Introducing the postoperative care team

BMJ 1997; 314 doi: https://doi.org/10.1136/bmj.314.7090.1346 (Published 03 May 1997) Cite this as: BMJ 1997;314:1346

Effective postoperative care remains surgeons' role

  1. Michael J Boscoe, Consultant anaesthetista
  1. a Harefield Hospital, Harefield, Middlesex UB9 6JH
  2. b 45 Hollybush Road, Cardiff CF2 6SZ
  3. c Middlesex Hospital, London W1N 8AA
  4. d James Paget Hospital, Great Yarmouth NR31 6KA

    Editor—I am concerned that the suggestions made by David R Goldhill might be taken too seriously rather than remain a point for discussion.1 Goldhill is right in his assertion that patients can fare badly in their postoperative course because of lack of attention by their attendants and lack of understanding of common postoperative complications. I believe, however, that he has missed the opportunity to lay the blame at the correct door. Surely it is the surgeons' role to carry out preoperative assessment, surgery, and effective postoperative care. If they choose to emphasise their importance in the operating theatre, delegating their other responsibilities to their trainees, the nurse practitioners, and the anaesthetists, why should we encourage this path?

    Undoubtedly, anaesthetists are fast becoming the new generalists, with an increasing role outside the operating theatre. These new skills and responsibilities include pain control, intensive care, and transoesophageal echocardiography, to name but a few. Some of my professional colleagues may relish even more diversification and abhor my comments.

    Goldhill implies that anaesthetists and postoperative care nurses will lead the postoperative care team; indeed, this is already happening in North America, where they have been sent to run preoperative assessment clinics by surgeons based in the operating room. If the surgical ward round …

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