It has been edited slightly to remove reference to the original author, and to include a link to the article he refers to.
On occasion what I have written has got me into trouble.
Over the years I have caused frothing at the mouth among sports physicians, managers, environmentalists and flat earth lefties of all descriptions.
After one article on christianity, I was sent prayers and evangelical paperbacks. I am still getting death threats from midwives as a result of another piece, which frankly, is easier to cope with.
But nothing comes close to the hoo-ha that erupted last year when I called into question the intellectual capabilities of some of our nursing colleagues, and the rigour of their degree course.
The stink was such that there was high level talk of disciplinary action locally, as a result of which I now have to carry a byline, lest I discredit my own fine institution with my insane views.
I would like to assure everyone that I have learnt my lesson, and I will never again question the fact that nurses and doctors are intellectually equivalent, which is why I am having a little bit of trouble with a news item that appeared in the Daily Telegraph to almost no comment.
Under the headline “a third of new nurses fail simple english and maths test” it reported that 13 out of 40 graduates of the nursing course at Canterbury Christ Church University failed to score the required 60% in a test of basic reading and numeracy.
And when they say “basic” they’re not kidding. One question asks: “How many minutes are there in half an hour?” Another is: “A prescription costs 650p, what is this in decimal nomination, 605p, £6.50, £65, £6.05?”
It’s hard to know what to do with this information, other than rush out and set up a pharmacy just for nurses so you can charge them 65 quid for a prescription.
It’s tempting to make cheap cracks about how they were confused because none of the answers were “I’m on my break”.
But as all the graduates were UK educated and have GCSE english and maths, I suspect this is another symptom of the pathetic anti-intellectualism, and the “all-shall-have-prizes” attitude of the government. But that is a different libertarian rant for a different day.
I could of course question the value of a degree course that such poorly educated people can pass, but if I did next month’s byline would read “Dr ............., consultant anaesthetist Western Europe somewhere”. So I won’t.
I had to take one of these hospital "maths" tests, I passed, just. I took the paper home and gave it to my daughter in law and she could not understand half of it - she has a maths degree and is head of the maths department at a secondary school.
ReplyDelete"I will never again question the fact that nurses and doctors are intellectually equivalent", sometimes we are - get over it.
"It’s tempting to make cheap cracks about how they were confused because none of the answers were “I’m on my break”". - Childish and patronising.
"But as all the graduates were UK educated and have GCSE english and maths", and "I could of course question the value of a degree course that such poorly educated people can pass". Have a look at;
http://www.timesonline.co.uk/tol/news/uk/article7128366.ece
So in summary, usual crap from a doctor about stupid nurses and previously about midwives written in what is basically a comic for doctors.
I fully expected that there would be criticism.
ReplyDeleteThe point I was raising was that the author was threatened with disciplinary action for writing this. No matter how much you disagree with what is written do you believe those threats were appropriate?
Do you believe people who wish to express such views should be silenced?
No! And he was right too.
ReplyDeleteHe should be threatened with disciplinary action if the comments were libelous or defamatory, but at what point do management intervene to stop what could become a nasty situation. It does strike me as rather stupid to abuse nurses and other colleagues in print and then expect them to work harmoniously with you in the future. His position, certainly in my department, would become untenable. To my mind it is unprofessional behaviour.
ReplyDeleteUnfortunately he had a real point about modern education but allowed a bias against nurses to cloud his writing. If he can back up his assertions and it is only Nursing Students who are failing then go for it and publish the research. But the link I gave shows that this is system wide in a lot of degree courses. As I stated earlier, usual crap from a doctor about 'stupid' nurses; team spirit and morale out the window.
Instead of worrying about the intellectual capability of nurses perhaps the doctor in question should be concerned about a far more insidious problem - the dangers that can arise when intellectual superiority acts as a barrier to patients ever being listened to properly.
ReplyDeleteWe've all heard, or read, about incidents when a patient (or their relative) tried to impress upon a doctor that something was going terribly wrong, only to be dismissed because doctor knows best - a position reinforced by the typical demographics associated with the doctor-patient relationship (doctors primarily from the upper classes, statistically speaking, patients from the lower classes).
Will there ever be a time when we can past these patronising attitudes?
