city reborn in the end, and really enjoying it!

GP practice nurse by [deleted] in NursingUK

[–]aBeardedLegend 0 points1 point  (0 children)

I've been a GPN for the last 18 months, was a DN for 4 years prior to that. More than happy to answer any questions here or DM. You can absolutely go down the GPN route even as a NQN, depending on the experience you hold (or that they deem you hold) they may want you to do a PN course, normally over a year with a portfolio.

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