Re: Restore ward rounds to former glory to improve patient care, say colleges
7 October 2012
Whilst it is a welcome call to improve and reinstate the status of regular ward round, I feel that modern medicine and nursing may prevent this for several reason. Firstly,gone are days that there are "teams" on a ward. Very often several teams cover a single ward with outliers distributed amongst the dedicated speciality. Secondly, the demands that the EWTD has placed on compliant rotas mean that juniors are often away post nights, pre nights or on nights and some days, there is a solitary junior on the ward alone. Thirdly, and perhaps most controversially, Doctors often find that when they are on a round and request the attendance of a nurse we are told they are on their break or they are not caring for that particular patient. Surely we all care for our patients and they are all our responsibility.
With the pressures on time increasing, and consultants and registrars having to fit in more clinics, procedural lists, outlying hospital visits etc... How do the teams ensure morning ward round if there are endoscopy lists, clinics etc... Should the rounds start early, expect the juniors to come in early and therefore break the hallowed EWTD and contracted hours? I question how these regular ward round and feedback can take place. Doctors struggle to fit in the required jobs in a day as it is, without now having to provide a written summary to each family on the events of the ward round.
In our hospital our team employ a policy of open ward round where families are informed of the consultant ward round times (3 times a week) and the registrar ward round (once a week) and can attend, and are actually encouraged to attend to discuss concerns or receive updates. In addition, like the familiar drug round nurse sachets worn by staff, we also have a do not disturb ward round in progress overall that is worn so that everyone knows the team is on a round. How this would work in larger hospitals is still to be seen.
Competing interests: None declared
Prince Phillip Hospita, Dafen, Lanelli SA14 8QF
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