Better still - if doctors are really so worried about incompetent nurses working out drug calculations how about if one or two of them were to roll up their sleeves and give the medication themselves (I believe once upon a time this was something they were able to do?)
Grumpy RN. Libel and defamation apply to specific named individuals only. A profession has no such protection. How would it be for example if we were not allowed to express criticism of professions other than Nurses, such as, say, politicians, homeopaths or doctors.
ReplyDeleteWhile you may have the view that such statements are unprofessional this can only ever be a personal view, as the original author was doing no more than exercising his contractual and legal right. As I keep banging on, any interference with that right is unlawful.
"If he can back up his assertions"
ReplyDeleteA level results? If any?
And to Anonymous 16:13, what you are talking about is to do with 'modesty', whether you are intellectually more superior or not. I support that doctors need to show modesty when dealing with other staff members for the sake of achieving the best outcome for patients. That said, I also happen to think it dangerous, for patients, to artificially lift those intellectual levels of those who 'somewhat' lack them [talking about averages in both]! You have to call a spade a spade or else, it's that same patient who will suffer at the end! Surely, many maybe are now, all because of this artificial leveling of heads that do not level - your fingers are not all the same lengths, are they?! It's because they are not meant to be - and there is nothing wrong in that!
The CBI has expressed concerns re the grammatical and mathematical capabilites of school leavers and university graduates for some time.
ReplyDeleteFor the NMC to express the same concerns in 2006 would suggest there is a case to answer.
The NMC has a right to be concerned if students who have attained the required GCSE passes in maths and English are unable to solve something as basic as 'how many minutes equal half and hour.'
The doctor who wrote the article in which your post is based had the same right to express an opinion too - it is called free speeech. Likewise, those who were upset by his article had the same right to practice free speech by responding.
Our right to free speech in in jeopardy when we attempt to silence those with whom we do not agree - even if the truth is blatantly obvious. I think the problem here is in how the story was told.
It cannot be denied that nurses can exist on an intellectual par with doctors; an average IQ is not a prerequisite for entering nursing. However, this nurse will not share the breadth of knowledge a doctor acquires during medical training - and never will do.
I am not trying to suggest that all nurses are unrecognised geniuses - but neither are they all dumb. Some are downright dangerous! Nor do I think all doctors are brilliant and perfect - for some are downright dangerous too!
The above is not an attempt to dispute the findings of Canterbury Christ Church University. I am concerned that this silly 'us and them' argument will forever lower the tone of both professions. The problem lies in our perception of each other and this silly infighting is childish and destructive. Should we not work together and respect each others roles and have the maturity to accept praise and positive criticism?
As for free speech - I'm with Voltaire - or was it Evelyn Beatrice Hall?!
Dr Zorro,
ReplyDeleteCan you explain to me what 'contractual and legal right' you are talking about?
Your point seems to me to be 'this doctor has the right to say what he likes regardless'. My point is that yes he can say what he likes but he must take responsibilty for it. When it interferes with the running of the hospital, (office, factory, shop, whatever) then management have a duty to step in and disciplinary action is one of the management tools.
Hypercritical,
I agree with what you say except for - "this nurse will not share the breadth of knowledge a doctor acquires during medical training - and never will do". 'Knowledge' is a bit too vague a term and different people gain different knowledge. Who is to say that the knowledge a doctor learns over his life is less than the knowledge I learn over my life? Quick anecdote, I once had to explain the workings of an ACE inhibitor to an orthopaedic consultant, now at that point and for that particular subject my knowledge was greater than his. But, I do take your point and am perhaps being a bit nitpicking.
The contractual right is :
ReplyDeleteParagraph 330 of the Terms and Conditions of Service for Hospital Medical and Dental Staff
"A practitioner shall be free, without prior consent of the employing authority, to publish books, articles, etc, and to deliver any lecture or speak, whether on matters arising out of his or her hospital service or not."
The broader right is article 10 of the Human rights act.
Neither imposes any duty of responsibility arising out of the reaction of those who may find expressed views disagreeable or offensive.
You still have not got the point. Any citizen has the right to say what he likes regardless. Doctors have no more or less entitlement to this as anyone else.
Thank you for the clarification.
ReplyDeleteActually I do understand exactly what you are saying, and completely agree with it. I go along with 'Hypercritical' above - "I'm with Voltaire - or was it Evelyn Beatrice Hall?!".
