Editor's choice

BMJ 1996; 313 doi: (Published 16 November 1996) Cite this as: BMJ 1996;313:0

Come on, come on, let's work together One of the strange things about health care is how doctors, nurses, and other health professionals remain quite separate tribes. Despite years of working side by side, the professions have their own hierarchies, languages, journals, and ways of thinking. In Britain, for instance, there is no journal that comes anywhere close to reaching all the professions working in the NHS, and journals like Quality in Health Care that want to reach all professions must work hard to make only a limited impact. Quality in Health Care wants to reach all professions because those interested in raising the quality of care recognise that it can be done only by the professions working closely together. But papers in this week's BMJ illustrate how hard that can be to achieve.

John Kellett describes the case of a nursing sister who was suspended for giving an elderly, hypomanic patient a tranquilliser disguised in a cup of tea (p 1249). The consultant who decided on the action was exonerated. Two commentators ask how multidisciplinary teams can work in such circumstances and argue that disciplinary procedures may need to be multidisciplinary (p 1251).

A second case study describes the reaction of midwives, ultrasonographers, and pregnant women to leaflets on the best available evidence on the effectiveness of routine ultrasonography in early pregnancy (p 1251). The midwives and pregnant women were generally positive, but the ultrasonographers in one hospital refused to allow them to be distributed.

Finally, an editorial describes disputes over who should provide emergency prehospital care (p 1220). Some ambulance staff believe that prehospital care belongs to paramedics and that doctors should stay away. Tentative evidence suggests that doctors have a lot to offer, but the real answer - as almost always - is that a fully functioning multidisciplinary team is needed. The Royal College of Surgeons of Edinburgh has thus established a multidisciplinary faculty of prehospital care, and the BMJ Publishing Group is publishing a journal on the subject together with BASICS (British Association for Immediate Care).

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