I had been told that there will be no more money for me to go on a particular course I wish to attend, at least until September. Not wishing to let that deter me I asked if I could visit the clinic where this particular aspect of care is carried out by a nurse-led specialist unit. Of course I could. In my own time.
I rang the clinic a couple of weeks ago and booked a day. The nurse I spoke to was delighted in my interest and very welcoming.
Yesterday was the day.
Yesterday I watched a practitioner with expert hands perform highly skilled tasks, while communicating effectively, empathetically and with humour. She respected her patients. She taught me and involved me, asked my opinion and was open to ideas from a nurse outside her sphere.
This clinic is called ‘nurse-led’ clinic because there are no doctors in charge, though there are doctors in the department next door who are willing to provide support when needed. And this nurse-led clinic is highly effective in what it does, bringing relief and comfort to a diverse group of patients in a calm and organised manner. This type of clinic is one of the things that is good about the NHS and is rarely applauded. There are little pockets of excellence, each doing their own thing and doing it so well.
But…. (there has to be a ‘but’ doesn’t there?)….the work this clinic does barely scrapes the tip of the iceberg. The demand is growing, in the main exacerbated by the growing band of bariatric patients.
Strangely the clinic does not have direct access or referral rights to a dietitian or to a psychologist, and if it is felt that the patient would benefit from either of these the clinic nurse has to refer back to the GP to refer on to another professional. This seems odd to me. Surely this is creating another layer of unnecessary work?
What concerns me most about the way the NHS is currently being disorganised is this risk of fragmentation of services, of duplication and of the right hand not being fully aware of what the left is planning to do, or is doing already.
Yesterday I had a coffee break and piece of cake: that’s how I celebrated Nurses day.
Hey ho, back to reality today.
Boadicea's Chariot 
I expect the NHS sees most of those problems as self inflicted which is why they don’t have an in house psychiatrist. Nothing like the UK for the acquisition of hair shirts! People are expected to suffer, according to the UK it is almost a mandatory requirement.
I agree with you that some of the nurse led clinics are extremely effective. There was an extreme pain clinic in Brum that the boy used that was far more effective than any of the doctors efforts.
Another was an oedema clinic, again far more effective than the doctors.
It almost appears that anything in the UK that actually works effectively is deliberately destroyed with Byzantine rules and regulations.
Where they could save money, they don’t. Here no one prints xrays anymore, within the County system xrays are available by computer and can be viewed by the GP, specialists, local hospital anyone of whom you approve and wish granted access. I’ve had xrays emailed from here to the UK rather than keep taking more.
Interesting you have experience of some of these clinics, Christina. I’m just wondering about moving areas and I’d really like to work in such a motivated and effective environment,
I’ve often wondered why more use is not made of Nurse Practitioners, (is that what we used to call Nurses like those you describe?) and para-medics in these sort of clinics?
it’s happening, Bravo, but progress is slowish I think
We have a fairly large Foundation hospital in my town, not only is it large it’s relatively new, late eighties, it’s in grounds with extensive parking and a five minute bus drive from town, nevertheless the NHS has had to have it’s nurses clinic in another part of town in a beautiful house in a residential area, the NHS bought another large house for a sexual health clinic and yet another large block of offices for dishing out vouchers for alcoholics and drug addicts, that was labours prolific era, still on going. I know this is not on your subject Pseu but it shows where some of the NHS money goes.
‘NHS has had to have it’s nurses clinic in another part of town…’ what clinic was that, Rosie?
I wonder what the reasoning was?
It didn’t have to have the clinic elsewhere, that was me being sarcy about the NHS, plenty of room at the Hospital and the proper place with all the facilities.
What I meant was what sort of nurse led clinic was it?
Pseu, I would say that they were highly motivated and effective.
The fact that the nurses only saw a specific problem again and again gave them an insight far beyond that of the doctors and surgeons, they had far better practical suggestions too.
We had to mess with this with the boy for 8 years so I am a bit of a connoisseur when it comes to these clinic area, the prosthetcis was handled in the same way.
My suggestion is that it would be a very good area in which to move, but be careful how you choose. Whatever you pick you are going to see an awful lot of it and virtually nothing else!!!
Personally I wouldn’t particularly want to deal with just the fat as I would feel that was self inflicted however there are a lot of other areas such as kidney or the results of surgery where the patient didn’t ask for it so to speak. That is where I would head.
But I suppose it all depends on how charitable one feels psychologically, not my strong point as you know!
Oops sorry pseu it was a pain clinic, run by senior nurses and holistic care.
Pseu, you don’t surprise me when you say there was no money left to pay for a course for you. Doctors in hospitals are supposed to have an individual allowance to allow them to go on courses of interest in their particular field. For a few years now daughter has always had to pay her own way because the training budget has just been misappropriated for other things, even at the beginning of a financial year.
I am full of admiration for nurses. The job has so few rewards. They all deserve sainthood.
Thanks, Julie, though I disagree – there are plenty who are not professional in their approach who counterbalance those who are and do an excellent job.
Good points Christina.
Thanks Rosie.
Yes, Sheona, it’s true training budgets are tight and this leaves a gap. Not everyone will be prepared or able to pay their way for training.
Our local GP surgery is very nurse led I have to say. The nurses are the main front of the practice and see a huge number of patients very professionally and free up so much GP time. I’ve always been impressed with them and their knowledge, but best of all, their people skills. Not many doctors reassure me, nurses always do!