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Rapid responses are electronic letters to the editor. They enable our users to debate issues raised in articles published on thebmj.com. Although a selection of rapid responses will be included online and in print as readers' letters, their first appearance online means that they are published articles. If you need the url (web address) of an individual response, perhaps for citation purposes, simply click on the response headline and copy the url from the browser window. Letters are indexed in PubMed.
First a response to Dr Mann
Dear Dr Mann
Here, in England, at least, nurses do not accept the role of doctors' hand-maidens. Indeed, they used to say, some years ago, that They were patients' advocates. (Their advocacy seems to have disappeared.)
Second, a response to Mr Stone. I agree totally.
Third, a response to Dr Oliver.
You are right. We, the patients, should not blame ONLY the local management for the failures of the SYSTEM imposed upon us by the S o S.
But we must express our anger at those NHS managers = chief executives (some doctors, some nurses, some lay) who wring their hands in public because there are not enough resources, but then allow themselves to be browbeaten into returning to their hospitals and extracting the last drop of blood from the nearly exsanguinated staff.
Finally - we should also thank those members of the NHS staff who, despite the sadism of the management, keep treating the patients as fellow humans. A few days ago, SOMEWHERE IN ENGLAND, I had a cataract operation. The surgeon came out, took each dottery patient by the hand, gently leading her (more old girls than old boys) to the operating theatre. The nurses too were kind. To all those staff I thank for treating me as a human being, not as a digit on a computer screen.
The hospital is a battlefield in which doctors and nurses fight sickness. Doctors are officers, and nurses are enlisted. Doctors have authority, issue orders, enjoy comforts, and receive rewards; while nurses lack authority, take orders, do dirty work, and receive blame. This gross inequality is counterproductive, because it hurts nurses, creates internecine conflict, subverts the hospital’s mission, and subjects patients to suboptimal healthcare. The Hippocratic Oath should include the doctor-nurse relationship.
I completely agree with Professor Oliver's comment 'it is wrong to hold hospital leaders and teams solely to account for problems beyond their doors and not in their gift to solve' and, in general, there are too many instances, both within the NHS and outside of it, when people [or categories of people] are blamed for problems not of their making, and when the people being blamed could not resolve the problems. Doubtless, however, such 'inappropriate blaming' will continue. At least, those incorrectly being blamed, do then have an opportunity to give a more detailed description of the problems, as viewed from their own perspective: whether those doing the blaming will listen, is a different issue.
Re: David Oliver: Blaming hospitals for systemwide problems will make winter bleaker
First a response to Dr Mann
Dear Dr Mann
Here, in England, at least, nurses do not accept the role of doctors' hand-maidens. Indeed, they used to say, some years ago, that They were patients' advocates. (Their advocacy seems to have disappeared.)
Second, a response to Mr Stone. I agree totally.
Third, a response to Dr Oliver.
You are right. We, the patients, should not blame ONLY the local management for the failures of the SYSTEM imposed upon us by the S o S.
But we must express our anger at those NHS managers = chief executives (some doctors, some nurses, some lay) who wring their hands in public because there are not enough resources, but then allow themselves to be browbeaten into returning to their hospitals and extracting the last drop of blood from the nearly exsanguinated staff.
Finally - we should also thank those members of the NHS staff who, despite the sadism of the management, keep treating the patients as fellow humans. A few days ago, SOMEWHERE IN ENGLAND, I had a cataract operation. The surgeon came out, took each dottery patient by the hand, gently leading her (more old girls than old boys) to the operating theatre. The nurses too were kind. To all those staff I thank for treating me as a human being, not as a digit on a computer screen.
Competing interests: No competing interests