Clinical examination of peers

[rjm]

Why would you expect to get extra pay for having these skills?? I dont get paid more when I can get a cannula in that my colleague cant. My fellow SHOs dont get paid more because they are competent in ascitic drains whereas I can do chest drains but not ascitic drains. It doesnt seem like madness to me.

[charlie30]

rjm...I wasn't intending to compare medicine against midwifery...more that as a whole it seems wrong that those who continue to gain new skills and qualifications once they graduate do not seem to progress pay-wise..if that makes sense?!

Like, the 'examination of the neonate' module is pretty demanding whilst working fulltime and it also relieves some of the neonatal paeds workload, but most midwives are reluctant to do it because there is no incentive and more responsibilty. Same with cannulation. Unless you personally want to gain these skills there is no monetary benefit and when all is said and done nursing/midwifery/medicine is simply a way to pay the bills for many people (not all obviously).

Charlie x

[rjm]

I was not comparing midwifery with medicine either, I was just pointing out that in many jobs possessing a certain skill does not give you monetary benefit. I would not progress pay wise if now I can do an LP, therefore taking the workload of a senior doctor. Maybe its not always about money, maybe its about job satisfaction, interest and life-long learning. Quite frankly I'd be quite bored if I didnt continue learn and develop new skills.

[trouble]

Cannulation and venapuncture are taught as core midwifery, they are not extra skills.

[charlie30]

Yeah venepuncture is taught early on in training (not sure why I included that!) but cannulation is not taught in some uni's.

Obviously I do realise that job satisfaction/lifelong learning is important and I too would be bored if my working life became static. A scenario I have encountered pretty often is that one midwife with all the 'extras' is constantly called upon to go up to delivery suite and cannulate, or called onto the p/n ward to do the paed check for 5 babies who need discharging, whilst trying to mentor a student (another extra course) and trying to build rapport with the women she is originally assigned to care for...whilst other midwives are doing the bare minimum for the same salary.

This is NOT me saying that I would not take on this additional training because I would for my own personal growth, but it does cause tension y'know? Who has it right? The ones who are happy with their lot or the ones who want to expand their role but are in the minority and therefore stretched? Maybe it has more to do with the staffing issues in midwifery or maybe more of these 'extra' skills ought to become core as part of the BSc then everyone shares the load..or maybe I'm on the wrong forum..

Charlie x

ETA - apologies for the thread hijack!

[rjm]

Quite frankly train as many people as want to do it to bleed and cannulate in my opinion, having spent a night shift running around doing basic tasks like that because there were no assistants meant that sick people were delayed in being seen by doctors.

[charlie30]

Originally Posted by rjm

Quite frankly train as many people as want to do it to bleed and cannulate in my opinion, having spent a night shift running around doing basic tasks like that because there were no assistants meant that sick people were delayed in being seen by doctors.

Yep, that just strengthens my point...women are also being delayed in being seen by their midwife who is running around doing the very same.

[Polldoll]

I think the original point was that venepuncture and cannulation are not part of a NURSES job.. and student nurses are not taught this at all. It is classed as an extended role and qualified nurses can do the course. I was saying that I have heard nurses in the past saying that they shouldnt be doing it anyway, they dont get paid extra for taking on an extended role and are busy enough trying to do their jobs without this. A FY1 or above are paid more than nurses and it is seen to be part of their remit, so why should the nurses word hard, do tasks outwith their remit and all for less pay than the doctors?

I am only saying that this is what Iv heard discussed by many staff nurses, and it is not my own personal opinion. I am looking forward to learning this skill, either as a nurse or as a dr.. and believe that that the novalty will not wear off. It is an essential part of patient care, and also gives us a small time of patient contact.

If I ever get to the point that I dont want to spend time with patients, or do "mundane" tasks like taking their blood then its time to quit. Medicine is huge, yes doctors are busy and have loads to do, but you should always have time for patients, even if its just 5 mins whilst you are cannulating them. Thats my humble opinion anyway!!

[charlie30]

That's definitely how it is with the midwives too polldoll. There is lots of give and take between the midwives and the doctors and they help each other out on the wards I'm placed...midwives lighten the loads for the docs when they are stretched and vice versa, so the unrest is not with the docs...more with the discrepancy between the skills within the midwifery dept and the fact that pay does not reflect this. I am not saying that it is a huge issue or that it isn't the same in medicine too...but no matter how much of a vocation our chosen career is there will always be a degree of friction when workload isn't distributed fairly doncha think?

I actually love taking blood...but I am DREADING cannulation! I watched a paed cannulating a newborn the other day and it looked awful...I struggle doing SBR's on babies and am soooo thankful that I don't have to think about cannulating them as part of my current training!

Charlie x

[belis]

I am looking forward to learning this skill, either as a nurse or as a dr.. and believe that that the novalty will not wear off. It is an essential part of patient care, and also gives us a small time of patient contact.

If I ever get to the point that I dont want to spend time with patients, or do "mundane" tasks like taking their blood then its time to quit. Medicine is huge, yes doctors are busy and have loads to do, but you should always have time for patients, even if its just 5 mins whilst you are cannulating them.

The point is that while you cannulate patients on wards A, B and C so they can have their fluids/antibiotics etc somone is waiting on ward D for their pain relief to be prescribed, on ward E somone fallen out of bed and needs an urgent review and there are 5 new admissions on MAU all waiting. Anyway you are a student nurse, you know how hospitals are like. It is not that doctors don't want to spend time with patients, or that mundane tasks like cannulation are beyond them. It is more that tasks like this take you away from other patients, who require intervention that cannot be delegated to HCA, nurses etc. You want to spend time taking histories and alowing people to talk and ask questions, attend to seriously ill people promptly etc. You don't want to rush through those becouse people are waiting on wards A,B and C to get a cannula. It is not that their needs are less important. But if they can be met by the nurse who is already on the ward then IMO it makes more sence. In the time it takes to page the doctor you can put the straight forward cannula in. In the trust I am based at the moment majority of nurses cannulate and I don't hear them complaining about it. Quite to the contrary it removes the frustrations of hunting down the HO at 3am when you need to give antibiotics.

As for patient contact cannulating delirius elderly lady while she was bashing me on the head and pulling out my hair springs to mind lol. It is nice to have a little chat, put people at ease, great if you get a cannula in a first time with no much fuss and they are happy. When you need to stab them multiple times with no joy despite your best efforts it is not so fun.

For me the novelty of cannulas has already worn off but I still find it quite satisfying. If I end up in anaesthetics as I plan to do I will be putting them every day through out my career.

I actually love taking blood...but I am DREADING cannulation! I watched a paed cannulating a newborn the other day and it looked awful...

Cannulating adults is straight forward in comparison. Don't base your opinion on cannulating tiny babies. Watch somone put cannula in the mum, who will have veins like pipes, and that should reduce your fear lol.