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At the heart of general practice since 1960

My fears for young GPs

From Dr MV Rama Rao

Sparkbrook, Birmingham

One fine morning a couple of weeks ago two very enthusiastic ladies appeared in my office. They introduced themselves as new district nurses, providing services to my patients on an ad hoc basic.

Among the services district nurses had been delivering to my patients was giving twice-weekly intramuscular injections to a group of elderly patients who could not be relied upon to look after their own ampoules because of memory and other problems.

These nurses announced that it was ‘dangerous' for nurses to carry medications with them. According to the rules of the Nursing and Midwifery Council and the PCT, nurses were not allowed to carry medications with them.

I decided it would be a good idea to get some clarification. Lo and behold the next day our matron rang and told me I did not have the right to ask for clarification from anybody and I should not quote the name of the nurses involved.

She then questioned the appropriateness of the medication and my clinical judgment. She informed me the PCT's risk management team would interview me. The pharmaceutical adviser duly phoned to discuss the matter with me.

A couple of weeks later, modern matron admitted that my treatment was appropriate and effective and that neither the NMC nor the PCT had rules that nurses should not carry medication.

However, she said that, as independent professionals, nurses could refuse to take part in any process they considered hazardous. Carrying medications from surgery to the patient was such a process and the nurses had therefore stopped giving injections to these patients.

By treating these patients at home I have prevented emergency admissions, but if district nurses refuse to do this how could any GP continue to take responsibility?

What would other GPs do in this situation?

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