Can nurse practitioners provide equivalent care to G.P.s
Can Nurse Practitioners provide equivalent care to G.P.s?
EDITOR – Horrocks et al. state in their title, that the focus of
their review, is the role of Nurse Practitioners in Primary care [1 ] .
They concede that ambiguity exists over the definition of a Nurse
Practitioner, yet go on to include studies involving nurses working in
Hospital departments [2, 3, 4]. Before large sums of money are thrown at
such projects, it would be wise to compare like with like. In addition,
‘Policy Implementers’ aught to consider several other points, not covered
by the above review: -
1. A G.P. registrar in their final 3 months of training, has a minimum of
4 years of post-graduate work experience, yet is deemed unfit to practise,
without first passing various elements of Summative Assessment. Approved
video consultative technique
is not a criteria needing to be passed, to be a Nurse Practitioner.
2. If Nurse Practitioners wish to be considered as independent
Practitioners, then they need to have their own comprehensive indemnity,
so that litigation stops with them, rather than their employing practice.
3. During employment of a Nurse Practitioner on a 3-month trial
basis, we asked our Trainer to ‘Hot’ review each of the Nurse
Practitioner’s surgeries, as he would a G.P. registrar. The trainer felt
that there was little insight into why specific
questions/investigations/drugs were used. The basic understanding of the
pathology and pharmacology, lagged far behind the automated efficiency of
following guidelines.
Whilst there certainly seems to be an evolving role for Nurse
Practitioners, it is important that future studies clearly document the
context in which patients are seen, and that there is some form of
assessment of Nurse Practitioner consultation technique, similar to that
seen in General Practice.
Ian O’Connor, General Practitioner, Oldcastle Surgery, South St.,
Bridgend, South Wales, CF31 3ED. T
email elaineianoconnor@hotmail.com
References:
1. Horrocks S, Anderson E, Salisbury C. Systematic review of whether
nurse practitioners working in primary care can provide equivalent care to
doctors.
BMJ 2002; 324: 819-823.
3. Saker M, Angus J, Perrin J, Nixon C, Nicholl J, Wardrope J. Care
of minor injuries by emergency nurse practitioners or junior doctors: a
randomised controlled trial. Lancet 1999; 354: 1321-1326.
4. Cooper M. An evaluation of the safety and effectiveness of the
emergency nurse practitioner in the treatment of patients with minor
injuries: a pilot study. Glasgow: Accident and Emergency, Glasgow Royal
Infirmary, 2001.( Typescript.)
Rapid Response:
Can nurse practitioners provide equivalent care to G.P.s
Can Nurse Practitioners provide equivalent care to G.P.s?
EDITOR – Horrocks et al. state in their title, that the focus of their review, is the role of Nurse Practitioners in Primary care [1 ] . They concede that ambiguity exists over the definition of a Nurse Practitioner, yet go on to include studies involving nurses working in Hospital departments [2, 3, 4]. Before large sums of money are thrown at such projects, it would be wise to compare like with like. In addition, ‘Policy Implementers’ aught to consider several other points, not covered by the above review: -
1. A G.P. registrar in their final 3 months of training, has a minimum of 4 years of post-graduate work experience, yet is deemed unfit to practise, without first passing various elements of Summative Assessment. Approved video consultative technique is not a criteria needing to be passed, to be a Nurse Practitioner.
2. If Nurse Practitioners wish to be considered as independent Practitioners, then they need to have their own comprehensive indemnity, so that litigation stops with them, rather than their employing practice.
3. During employment of a Nurse Practitioner on a 3-month trial basis, we asked our Trainer to ‘Hot’ review each of the Nurse Practitioner’s surgeries, as he would a G.P. registrar. The trainer felt that there was little insight into why specific questions/investigations/drugs were used. The basic understanding of the pathology and pharmacology, lagged far behind the automated efficiency of following guidelines.
Whilst there certainly seems to be an evolving role for Nurse Practitioners, it is important that future studies clearly document the context in which patients are seen, and that there is some form of assessment of Nurse Practitioner consultation technique, similar to that seen in General Practice.
Ian O’Connor, General Practitioner, Oldcastle Surgery, South St., Bridgend, South Wales, CF31 3ED. T
email elaineianoconnor@hotmail.com
References:
1. Horrocks S, Anderson E, Salisbury C. Systematic review of whether nurse practitioners working in primary care can provide equivalent care to doctors. BMJ 2002; 324: 819-823.
2. Hoekelman RA. What constitutes adequate well-baby care? Pediatrics 1975; 55: 313-326.
3. Saker M, Angus J, Perrin J, Nixon C, Nicholl J, Wardrope J. Care of minor injuries by emergency nurse practitioners or junior doctors: a randomised controlled trial. Lancet 1999; 354: 1321-1326.
4. Cooper M. An evaluation of the safety and effectiveness of the emergency nurse practitioner in the treatment of patients with minor injuries: a pilot study. Glasgow: Accident and Emergency, Glasgow Royal Infirmary, 2001.( Typescript.)
Competing interests: No competing interests