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At the heart of general practice since 1960

Nurses lack the science for GP role

I am concerned at the ever-increasing responsibility that nurses are undertaking, particularly in the new GP-led health centres ('GP-led health centres dominated by nurses and salaried doctors').

I have taught and examined nurses recruited from GP practices to undertake nurse practitioner courses for several years, in areas such as pathophysiology, pharmacology and clinical skills.

From my experience, although the nurses had been qualified for many years, they lacked the knowledge of basic science required for medical examinations, diagnosis and the safe prescribing of drugs.

To understand pathophysiology and pharmacology, a knowledge of chemistry, physics and mathematics is essential. Most nurses do not have this basic knowledge but medical students do.

Before discussing acid-base balance, I always had to explain what the 'p' and the 'H' stood for even though they had been responsible for testing the pH of urine routinely for many years. The nurses I have taught have all been very nice individuals, but being given more and more responsibility requires an in-depth understanding that cannot be obtained in such a short time.

From Dr Barbara Todd, neuroscientist, Nottingham

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