" Any citizen has the right to say what he likes regardless. Doctors have no more or less entitlement to this as anyone else". Sadly only the second sentence is true. Does not matter what the human rights act or contracts of employment say, try protesting outside the Houses of Parliament, or heckling a labour home secretary at a party conference. Try holding posters stating that homosexuality is against god's law and is unnatural and you will soon be stopped by the police and arrested. I don't for 1 second support any of this but they are recent examples of the UK's adherence to 'free speech', and always remember, whistleblowers are punished for telling the truth.
I think that we are actually arguing for the same things. You are stating that 'free speech' is an absolute right and should not be interfered with. I am agreeing with you but think in the real world free speech is never free and has consequences.
"Any citizen has the right to say what he likes regardless. "
ReplyDeleteActually that is not quite true. Article 10 is a qualified right, and since there are laws against hate speech which overule art 10, the example you give re homosexuality is one where free speech does NOT apply. The point is that exceptions can only be made in law. It is not for individuals, employers or even regulatory bodies to decide what they think is acceptable.
Dr Zorro - I think it is slightly disingenuous to portray the fundamental message behind this post as something as portentous as 'freedom of speech'.
ReplyDeleteIt seems our anonymous medic, rather like a latter day game hunter, has a number of targets in his/her sights, including sports physicians, managers, environmental flat earth lefties of all descriptions, christians and of course, midwives (well it is a doctor after all).
The denouement arrives when our the author finally concludes, "I will never again question the fact that nurses and doctors are intellectually equivalent".
Ah, so it was the old chestnut all along - you (nurses) are not as clever as us (doctors) - in fact some nurses are so thick nowadays that they cannot perform even the most rudimentary form of math?
In short we have a rather predictable item that plummets depths that even the likes of the Daily Fail have yet to sink to.
Of course I entirely agree with Grumpy - the anonymous doctor is perfectly entitled to offer such an opinion, because let's face one or two health professionals do not really care if everybody else who has the misfortune of coming into contact with them ends up regarding them as a bit of a ...........
The A&E Charge Nurse.
I was hoping we could finish this amicably, however I am going to discuss one point.
ReplyDelete"It is not for individuals, employers or even regulatory bodies to decide what they think is acceptable".
I disagree with you, employers and regulatory bodies must have a system in place to protect the good name of their organisation, to prevent industrial strife and to stop bullying. If an employee in a senior position eg. a consultant, causes problems with other staff because of what he writes or says he must be stopped. Unless he can prove what he is writing is truth in which case publish and be damned.
Do you allow 1 consultant to cause industrial strife because what he writes has offended the team that surrounds him to the extent that no one will work with him? Or do you follow the disciplinary path to prevent him writing? Remember, the trust can be taken to an industrial tribunal for construtive dismissal if someone is upset enough to leave and nothing has been done (I have a relative who works with CAB who tells me that these kind of cases tend to be open and shut). I would stress that I am talking only about extreme cases not the run of the mill annoying someone.
I wonder, are you perhaps arguing that "as a consultant" he should be allowed to write and say what he likes? In that case my position is, no he can't, for the reasons I have set out. In todays NHS this is seen as bullying and offensive and nurses (because that's who he wrote about) should not put up with that behaviour.
"It is not for individuals, employers or even regulatory bodies to decide what they think is acceptable".
ReplyDeleteGrumpy RN, you don't seem to understand. I have not stated this as a matter of opinion but as a description of the law as it stands relating to article 10. You may not like it but that is a fact. You would clearly like to be able to silence those who offend you, but you may not.
Your disagreement seems to imply that the law is subject to personal interpretation. It is not. Employers are not permitted to introduce their own rules relating to freedom of speech. That is article 10 which is the law.
Your hypothetical situation where someone resigns confuses general statements of opinion with personal attacks on a specified individual.
Your statement "If an employee in a senior position eg. a consultant, causes problems with other staff because of what he writes or says he must be stopped." If that were to happen then that is an infringement of a convention right, and as such would be unlawful.
Phrases such as "must be stopped" are exactly why the Human Rights Act was laid down in law.
It is not a question of "allowing" people to speak their views. They do not need anyone's permission. It is their right. What is it about that you don't understand?
We are not going to agree about this and are now going round in circles.
ReplyDelete