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Don't knock employing skilled nurses

I have worked as a practice nurse for various GPs for 13 years and would like to respond to recent letters and articles about nursing in general practice and the nurse-doctor ratio proposed by Lord Darzi for polyclinics.

If polyclinics can be run with nurses offering a safe and effective service then of course that is what the Department of Health will want. I would certainly try to employ more nurses than doctors if I was running a business given the huge disparity in pay.

Nurses, even nurse prescribers working at an advanced level, get a fraction of a GP's salary. As long as nurses have good-quality training that includes thorough assessment, their use in polyclinics seems an obvious way forward in a system of finite resources - and one GPs are quite happy to take advantage of in their own practices.

Some GPs seem sceptical of nurses' abilities and fear they may undermine general practice. Are these the same nurses helping practices achieve QOF points, run travel clinics and manage screening programmes such as cervical cytology? Strange how their expertise and knowledge is perfectly acceptable then.

I have respect for my GP colleagues and for the difficult and demanding work they do. I used to think doctors' training gave them an extensive and thorough knowledge of medicine that I could never equal as a nurse, no matter how many books and journals I read or diplomas I undertook.

I began to realise this was a myth when I started attending study days on asthma - my nurse colleagues and I were frequently amazed at the nature of the questions the doctors asked.

We all have our individual skills and the best practices are those where the doctors appreciate this, rather than feeling threatened.

Name supplied, practice nurse, Hertfordshire

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