Doctors, nurses, and terminal care

BMJ 1997; 314 doi: https://doi.org/10.1136/bmj.314.7076.306 (Published 25 January 1997) Cite this as: BMJ 1997;314:306

Nurses need to accept more responsibility, and doctors need better training

  1. J C Hughes, Senior registrara
  1. a Department of Anaesthetics, Prince Charles Hospital, Merthyr Tydfil CF47 9DT
  2. b University of Cambridge School of Clinical Medicine, Addenbrooke's Hospital, Cambridge CB2 2SP
  3. c Addenbrooke's Hospital

    Editor–I cannot condone the attitude of the medical registrar referred to in the personal view by Staff nurse Jones about the care of a terminally ill patient.1 The nurse was right to believe that the patient should receive adequate analgesia. I would like, however, to try to explain why the registrar acted in this way.

    Firstly, many doctors' training in pain relief is inadequate. I suspect that it was not a lack of compassion that was the problem, though it is difficult to be compassionate when you are rushed off your feet. No, I suspect that the problem was purely a lack of knowledge of how to deal with the patient. Adequate terminal care is rarely taught in medical schools or practised on the wards.

    Secondly, it is difficult for doctors to take advice from nurses, for a variety of reasons; one …

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