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Who needs a medical degree?

Posted Oct 07 2008 7:21pm


The following passage is a small chunk of a patient clerking:

"On examination BP 139/70 pulse 90, sats 99% RA, GCS 15, no apparent weakness in arms or legs, pupils equal, but left slower to respond to light. Swollen area from sternocleidomastoid up behind ear ? haematoma.? Boney pain here. Tender over C3 and C4. prominent blood vessel here ? subclavian vein? Suspect underlying skull fracture, pt may be experiencing start of raised intracranial pressure. Alert and coherent at present, I feel he is safe to go in a car."

There are so many faults in this drivel that it is hard to know where to start, but the use of 'no apparent weakness in arms or legs' instead of doing a proper examination is not a bad place to start. Then the health care practitioner queries whether the subclavian vein may be located near to the patient's cervical spine; rather unlikely given that the subclavian vein does not rise above the clavicle at its most superior position. Then the complete negligence of the final couple of lines, if one thinks the patient may have a skull fracture (even though this patient clearly didn't) then it is completely indefensible to let them make their own way to hospital in a car.

This is no one off. This is the reality of New Labour's empowerment of the 'Health Care Practitioner', a new range of undertrained staff who are being given roles beyond their means. The patient in this case was completely well and had a small bruise on the occiput. The above clerking is used to demonstrate how clueless the Health Care Practitioner can be, especially when given jobs that should require a proper medical degree. Whether it be Classroom Assistants, Police Community Support Officers or Nurse Practitioners; Labour has really shown us how to dumb down and wreck a service.

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