06.26.07
The role of specialist nurses in the private sector
I have always had a bit of a problem with the way some of our private hospitals are run. I don’t mean in terms of the hotel type services or even the staffing by those who actually work there, but I have been quite suspicious of the way they employ medical staff. Speaking as someone who on a number of occasions picked up the pieces of poor private medical management, and who as a specialist nurse working in the NHS was called in on a number of occasions to provide care ‘on the side’ as it were for private patients. The consultant I worked with had a thriving private practice, he could do little else when at the time the wait to be seen on the NHS was quite long, ok so mainly these people were outpatients, but that doesn’t detract from the fact that I provided care for people that were essentially private patients and I provided it for free. This didn’t take place in the private hospital but on the phone, and in people’s homes. More fool you I hear you say, well no I did it in my working week (in NHS time) and I was being paid by someone, I also cared about the welfare of the patients and it did not matter to me if they were paying someone or not.
Dr Crippen is right, up until now there has been little use of nurse specialists / practitioners in private healthcare in the UK, that may be because they are getting NHS care for free.
There is also another kind of private, this is where a drug company or private healthcare facility fund a nurse or group of nurses to work in the NHS as specialist nurses. This whole thing, I guess started with charity funding for example Macmillan where nurses who specialised in caring for people who were dying of cancer were employed through their local NHS trust but were funded through macmillan cancer relief. My own experience of this kind of nurse, apart from in palliative care has been a nurse looking after people with multiple sclerosis and one for parkinsons disease. The trouble with these kinds of posts is firstly that they are often related to the use of specific drugs and second that the funding is usually only for a fixed term (say 2-3 years) and this funding may not be sustainable. In the case of the MS nurse it resulted in a nurse who was redundant, patients who lost a service and a neurologist unable to safely prescribe drugs in the way he had. The other problem for me is that while the term ‘nurse’ is protected and you have to be one to practice as one, the term ’specialist nurse’ is not. I could get myself some funding and set up as a specialist nurse in any kind of specialty today and possibly I could blag my way into getting people (though probably not Dr Crippen) to believe that I was more knowledgeable than I am. It is time then that the nursing profession did something about this and that you could not pretend you were something that you were not. I would be interested in hearing from British nurses who have something to say about this topic because it strikes me as wrong and partly to blame for the accusations of ‘dumbing down’ which we are being accused of at the moment.
Have a look over at Mental Nurse for an excellent debate on specialist nursing too.
Labor Nurse said,
June 29, 2007 at 3:53 am
Hi Julie,
I have to admit I am quite confused about the RN situation over there. Are advanced practice nurses considered the specialist nurses?
BTW, I have a new blog.
Julie said,
June 29, 2007 at 8:00 am
You are confused? I think the people working in it are confused too. Specialist nurse is a generic term for someone specializing in something, you don’t need to have any advanced practice qualification, though many will have them. An advanced practitioner or nurse practitioner is a designated title, but again I don’t think there is anything to stop anyone calling themselves by those titles. The Nursing and Midwifery Council (our regulating body) are meant to be looking into this, and I have certainly inputted into the consultation, but for some reason we still have no guidance. I might take a look at the evidence for this and write something later.
Labor Nurse said,
June 30, 2007 at 4:11 am
Hmmm…. interesting. So any nurse can call themselves advanced practice or nurse practitioner? I had no idea. In the US, an advanced practice nurse must take a certification exam or boards exam in their speciality in order to be awarded the designation of advanced practice. I’m sure your Council should see to this?
And to think our problem over here is deciding which degree (2 year, 3 year, or 4 year) should be the minimum required of an RN. ha!
Julie said,
June 30, 2007 at 7:47 am
Well all nurses have to complete a 3 year course first. In some areas this is a BSc and in others a Diploma. If you look at my post yesterday you will see that it actually needs a law change and that has been the hold up. For those of us who have studied for all of the correct qualifications it is a continuing annoyance!