Doctors object to a wider role for surgical care practitioners
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《英国医生杂志》
Junior doctors have warned that allowing nurses, therapists, and technicians to perform basic surgical procedures would jeopardise patients' safety and diminish training opportunities for trainee surgeons.
At an annual conference for junior doctors held last week, delegates urged the BMA to oppose a new policy that would formalise the role of surgical care practitioners. The trainees believe that a political drive to cut costs and waiting lists underlies the proposals regarding such practitioners, which a conference resolution portrayed as "a misguided attempt by government to reach its arbitrary targets and to trick patients into accepting lower standards of care in return for lower costs."
Junior doctors also believe that patients would be misled by the job title and wrongly assume that surgical care practitioners are medically qualified.
A sample curriculum for these practitioners has been drawn up by the Royal College of Surgeons of England and the NHS Modernisation Agency, and a consultation exercise is currently under way. Under the proposals surgical care practitioners would assist in operations, under the supervision of a consultant surgeon. They would also take on more responsibility for preoperative and postoperative care.
Various career paths in the proposals are under consideration, and entrants to the training scheme could range from experienced theatre nurses to students fresh from secondary school.
The main safety risk is that professionals without broad medical training would not be equipped to make quick decisions when complications arise, said Ram Moorthy, the conference delegate who proposed the motion and an ear, nose, and throat specialist registrar at Royal Shrewsbury Hospital. "I don't think any operation is basic. There is always the potential for complications."
Mr Moorthy also worries that consultant surgeons will have less time to train junior doctors if they have the added responsibility of supervising surgical care practitioners. "If the consultant has to train the SCP , who will be training me?"
The Royal College of Surgeons' proposals have been broadly supported by the Royal College of Nursing, with the caveat that entry to practitioner training should be restricted to experienced health professionals.
Mike Hayward, the college's professional nurse adviser in acute care, commented: "All this programme does is formalise what has been done for years, in a safe framework of knowledge and competencies. If you think of the years and years of experience that a theatre nurse may have, then they are ideally placed to perform minor surgical procedures."
He said that junior doctors would not have to miss out on training. There was no reason why an experienced surgical care practitioner could not teach a junior doctor about some aspects of surgery, he added. "Nurses are not trying to become mini-surgeons. Ultimately, modern day health care is about teams."(Colleen Shannon)
At an annual conference for junior doctors held last week, delegates urged the BMA to oppose a new policy that would formalise the role of surgical care practitioners. The trainees believe that a political drive to cut costs and waiting lists underlies the proposals regarding such practitioners, which a conference resolution portrayed as "a misguided attempt by government to reach its arbitrary targets and to trick patients into accepting lower standards of care in return for lower costs."
Junior doctors also believe that patients would be misled by the job title and wrongly assume that surgical care practitioners are medically qualified.
A sample curriculum for these practitioners has been drawn up by the Royal College of Surgeons of England and the NHS Modernisation Agency, and a consultation exercise is currently under way. Under the proposals surgical care practitioners would assist in operations, under the supervision of a consultant surgeon. They would also take on more responsibility for preoperative and postoperative care.
Various career paths in the proposals are under consideration, and entrants to the training scheme could range from experienced theatre nurses to students fresh from secondary school.
The main safety risk is that professionals without broad medical training would not be equipped to make quick decisions when complications arise, said Ram Moorthy, the conference delegate who proposed the motion and an ear, nose, and throat specialist registrar at Royal Shrewsbury Hospital. "I don't think any operation is basic. There is always the potential for complications."
Mr Moorthy also worries that consultant surgeons will have less time to train junior doctors if they have the added responsibility of supervising surgical care practitioners. "If the consultant has to train the SCP , who will be training me?"
The Royal College of Surgeons' proposals have been broadly supported by the Royal College of Nursing, with the caveat that entry to practitioner training should be restricted to experienced health professionals.
Mike Hayward, the college's professional nurse adviser in acute care, commented: "All this programme does is formalise what has been done for years, in a safe framework of knowledge and competencies. If you think of the years and years of experience that a theatre nurse may have, then they are ideally placed to perform minor surgical procedures."
He said that junior doctors would not have to miss out on training. There was no reason why an experienced surgical care practitioner could not teach a junior doctor about some aspects of surgery, he added. "Nurses are not trying to become mini-surgeons. Ultimately, modern day health care is about teams."(Colleen Shannon)